1.Serological characteristics of individuals with hepatitis C virus/hepatitis B virus overlapping infection
Yanfei CUI ; Xia HUANG ; Chao ZHANG ; Yingjie JI ; Song QING ; Yuanjie FU ; Jing ZHANG ; Li LIU ; Yongqian CHENG
Journal of Clinical Hepatology 2026;42(1):74-79
ObjectiveTo investigate the status of overlapping hepatitis B virus (HBV) infection in patients with chronic hepatitis C virus (HCV) infection and the serological characteristics of such patients. MethodsA total of 8 637 patients with HCV infection who were hospitalized from January 1, 2010 to December 31, 2020 and had complete data of HBV serological markers were enrolled, and the composition ratio of patients with overlapping HBV serological markers was analyzed among the patients with HCV infection. The patients were divided into groups based on age and year of birth, and serological characteristics were analyzed, and the distribution of HBV-related serological characteristics were analyzed across different HCV genotypes. ResultsThe patients with HCV/HBV overlapping infection accounted for 5.85%, and the patients with previous HBV infection accounted for 48.10%; the patients with protective immunity against HBV accounted for 14.67%, while the patients with a lack of protective immunity against HBV accounted for 31.39%. The patients were divided into groups based on age: in the 0 — 17 years group, the patients with protective immunity against HBV accounted for 61.41% (304 patients); the 18 — 44 years group was mainly composed of patients with previous HBV infection (698 patients, 37.31%), the 45 — 59 years group was predominantly composed of patients with previous HBV infection (1 945 patients, 50.38%), and the ≥60 years group was also predominantly composed of patients with previous HBV infection (1 486 patients, 61.66%). The patients were divided into groups based on the year of birth: in the pre-1992 group, the patients with previous HBV infection accounted for 51.63% (4 112 patients); in the 1992 — 2005 group, the patients with protective immunity against HBV accounted for 54.72% (168 patients); in the post-2005 group, the patients with protective immunity against HBV accounted for 64.38% (235 patients). In this study, 6 301 patients underwent HCV genotype testing: the patients with genotype 1b accounted for the highest proportion of 51.71% (3 258 patients), followed by those with genotype 2a (1 769 patients, 28.07%), genotype 3b (63 patients, 1.00%), genotype 3a (10 patients, 0.16%), genotype 4 (21 patients, 0.33%), and genotype 6a (5 patients, 0.08%). ConclusionWith the implementation of hepatitis B planned vaccination program in China, there has been a significant reduction in the proportion of patients with previous HBV infection among the patients with HCV/HBV overlapping infection, but there is still a relatively high proportion of patients with a lack of protective immunity against HBV.
2.Mechanisms of Jianpi Yangzheng Xiaozheng Prescription in Regulating USP51 to Inhibit Progression of Poorly Cohesive Gastric Carcinoma
Sitian LIN ; Yuanjie LIU ; Yi YIN ; Shenlin LIU ; Xi ZOU
Chinese Journal of Experimental Traditional Medical Formulae 2026;32(11):97-111
ObjectiveTo investigate the mechanisms by which Jianpi Yangzheng Xiaozheng prescription (JPYZXZ) treats poorly cohesive gastric carcinoma (PC-GC) through regulation of ubiquitin-specific peptidase 51 (USP51). MethodsIn vitro experiments: Cell viability and proliferation of PC-GC cell lines (MKN-45 and HGC-27) treated with different concentrations of JPYZXZ (2, 4, 6 g·L-1) were assessed using Cell Counting Kit-8 (CCK-8) and colony formation assays. Cell migration was evaluated by wound healing (scratch) and Transwell assays. The mRNA and protein expression levels of USP51, zinc finger E-box-binding homeobox 1 (ZEB1), and epithelial-mesenchymal transition (EMT)-related markers (e.g., E-cadherin) were detected by quantitative real-time PCR (Real-time PCR) and Western blot, respectively. Subsequently, stable MKN-45 and HGC-27 cell lines with USP51 knockdown (sh-USP51) and overexpression (oe-USP51) were constructed. Their migration ability and EMT-related protein expression were further evaluated by scratch assay, Transwell assay, and Western blot. In vivo experiments: A subcutaneous xenograft model of MKN-45 human gastric cancer was established in BALB/c nude mice. Thirty mice were randomly divided into six groups (NC, NC + JPYZXZ, sh-USP51, sh-USP51 + JPYZXZ, oe-USP51, and oe-USP51 + JPYZXZ), with five mice in each group. After successful modeling, mice in the treatment groups were administered JPYZXZ (30 g·kg-1) by gavage for 28 days. Body weight and tumor volume were monitored during the experiment. The expression levels of USP51 and EMT-related proteins in tumor tissues were detected by Western blot and immunohistochemistry (IHC). ResultsCompared with the blank group, the colony formation rate, wound healing rate, and number of migrated cells in MKN-45 and HGC-27 cells were significantly reduced in all JPYZXZ groups and the 5-fluorouracil (5-FU) group (P<0.05). The mRNA and protein expression levels of USP51 were decreased (P<0.05). The expression of ZEB1 and mesenchymal phenotype proteins (e.g., N-cadherin and vimentin) was reduced (P<0.05), whereas the expression of the epithelial marker E-cadherin was increased (P<0.05). Compared with the control group, USP51 expression was decreased in the sh-USP51 group and increased in the oe-USP51 group (P<0.05). Compared with the NC group, USP51 knockdown significantly reduced the migration and proliferation of gastric cancer cells (P<0.01), decreased the expression of ZEB1 and EMT-related proteins, and increased E-cadherin expression (P<0.05). In vivo results showed that JPYZXZ significantly inhibited the growth of xenograft tumors in nude mice (P<0.05) and markedly reversed the abnormal expression of EMT-related proteins in tumor tissues (P<0.05). ConclusionThe therapeutic mechanisms of JPYZXZ in PC-GC may be associated with inhibition of the EMT process via regulation of the USP51-ZEB1 signaling pathway.
3.Prediction and verification of the mechanism of Chaiqi yigan granules improving hepatocellular carcinoma
Guiping MA ; Yuanjie ZHANG ; Yichi ZHOU ; Jinzhen LYU ; Conghui WANG ; Fenping LU ; Bowen LIU ; Yun RAN ; Shiping HU
China Pharmacy 2026;37(5):620-625
OBJECTIVE To predict and validate the mechanisms of Chaiqi yigan granules (CQYG) improving hepatocellular carcinoma (HCC). METHODS The signaling pathways of CQYG intervention in HCC were predicted using network pharmacology. A mice model of transplanted hepatocellular carcinoma was established by injecting H22 hepatoma cells into the axilla. Successfully modeled mice were randomly divided into model group (normal saline), sorafenib group (positive control, 50 mg/kg), and CQYG low-, medium- and high-dose groups (24.83, 49.66, 99.32 g/kg), with 10 mice in each group. Mice in each group were administered the corresponding drug solution or normal saline intragastrically, once a day, for 14 consecutive days. After last administration, pathological morphological changes in the tumor tissues of mice were observed in each group. Immunohistochemical staining was performed to detect the expression of the nuclear proliferation antigen Ki-67 in tumor tissues of mice. Western blot assay was used to measure the expression of proteins related to epithelial-mesenchymal transition (EMT) [N-cadherin, E-cadherin, Vimentin, matrix metalloproteinase 7 (MMP7)] and the mitogen-activated protein kinase (MAPK) signaling pathway [p38 MAPK, phosphorylated p38 MAPK, c-Jun N-terminal kinase (JNK), phosphorylated JNK, extracellular regulated protein kinase 1/2 (ERK1/2), phosphorylated ERK1/2] in tumor tissue of mice. RESULTS Network pharmacology analysis revealed that metabolic pathways, pathways in cancer, and the MAPK signaling pathway were key signaling pathways through which CQYG exert their anti-hepatocellular carcinoma effects. In animal experiments, the tumor tissues of mice in the model group exhibited dense tumor cells and vigorous growth. Compared with model group, CQYG high-dose group showed a decreased density of tumor cells in the tumor tissues of mice. Moreover, the expression levels of Ki-67, N-cadherin, MMP7 and Vimentin proteins, along with the phosphorylation levels of ERK1/2 and JNK proteins, were all significantly reduced ( P <0.05). The expression level of E-cadherin protein was significantly increased ( P <0.05), the phosphorylation level of p38 MAPK protein was increased, the difference was not statistically significant ( P >0.05). CONCLUSIONS CQYG can inhibit EMT by regulating the MAPK signaling pathway, thereby suppressing tumor cell invasion and metastasis and ultimately exerting a therapeutic effect in improving HCC.
4.Regulation of DZIP1 Expression in CAFs by Jianpi Yangzheng Xiaozheng Formula and Its Impact on Mesenchymal Characteristics of Diffuse Gastric Cancer
Yuanjie LIU ; Qianwen YE ; Xi ZOU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):90-101
ObjectiveTo establish a subcutaneous xenograft model of gastric cancer in nude mice and to identify differentially expressed genes (DEGs) affected by Jianpi Yangzheng Xiaozheng formula (JPYZXZ) in diffuse gastric cancer (DGC) using transcriptome sequencing. The study aims to identify potential key prognostic factors and preliminarily elucidate the therapeutic mechanism of JPYZXZ. MethodsSubcutaneous tumor tissues were collected from nude mice treated with JPYZXZ (6 g·kg-1)and from the untreated traditional Chinese medicine control group. High-throughput RNA sequencing was performed to extract and analyze total RNA and identify DEGs, followed by functional enrichment analysis. DEGs were intersected with cancer-associated fibroblast (CAF)-related genes identified from single-cell RNA sequencing (scRNA-seq) data. A Cox proportional hazards regression model (Cox model) was constructed to identify potential key targets, among which DAZ interacting protein 1 (DZIP1) was selected. The role of DZIP1 in DGC progression was further verified through in vitro and in vivo experiments. ResultsTranscriptome sequencing revealed that DEGs regulated by JPYZXZ were significantly enriched in biological processes such as focal adhesion, phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway, and vascular development (P<0.05). Intersection analysis with CAF marker genes identified ten potential common target genes. Cox regression analysis combined with the Cancer Genome Atlas (TCGA) dataset for stomach adenocarcinoma (STAD) confirmed that DZIP1 is an independent prognostic factor significantly associated with poor outcomes. Transcriptome and immunohistochemical analyses showed that DZIP1 expression was significantly higher in gastric cancer tissues than in adjacent tissues, while JPYZXZ treatment downregulated DZIP1 expression in a dose-dependent manner. Clinical data further demonstrated that serum DZIP1 levels in patients treated with JPYZXZ were significantly lower than those in the control group. ConclusionJPYZXZ may inhibit the malignant progression of DGC by downregulating DZIP1 expression, thereby suppressing CAF activation and epithelial-mesenchymal transition (EMT). These findings provide experimental evidence and identify DZIP1 as a potential therapeutic target in DGC treatment.
5.Regulation of DZIP1 Expression in CAFs by Jianpi Yangzheng Xiaozheng Formula and Its Impact on Mesenchymal Characteristics of Diffuse Gastric Cancer
Yuanjie LIU ; Qianwen YE ; Xi ZOU
Chinese Journal of Experimental Traditional Medical Formulae 2025;31(21):90-101
ObjectiveTo establish a subcutaneous xenograft model of gastric cancer in nude mice and to identify differentially expressed genes (DEGs) affected by Jianpi Yangzheng Xiaozheng formula (JPYZXZ) in diffuse gastric cancer (DGC) using transcriptome sequencing. The study aims to identify potential key prognostic factors and preliminarily elucidate the therapeutic mechanism of JPYZXZ. MethodsSubcutaneous tumor tissues were collected from nude mice treated with JPYZXZ (6 g·kg-1)and from the untreated traditional Chinese medicine control group. High-throughput RNA sequencing was performed to extract and analyze total RNA and identify DEGs, followed by functional enrichment analysis. DEGs were intersected with cancer-associated fibroblast (CAF)-related genes identified from single-cell RNA sequencing (scRNA-seq) data. A Cox proportional hazards regression model (Cox model) was constructed to identify potential key targets, among which DAZ interacting protein 1 (DZIP1) was selected. The role of DZIP1 in DGC progression was further verified through in vitro and in vivo experiments. ResultsTranscriptome sequencing revealed that DEGs regulated by JPYZXZ were significantly enriched in biological processes such as focal adhesion, phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt) signaling pathway, and vascular development (P<0.05). Intersection analysis with CAF marker genes identified ten potential common target genes. Cox regression analysis combined with the Cancer Genome Atlas (TCGA) dataset for stomach adenocarcinoma (STAD) confirmed that DZIP1 is an independent prognostic factor significantly associated with poor outcomes. Transcriptome and immunohistochemical analyses showed that DZIP1 expression was significantly higher in gastric cancer tissues than in adjacent tissues, while JPYZXZ treatment downregulated DZIP1 expression in a dose-dependent manner. Clinical data further demonstrated that serum DZIP1 levels in patients treated with JPYZXZ were significantly lower than those in the control group. ConclusionJPYZXZ may inhibit the malignant progression of DGC by downregulating DZIP1 expression, thereby suppressing CAF activation and epithelial-mesenchymal transition (EMT). These findings provide experimental evidence and identify DZIP1 as a potential therapeutic target in DGC treatment.
6.Distribution characteristics of smoking behavior among adult twins in China
Shunkai LIU ; Wenjing GAO ; Weihua CAO ; Jun LYU ; Canqing YU ; Shengfeng WANG ; Tao HUANG ; Dianjianyi SUN ; Chunxiao LIAO ; Yuanjie PANG ; Ruqin GAO ; Min YU ; Jinyi ZHOU ; Xianping WU ; Zhong DONG ; Fan WU ; Dezheng WANG ; Zhihua XU ; Yu LIU ; Jianrui WANG ; Jie YIN ; Shengli YIN ; Liming LI
Chinese Journal of Preventive Medicine 2025;59(7):1090-1096
This study aims to describe the population and regional distribution characteristics of smoking behavior among adult twins in the China Twin Registry (CNTR), as well as the concordance rates for smoking behavior in monozygotic and dizygotic twins, and estimate the heritability. The study population included adult twins in CNTR who had smoking questionnaire data. A random-effects regression model was used to describe the distribution of smoking behavior among different subgroups based on various characteristics. The concordance of smoking behavior between different zygosity groups was calculated, and heritability was estimated. A total of 28 444 twin pairs were included in this study, with an average age of (36.6±12.0) years. Among male twins, 41.2% were current smokers, while only 1.2% of females smoked. Higher smoking rates were observed among male smokers in the 50-59 age group ( z=23.0, P<0.001), northern regions ( z=2.9, P<0.01), rural areas ( z=-5.2, P<0.001), those who were divorced/widowed ( z=3.8, P<0.001), and first-born twins ( z=-4.3, P<0.001), while lower smoking rates were found in those with higher education ( z=-16.1, P<0.001) and unmarried individuals ( z=-16.0, P<0.001). The smoking concordance rate for male monozygotic twins was 69.6%, significantly higher than the 57.3% concordance rate for dizygotic twins ( χ 2=105.0, P<0.05). The heritability of smoking behavior in male twins was estimated at 28.9% (95% CI: 24.3%-33.4%). Stratified analyses showed differences in heritability across regions and age groups: the heritability in northern regions was 32.6% (95% CI: 27.3%-38.0%), higher than the 21.0% (95% CI: 12.4%-29.5%) observed in southern regions; the highest heritability of 35.1% (95% CI: 26.3%-43.9%) was found in the 18-29 age group, with heritability decreasing with age. In conclusion, the smoking rate and influencing factors in the twin population are similar to those in the general population, with unique characteristics, such as higher smoking rates in first-born twins. Genetic factors have a significant impact on smoking behavior.
7.Association between DNA methylation clock and obesity-related indicators:A longi-tudinal twin study
Shunkai LIU ; Weihua CAO ; Jun LV ; Canqing YU ; Tao HUANG ; Dianjianyi SUN ; Chunxiao LIAO ; Yuanjie PANG ; Runhua HU ; Ruqin GAO ; Min YU ; Jinyi ZHOU ; Xianping WU ; Yu LIU ; Wenjing GAO ; Liming LI
Journal of Peking University(Health Sciences) 2025;57(3):456-464
Objective:To explore the relationship between obesity indicators and DNA methylation clocks acceleration,and to analyze their temporal sequence.Methods:Data were obtained from two sur-veys conducted in 2013 and 2017-2018 by the Chinese National Twin Registry.Peripheral blood DNA methylation data were measured using the Illumina Infinium Human Methylation 450K BeadChip and EPIC BeadChip.DNA methylation clocks/acceleration metrics(GrimAA,PCGrimAA and Dunedin-PACE)were calculated using the DNA methylation online tool(https://dnamage.genetics.ucla.edu/)or R code provided by researchers.Obesity indicators included weight,body mass index(BMI),waist circumference,waist-hip ratio,and waist-height ratio.A total of 1 070 twin individuals were included in the cross-sectional analysis,comprising 378 monozygotic(MZ)twin pairs and 155 dizygotic(DZ)twin pairs for within-pair analysis.Mixed-effects models were used to examine the associations between obesity indicators and DNA methylation clocks,as well as their acceleration measures.The longitudinal analysis included 314 twin individuals,comprising 95 MZ twin pairs and 62 DZ twin pairs for within-pair analy-sis.Cross-lagged panel models were applied to further explore the temporal relationships between obesity and DNA methylation clock indicators.All analyses were conducted both in the full twin sample and separately within MZ and DZ twin pairs.Results:In the cross-sectional analysis population,monozygotic twins accounted for 71.0%,males for 68.0%,and the mean chronological age was(49.9±12.1)years.In the longitudinal analysis population,monozygotic twins accounted for 60.5%,males for 60.8%,with a mean baseline chronological age of(50.4±10.2)years and a mean follow-up duration of(4.6±0.6)years.Except for the waist-to-hip ratio,which was significantly higher at follow-up com-pared with baseline,no statistically significant differences were observed in the means of other obesity in-dicators between baseline and follow-up.Correlation analysis revealed that weight,BMI,waist circumfe-rence,waist-hip ratio(WHR),and waist-height ratio(WHtR)were positively correlated with Dunedin-PACE in all the twins,with WHtR showing the strongest association(β=0.21,95%CI:0.11 to 0.31).Weight and BMI were negatively associated with GrimAA(β=-0.03,95%CI:-0.05 to-0.01;β=-0.07,95%CI:-0.12 to-0.02),while weight was negatively associated with PCGrim-AA(β=-0.02,95%CI:-0.03 to 0.00).However,within-twin-pair analyses showed no statistically significant correlations.Cross-lagged panel model analysis indicated that higher baseline weight might lead to increased GrimAA at follow-up,while elevated baseline weight,BMI,and waist circumference might increase PCGrimAA.Higher baseline WHR was associated with increased DunedinPACE at follow-up.Conclusion:Obesity indicators correlate with DNA methylation clock acceleration metrics.Baseline obesity may influence changes in certain DNA methylation clock indicators over time,suggesting that obesity could exert long-term health effects by accelerating DNA methylation aging.However,these associations may be confounded by shared genetic or environmental factors among the twins.
8.Distribution characteristics and heritability of alcohol consumption behavior in adult twins in China
Yuanchen LI ; Wenjing GAO ; Weihua CAO ; Jun LYU ; Canqing YU ; Shengfeng WANG ; Tao HUANG ; Dianjianyi SUN ; Chunxiao LIAO ; Yuanjie PANG ; Ruqin GAO ; Min YU ; Jinyi ZHOU ; Xianping WU ; Zhong DONG ; Fan WU ; Dezheng WANG ; Zhihua XU ; Yu LIU ; Yanxia MA ; Jie YIN ; Shengli YIN ; Liming LI
Chinese Journal of Epidemiology 2025;46(1):73-80
Objective:To describe the distribution characteristics of alcohol consumption in adult twins in the Chinese National Twin Registry (CNTR), and further explore the influence of genetic factors on alcohol consumption in adult twins.Methods:The subjects of the study were twins registered by CNTR in 11 project areas across China from 2010 to 2018. A total of 56 966 twins (28 483 pairs) aged 18 years and above who answered questions about drinking behavior were included, and the random effect model was used to describe the population and regional distribution characteristics of alcohol consumption. Intra-pair analysis was performed to calculate the concordance rate and heritability of their alcohol consumption.Results:The age of all subjects was (36.6±12.0) years, and current drinkers accounted for 16.6% (9 461/56 966) of all subjects. In men, those aged 50-59 years, those in northern China, those living in rural area, those with low education level and those with high BMI, the proportions of current drinkers were higher. After excluding 468 pairs of twins who had stopped alcohol use and 21 764 pairs of twins who had no drink or had small amount drink, an intra-pair analysis was conducted in 4 929 pairs of same-sex twins, and found that the concordance rate of alcohol consumption was 64.0% (2 059/3 215) in monozygotic twins, and 52.6% (902/1 714) in dizygotic twins, the difference was significant ( P<0.001), and the heritability of alcohol consumption was 24.1% (95% CI: 18.9%- 29.3%). The further stratified analysis found that in southern men, the heritability was highest in those aged 40-49 years (36.1%, 95% CI: 21.6%-50.7%), while in northern men, the heritability was highest in those aged 50-59 years (34.2%, 95% CI: 18.1%-50.3%). Conclusions:In adult twins in China, there were population and regional differences in the distribution of alcohol consumption behavior, and alcohol consumption was influenced by genetic factors, and gender, age and region had potential modifying effects.
9.Analysis of nutritional status of primary and middle school students in Baodi district,Tianjin
Xiaoqiong TAN ; Manman LIU ; Yuanjie LI
China Modern Doctor 2025;63(18):46-49,74
Objective To analyze the nutrition status of primary and middle school students in Baodi district,Tianjin in 2021 and 2023,as to provide scientific basis for improving the nutritional status of students.Methods A stratified random cluster sampling method was adopted to select 12 schools in Baodi district,Tianjin.Students' nutrition status were assessed from September to November of every year in 2021 and 2023,including questionnaire survey,physical examination and biochemical indicators.Results Compared with the same gender and age students in 2021,the height of boys aged 7-13 and girls aged 7-12 will significantly increase in 2023,while the body mass of boys and girls aged 8 and 11 will significantly increase.Compared with 2021,the overweight and obesity rates among males have significantly decreased in 2023,while the emaciation rates among males and females have significantly increased.The anemia rate,serum ferritin and vitamin A,and vitamin D deficiency rate among students in 2023 were 12.25%,3.77%,15.70%,and 50.31%,respectively,with no statistically significant difference compared to 2021(P>0.05).The awareness rate of nutrition knowledge and the proportion of related behaviors among students in 2023 have significantly increased compared to 2021.Conclusion Compared with 2021,the overweight and obesity rates among primary and secondary school students will decrease in 2023,while anemia,serum ferritin,vitamin A,and vitamin D deficiencies will not improve.Targeted intervention activities are urgently needed.
10.Association between DNA methylation clock and obesity-related indicators:A longi-tudinal twin study
Shunkai LIU ; Weihua CAO ; Jun LV ; Canqing YU ; Tao HUANG ; Dianjianyi SUN ; Chunxiao LIAO ; Yuanjie PANG ; Runhua HU ; Ruqin GAO ; Min YU ; Jinyi ZHOU ; Xianping WU ; Yu LIU ; Wenjing GAO ; Liming LI
Journal of Peking University(Health Sciences) 2025;57(3):456-464
Objective:To explore the relationship between obesity indicators and DNA methylation clocks acceleration,and to analyze their temporal sequence.Methods:Data were obtained from two sur-veys conducted in 2013 and 2017-2018 by the Chinese National Twin Registry.Peripheral blood DNA methylation data were measured using the Illumina Infinium Human Methylation 450K BeadChip and EPIC BeadChip.DNA methylation clocks/acceleration metrics(GrimAA,PCGrimAA and Dunedin-PACE)were calculated using the DNA methylation online tool(https://dnamage.genetics.ucla.edu/)or R code provided by researchers.Obesity indicators included weight,body mass index(BMI),waist circumference,waist-hip ratio,and waist-height ratio.A total of 1 070 twin individuals were included in the cross-sectional analysis,comprising 378 monozygotic(MZ)twin pairs and 155 dizygotic(DZ)twin pairs for within-pair analysis.Mixed-effects models were used to examine the associations between obesity indicators and DNA methylation clocks,as well as their acceleration measures.The longitudinal analysis included 314 twin individuals,comprising 95 MZ twin pairs and 62 DZ twin pairs for within-pair analy-sis.Cross-lagged panel models were applied to further explore the temporal relationships between obesity and DNA methylation clock indicators.All analyses were conducted both in the full twin sample and separately within MZ and DZ twin pairs.Results:In the cross-sectional analysis population,monozygotic twins accounted for 71.0%,males for 68.0%,and the mean chronological age was(49.9±12.1)years.In the longitudinal analysis population,monozygotic twins accounted for 60.5%,males for 60.8%,with a mean baseline chronological age of(50.4±10.2)years and a mean follow-up duration of(4.6±0.6)years.Except for the waist-to-hip ratio,which was significantly higher at follow-up com-pared with baseline,no statistically significant differences were observed in the means of other obesity in-dicators between baseline and follow-up.Correlation analysis revealed that weight,BMI,waist circumfe-rence,waist-hip ratio(WHR),and waist-height ratio(WHtR)were positively correlated with Dunedin-PACE in all the twins,with WHtR showing the strongest association(β=0.21,95%CI:0.11 to 0.31).Weight and BMI were negatively associated with GrimAA(β=-0.03,95%CI:-0.05 to-0.01;β=-0.07,95%CI:-0.12 to-0.02),while weight was negatively associated with PCGrim-AA(β=-0.02,95%CI:-0.03 to 0.00).However,within-twin-pair analyses showed no statistically significant correlations.Cross-lagged panel model analysis indicated that higher baseline weight might lead to increased GrimAA at follow-up,while elevated baseline weight,BMI,and waist circumference might increase PCGrimAA.Higher baseline WHR was associated with increased DunedinPACE at follow-up.Conclusion:Obesity indicators correlate with DNA methylation clock acceleration metrics.Baseline obesity may influence changes in certain DNA methylation clock indicators over time,suggesting that obesity could exert long-term health effects by accelerating DNA methylation aging.However,these associations may be confounded by shared genetic or environmental factors among the twins.

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