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@ARTICLE{Gao:141672,
      author       = {X. Gao$^*$ and Y. Zhang$^*$ and U. Mons$^*$ and H.
                      Brenner$^*$},
      title        = {{L}eukocyte telomere length and epigenetic-based mortality
                      risk score: associations with all-cause mortality among
                      older adults.},
      journal      = {Epigenetics},
      volume       = {13},
      number       = {8},
      issn         = {1559-2308},
      address      = {Austin, Tex.},
      publisher    = {Landes Bioscience},
      reportid     = {DKFZ-2018-01943},
      pages        = {846 - 857},
      year         = {2018},
      abstract     = {Telomere length (TL) has been established as a biomarker of
                      aging and aging-related health outcomes, but showed only a
                      weak or inconsistent association with all-cause mortality in
                      previous epidemiological studies. Recently, an epigenetic
                      'mortality risk score' (MS) based on whole blood DNA
                      methylation at 10 mortality-related CpG sites has been
                      demonstrated to be strongly related to all-cause mortality
                      at the population level. This study aimed to address the
                      association between TL and this MS, and to assess and
                      compare their associations with all-cause mortality. The MS
                      was derived from the DNA methylation profiles measured by
                      Illumina Human Methylation450K Beadchip and TL was measured
                      by quantitative PCR at baseline among 1517 participants aged
                      50-75 of the German ESTHER cohort study. In cross-sectional
                      bi- and multivariable analyses, the MS was strongly
                      associated and showed monotonic dose-response relationships
                      with TL (p-values <0.05). However, only the MS but not TL
                      was associated with all-cause mortality during a median
                      follow-up of 12.5 years. After controlling for potential
                      covariates and TL, hazard ratios $(95\%$ CI) for all-cause
                      mortality for low, moderate and high levels of the MS
                      defined by 1, 2-5 and >5 CpG sites with aberrant methylation
                      were 2.24 (1.13-4.41), 3.31 (1.76-6.22) and 6.33
                      (3.22-12.41) compared to a MS of 0, respectively. Our
                      investigation shows that the epigenetic-based MS is strongly
                      associated with TL, a broadly accepted aging biomarker, and
                      at the same time shows much stronger associations with
                      all-cause mortality than the latter.},
      cin          = {C070 / G110 / M050},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331 /
                      I:(DE-He78)M050-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30152726},
      pmc          = {pmc:PMC6224222},
      doi          = {10.1080/15592294.2018.1514853},
      url          = {https://inrepo02.dkfz.de/record/141672},
}