| Title: | Biological age acceleration predicts osteoporosis and reduced longevity in a large prospective cohort |
| Journal: | Bone |
| Published: | 13 Aug 2025 |
| Pubmed: | https://pubmed.ncbi.nlm.nih.gov/40816510/ |
| DOI: | https://doi.org/10.1016/j.bone.2025.117609 |
Publication 19740
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Abstract
BACKGROUND: Osteoporosis is a major age-related musculoskeletal condition, yet chronological age does not fully capture individual risk. Biological age acceleration (BAA), as a biomarker of systemic aging, may offer greater predictive value for osteoporosis and lifespan loss.</p>
METHODS: We analyzed data from 293,224 participants in the UK Biobank cohort who were free of osteoporosis at baseline. BAA was estimated using two validated models-Klemera-Doubal Method Biological Age (KDM-BA) and PhenoAge. Polygenic risk scores (PRS) were used to account for genetic susceptibility. Multivariable Cox models examined associations of BAA and PRS with incident osteoporosis and all-cause mortality.</p>
RESULTS: Over a median follow-up of 8.5 years, 9780 participants developed osteoporosis. Each one standard deviation (SD) increase in KDM-BA and PhenoAge acceleration was associated with a 22.6 % (95 % CI: 1.11, 1.36) and 19.3 % (95 % CI: 1.12, 1.36) higher risk of osteoporosis, respectively. Participants in the highest tertile of BAA had a 38-43 % increased risk compared to those in the lowest tertile. Individuals with both high BAA and high PRS had nearly threefold higher osteoporosis risk, indicating a strong additive effect. Accelerated aging was also linked to a 1.3-1.8-year reduction in life expectancy at age 45, independent of osteoporosis status.</p>
CONCLUSION: Accelerated biological aging is an independent predictor of osteoporosis and premature mortality. Integration of BAA into clinical assessment could enhance early identification of at-risk individuals and support aging-targeted interventions for skeletal health.</p>
5 Authors
- Rui Zhang
- Wanyang Zhong
- Yuelan Gao
- Xingxiang Duan
- Qingsong Ye
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