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In 2023, 527 Japanese adults aged 40\u201364 years underwent facial imaging with the VISIA Evolution, which estimated skin age and quantified eight skin parameters. The difference between skin and chronological age, derived from linear regression residuals, was analyzed for associations with lifestyle and cardiovascular factors using multiple regression. A greater skin\u2013chronological age difference was significantly associated with higher scores on all eight skin parameters. In multivariable-adjusted models, male sex, higher systolic blood pressure, elevated \u03b3-GTP, smoking, reduced grip strength, and frequent occupational sun exposure were associated with greater skin\u2013chronological age difference. Sex-specific multiple regression identified systolic blood pressure, blood glucose, smoking, reduced grip strength, and sun exposure in women, and systolic blood pressure, serum \u03b3-GTP, alcohol intake, reduced grip strength, and sun exposure in men. The present cross-sectional analysis showed that cardiovascular and metabolic health, as well as smoking and sunlight exposure, were associated with skin aging objectively assessed by facial imaging. Although causality cannot be inferred, improving systemic health may help promote healthier skin aging.<\/jats:p>","DOI":"10.1038\/s41598-025-29647-2","type":"journal-article","created":{"date-parts":[[2025,11,23]],"date-time":"2025-11-23T17:04:44Z","timestamp":1763917484000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk factors associated with higher skin age relative to chronological age in community-dwelling middle-aged Japanese adults"],"prefix":"10.1038","volume":"15","author":[{"given":"Toshiharu","family":"Ninomiya","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Oishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Asahi","family":"Kato","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ei","family":"Teshima","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junichi","family":"Taira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao","family":"Shibata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emi","family":"Ueda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiko","family":"Furuta","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naonori","family":"Uchida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atsushi","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naoto","family":"Minagawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tsuyoshi","family":"Matsuoka","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Taku","family":"Otani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuomi","family":"Chida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoko","family":"Sakata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,11,23]]},"reference":[{"key":"29647_CR1","doi-asserted-by":"publisher","first-page":"e16688","DOI":"10.1111\/jocd.16688","volume":"24","author":"RS Hussein","year":"2025","unstructured":"Hussein, R. S., Bin Dayel, S., Abahussein, O. & El-Sherbiny, A. A. Influences on skin and intrinsic aging: biological, environmental, and therapeutic insights. J. Cosmet. Dermatol. 24, e16688 (2025).","journal-title":"J. Cosmet. Dermatol."},{"key":"29647_CR2","doi-asserted-by":"publisher","first-page":"48","DOI":"10.7748\/ns.25.9.48.s52","volume":"25","author":"L Green","year":"2010","unstructured":"Green, L. The effect of skin conditions on patients\u2019 quality of life. Nurs. Stand. 25, 48\u201355 (2010).","journal-title":"Nurs. Stand."},{"key":"29647_CR3","doi-asserted-by":"publisher","first-page":"1187","DOI":"10.1046\/j.1365-2133.2002.04991.x","volume":"147","author":"WC Leung","year":"2002","unstructured":"Leung, W. C. & Harvey, I. Is skin ageing in the elderly caused by sun exposure or smoking? Br. J. Dermatol. 147, 1187\u20131191 (2002).","journal-title":"Br. J. 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Naonori Uchida and Atsushi Yamada, who are employed by Q\u2019sai Co., Ltd., Naoto Minagawa, who is employed by HuBit Genomix Inc., and Tsuyoshi Matsuoka, Taku Otani, and Kazuomi Chida, who are employed by Daiko Advertising Inc., contributed to the interpretation of data and critical review of the manuscript. The other authors declare that they have no conflicts of interest to disclose.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"45201"}}