Epigenetic Age Associations with Chronic Obstructive Pulmonary Morbidity and Severity

Individuals with Chronic Obstructive Pulmonary Disease (COPD) experience increased morbidity and mortality due to acute worsening of respiratory symptoms. A growing body of evidence suggests the aging pathway is implicated in both COPD risk and COPD-related phenotypes. Identifying the role aging plays in lung function, severity, morbidity, and quality of life in COPD patients could inform potential avenues for treatment. Additionally, understanding how socio-economic position and demographic characteristics might modify aging pathways could inform opportunities to address disparities in COPD. This study aims to identify whether subpopulations may be at most risk for COPD-related outcomes due to epigenetic aging in a diverse and low-income sample of COPD patients. Epigenetic clocks capture methylation at loci across the epigenome that are predictive of age. We estimated epigenetic age using the Horvath epigenetic clock and examined how divergences of epigenetic age from biological age were related to quantitative measures of lung function, COPD severity, morbidity, and quality of life in a low-income and racially diverse COPD population. Multivariable linear regression models adjusting for sex, continuous hospital anxiety and depression scale, baseline pack-years, European American race, and continuous baseline body mass index reveal null relationships between epigenetic aging and lung function or questionnaires measuring severity, morbidity, and quality of life. We also tested for effect measure modification of aging relationships by sex, income, and race. We observed significant effect measure modification for the relationship between increasingly better lung function categories and intrinsic epigenetic aging by income, dichotomized at a $20,000 threshold (p = 0.02). Individuals with incomes above$20,000 per year exhibited age deceleration with increasingly better lung function (p = 0.03). This result may indicate that the epigenetic aging pathway plays differential roles in lung function depending on income group

Greater Gestational Vitamin D Status is Associated with Reduced Childhood Behavioral Problems in the Environmental Influences on Child Health Outcomes Program

BackgroundVitamin D deficiency is common in pregnancy. Vitamin D plays an important role in the developing brain, and deficiency may impair childhood behavioral development.ObjectivesThis study examined the relationship between gestational 25(OH)D concentrations and childhood behavior in the Environmental influences on Child Health Outcomes (ECHO) Program.MethodsMother-child dyads from ECHO cohorts with data available on prenatal (first trimester through delivery) or cord blood 25(OH)D and childhood behavioral outcomes were included. Behavior was assessed using the Strengths and Difficulties Questionnaire or the Child Behavior Checklist, and data were harmonized using a crosswalk conversion. Linear mixed-effects models examined associations of 25(OH)D with total, internalizing, and externalizing problem scores while adjusting for important confounders, including age, sex, and socioeconomic and lifestyle factors. The effect modification by maternal race was also assessed.ResultsEarly (1.5-5 y) and middle childhood (6-13 y) outcomes were examined in 1688 and 1480 dyads, respectively. Approximately 45% were vitamin D deficient [25(OH)D < 20 ng/mL], with Black women overrepresented in this group. In fully adjusted models, 25(OH)D concentrations in prenatal or cord blood were negatively associated with externalizing behavior T-scores in middle childhood [-0.73 (95% CI: -1.36, -0.10) per 10 ng/mL increase in gestational 25(OH)D]. We found no evidence of effect modification by race. In a sensitivity analysis restricted to those with 25(OH)D assessed in prenatal maternal samples, 25(OH)D was negatively associated with externalizing and total behavioral problems in early childhood.ConclusionsThis study confirmed a high prevalence of vitamin D deficiency in pregnancy, particularly among Black women, and revealed evidence of an association between lower gestational 25(OH)D and childhood behavioral problems. Associations were more apparent in analyses restricted to prenatal rather than cord blood samples. Interventions to correct vitamin D deficiency during pregnancy should be explored as a strategy to improve childhood behavioral outcomes