NMR metabolomics-guided DNA methylation mortality predictors

BACKGROUND: H-NMR metabolomics and DNA methylation in blood are widely known biomarkers predicting age-related physiological decline and mortality yet exert mutually independent mortality and frailty signals. METHODS: H-NMR metabolomics could guide the construction of DNA methylation-based mortality predictors. FINDINGS: We trained DNA methylation-based surrogates for 64 metabolomic analytes and found that analytes marking inflammation, fluid balance, or HDL/VLDL metabolism could be accurately reconstructed using DNA-methylation assays. Interestingly, a previously reported multi-analyte score indicating mortality risk (MetaboHealth) could also be accurately reconstructed. Sixteen of our derived surrogates, including the MetaboHealth surrogate, showed significant associations with mortality, independent of relevant covariates. INTERPRETATION: The addition of our metabolic analyte-derived surrogates to the well-established epigenetic clock(definition) GrimAge demonstrates that our surrogates potentially represent valuable mortality signal. FUNDING: BBMRI-NL, X-omics, VOILA, Medical Delta, NWO, ERC.