{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:20:21Z","timestamp":1787721621553,"version":"build-2784847793"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">The ability to predict cardiometabolic risk is essential to support efforts to prevent future onset of disease. Biomarkers that assess biological aging\u2014the rate of decline in physiological functioning that occurs across the systems of the human body\u2014have the potential to support this goal.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">We investigated the extent to which Dunedin Pace of Aging Calculated From the Epigenome (DunedinPACE), an epigenetic measure of biological aging, predicted cardiometabolic disease onset in a cohort of 2062 US military veterans free of disease at baseline and followed for an average of 14.1\u2009years via electronic health records. Other clinical biomarkers included hemoglobin A1C, blood pressure, pulse, and body mass index.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      DunedinPACE predicted incident cardiometabolic disease onset (hazard ratio [HR]=1.82 [95% CI, 1.64\u20132.04];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001) and remained associated with cardiometabolic disease onset when accounting for hemoglobin A1C, blood pressure, pulse, and body mass index (HR=1.38 [95% CI, 1.23\u20131.55];\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001). DunedinPACE increased prediction of cardiometabolic disease (area under the receiver operating characteristic [AUROC]\u00a0curve=0.76, \u0394AUROC=0.04) compared with demographics alone and increased prediction when combined with clinical biomarkers, demographics, smoking, and alcohol use (AUROC=0.81, \u0394AUROC=0.01, \u0394\n                      <jats:italic toggle=\"no\">\u03a7<\/jats:italic>\n                      <jats:sup>2<\/jats:sup>\n                      = 27.81,\n                      <jats:italic toggle=\"no\">df<\/jats:italic>\n                      =1,\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      &lt;0.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">These results suggest that DunedinPACE improves prediction of cardiometabolic disease compared with other clinical biomarkers and could help identify individuals who would benefit from preventative interventions that delay the onset of cardiometabolic disease.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048750","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T10:36:13Z","timestamp":1782210973000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Using a Biomarker of Biological Aging to Predict Incident Cardiometabolic Disease"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9372-2309","authenticated-orcid":false,"given":"Kyle J.","family":"Bourassa","sequence":"first","affiliation":[{"name":"Durham VA Health Care System","place":["Durham, USA"]},{"name":"Georgetown University","place":["Washington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6205-4536","authenticated-orcid":false,"given":"Matthew J.","family":"Crowley","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System","place":["Durham, USA"]},{"name":"Duke University School of Medicine","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Edelman","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System","place":["Durham, USA"]},{"name":"Duke University School of Medicine","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Melanie E.","family":"Garrett","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5926-5415","authenticated-orcid":false,"given":"Kelsey N.","family":"Serier","sequence":"additional","affiliation":[{"name":"VA Boston Healthcare System","place":["Boston, USA"]},{"name":"Boston University Chobanian & Avedisian School of Medicine","place":["Boston, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2534-8700","authenticated-orcid":false,"given":"Jennifer C.","family":"Naylor","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System","place":["Durham, USA"]},{"name":"Duke University School of Medicine","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison E.","family":"Ashley\u2010Koch","sequence":"additional","affiliation":[{"name":"Duke University School of Medicine","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8746-8949","authenticated-orcid":false,"given":"Jean C.","family":"Beckham","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System","place":["Durham, USA"]},{"name":"Duke University School of Medicine","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7218-1005","authenticated-orcid":false,"given":"Nathan A.","family":"Kimbrel","sequence":"additional","affiliation":[{"name":"Durham VA Health Care System","place":["Durham, USA"]},{"name":"Durham VA Health Care System","place":["Durham, USA"]},{"name":"Duke University School of Medicine","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick S.","family":"Calhoun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric","family":"Dedert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric B.","family":"Elbogen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robin 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