Assessment of cardiometabolic age and aging rate in individuals with type 2 diabetes

Abstract

Background. Aging is associated with changes in organs and systems that contribute to the development of age-related pathology. Accelerated aging is characterized by metabolic disorders that create conditions for the development of type 2 diabetes (T2D). The development of T2D in older individuals can be considered as accelerated metabolic aging. In cases of T2D combined with cardiovascular pathology in the elderly, there is a cardiometabolic type of aging. To assess the rate of this process, it is advisable to use a formula for calculating biological age (BA) based on cardiovascular and metabolic parameters. In this case, partial BA can be called cardiometabolic age. Its value will assess the degree of hemodynamic and metabolic disturbances. The purpose of the study was to develop a simple method for assessing cardiometabolic age and to calculate it in individuals with T2D combined with cardiovascular pathology. Materials and methods. A total of 155 practically healthy individuals (without T2D, cardiovascular, and renal pathology) aged 30 to 80 years were examined, 23 patients with T2D without comorbidities, 92 with T2D and concomitant hypertension, 55 with T2D, concomitant hypertension and ischemic heart disease, 72 with T2D and chronic kidney disease, and 25 patients with T2D and peripheral neuropathy. All participants had anthropometric measurements taken, systolic and diastolic blood pressure measured. Serum levels of total cholesterol, triglycerides, low- and high-density lipoprotein cholesterol, creatinine, glomerular filtration rate, aspartate aminotransferase, alanine aminotransferase, and albuminuria were determined. A stepwise multiple regression method using the StatSoft Statistica package (USA) was used to develop the BA mathematical model. Aging rate was assessed by the difference between biological and chronological age. Results. Calculation of BA in practically healthy individuals using our formula showed that the average absolute error of calculation was 7.79 ± 0.49 years. Correction of the systematic error of the regression method significantly increased the accuracy of BA calculation (R2 = 0.78; p < 0.00001; age calculation error was 4.80 ± 0.32 years). Calculation of BA in individuals with pathology showed that it significantly exceeded their chronological age, on average by 12.7 ± 1.9 years in patients with T2D without comorbidities and from 14.5 ± 2.0 to 19.1 ± 1.5 years in the pre­sence of comorbidities or T2D complications. The obtained result indicates accelerated cardiometabolic aging in individuals with T2D and an increased risk of developing cardiovascular diseases, chro­nic kidney disease, and polyneuropathy. Conclusion. The method developed by us for assessing the rate of cardiometabolic aging has a sufficiently high accuracy and can be used to predict the risk of developing T2D in combination with cardiovascular pathology.

Keywords

• cardiometabolic age
• mathematical model
• type 2 dia­betes