Biological aging and the incidence and progression of diabetic retinopathy and kidney disease in type 2 diabetes mellitus: A prospective cohort study
Authors' conclusion
PhenoAge acceleration, a routine biomarker-based measure of biological aging, was associated with microvascular complications in T2DM.
Study context
- Population
- Adults with T2D; Phenotypic age (PhenoAge) calculated from nine routine biomarkers at baseline and follow-up
- Participants
- 8,194 adults
- Exposure
- Highest vs lowest tertile of baseline PhenoAge acceleration
- Outcome
- Incidence and progression of DR (deep-learning graded) and DKD (Kidney Disease: Improving Global Outcomes criteria)
Methodological detailsmodified Poisson models adjusted for conventional risk factors
- Modified Poisson models adjusted for conventional risk factors
Main finding
As reported in the abstract
Incident DR, DKD and concurrent DR-DKD
Each group vs lowest tertileEstimate (95% CI)
Highest tertile
RR (incident DR) 1.56(1.10–2.23)
Highest tertile
RR (incident DKD) 1.30(1.10–1.54)
Highest tertile
RR (concurrent DR and DKD) 3.24(1.56–6.76)
Observational data: associations, not effects.
Further findings
| Outcome | RR (CI) | |
|---|---|---|
| DKD progression (participants with baseline DKD) | 2.04 (1.60–2.59) | |
| 0.20.5125Relative risk (log scale) |
Diabetic retinopathy (DR) progression (participants with baseline DR)
- Highest tertile of PhenoAge acceleration not associated with increased risk of DR progression
Longitudinal increase in PhenoAge acceleration and incident diabetic kidney disease (DKD)
- RR for incident DKD with longitudinal increase
- 1.36 (CI 1.14-1.62)
Decrease in PhenoAge acceleration and DKD progression
- RR for DKD progression with decrease, lower risk
- 0.59 (CI 0.41-0.85)
Original publication
Biological aging and the incidence and progression of diabetic retinopathy and kidney disease in type 2 diabetes mellitus: A prospective cohort study. Diabetes Res Clin Pract. Published 8 July 2026. doi:10.
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