Epigenetic age acceleration and cardiometabolic health: a longitudinal investigation

Studies on epigenetic clocks and MetS are sparse and have been limited to cross-sectional analysis, a limited number of clocks, and small samples sizes [16, 17]. Recently, a longitudinal association between accelerated epigenetic age and MetS was reported in the Coronary Artery Risk Development in Young Adults (CARDIA) study, which involved two time points (5 years difference) in middle-age individuals [15]. To counter this research gap, we will systematically investigate epigenetic age acceleration over >14 years using three time points of the KORA study, focusing on MetS and its complications in cardiometabolic health. As most existing studies have relied on cross-sectional rather that "change"-focused longitudinal data, we will assess whether individual associations between epigenetic age acceleration and MetS change more notably during specific periods of life, e.g. in older ages. We will also analyze the "second generation" epigenetic clocks – gaining insight into specific biological mechanisms underlying metabolic dysfunction; compare our findings with the published CARDIA results; and discuss implications with regard to the German population.