{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T12:28:51Z","timestamp":1777638531669,"version":"3.51.4"},"reference-count":35,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Epidemiol Community Health"],"accepted":{"date-parts":[[2017,9,13]]},"published-print":{"date-parts":[[2017,12]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Visible age-related signs indicate biological age, as individuals that appear old for their age are more likely to be at poor health, compared with people that appear their actual age. The aim of this study was to investigate whether alcohol and smoking are associated with four visible age-related signs (arcus corneae, xanthelasmata, earlobe crease and male pattern baldness).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>We used information from 11\u2009613 individuals in the Copenhagen City Heart Study (1976\u20132003). Alcohol intake, smoking habits and other lifestyle factors were assessed prospectively and visible age-related signs were inspected during subsequent examinations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The risk of developing arcus corneae, earlobe crease and xanthelasmata increased stepwise with increased smoking as measured by pack-years. For alcohol consumption, a high intake was associated with the risk of developing arcus corneae and earlobe crease, but not xanthelasmata.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>High alcohol consumption and smoking predict development of visible age-related signs. This is the first prospective study to show that heavy alcohol use and smoking are associated with generally looking older than one\u2019s actual age.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/jech-2016-208568","type":"journal-article","created":{"date-parts":[[2024,5,31]],"date-time":"2024-05-31T14:25:49Z","timestamp":1717165549000},"page":"1177-1184","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Alcohol consumption, smoking and development of visible age-related signs: a prospective cohort study"],"prefix":"10.1136","volume":"71","author":[{"given":"Anne L","family":"Schou","sequence":"first","affiliation":[{"name":"National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Louise","family":"M\u00f8lbak","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Schnor","sequence":"additional","affiliation":[{"name":"Copenhagen City Heart Study, Frederiksberg Hospital, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Morten","family":"Gr\u00f8nb\u00e6k","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janne S","family":"Tolstrup","sequence":"additional","affiliation":[{"name":"National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2017,11,7]]},"reference":[{"key":"2025100704324508000_71.12.1177.1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d636"},{"key":"2025100704324508000_71.12.1177.2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d671"},{"key":"2025100704324508000_71.12.1177.3","doi-asserted-by":"publisher","DOI":"10.1111\/j.1360-0443.1990.tb03710.x"},{"key":"2025100704324508000_71.12.1177.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(99)00076-1"},{"key":"2025100704324508000_71.12.1177.5","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.001696"},{"key":"2025100704324508000_71.12.1177.6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.d5497"},{"key":"2025100704324508000_71.12.1177.7","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-012-9728-0"},{"key":"2025100704324508000_71.12.1177.8","doi-asserted-by":"crossref","first-page":"171","DOI":"10.1016\/j.ijcard.2014.04.025","article-title":"Ear lobe crease as a marker of coronary artery disease: a meta-analysis","volume":"175","author":"Lucenteforte","year":"2014","journal-title":"Int J Cardiol"},{"key":"2025100704324508000_71.12.1177.9","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(83)90883-5"},{"key":"2025100704324508000_71.12.1177.10","doi-asserted-by":"publisher","DOI":"10.1159\/000080847"},{"key":"2025100704324508000_71.12.1177.11","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(91)90123-F"},{"key":"2025100704324508000_71.12.1177.12","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.160.2.165"},{"key":"2025100704324508000_71.12.1177.13","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2012-002537"},{"key":"2025100704324508000_71.12.1177.14","doi-asserted-by":"publisher","DOI":"10.1016\/j.atherosclerosis.2006.08.060"},{"key":"2025100704324508000_71.12.1177.15","doi-asserted-by":"crossref","first-page":"1200","DOI":"10.2105\/AJPH.80.10.1200","article-title":"The association of corneal arcus with coronary heart disease and cardiovascular disease mortality in the Lipid Research Clinics Mortality Follow-up Study","volume":"80","author":"Chambless","year":"1990","journal-title":"Am J Public Health"},{"key":"2025100704324508000_71.12.1177.16","doi-asserted-by":"publisher","DOI":"10.1053\/euhj.2001.2842"},{"key":"2025100704324508000_71.12.1177.17","first-page":"1","article-title":"The Copenhagen City Heart Study. 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