BIOMARKERS

Deciphering Aging Biomarkers

The gap between individuals’ chronological and biological ages underscores the need for reliable aging biomarkers. These biomarkers, comprised of various biological parameters, serve to evaluate age-related changes, monitor physiological aging, and predict the onset of pathological conditions.

Clinical Biomarkers

Measurable health indicators commonly used in clinical settings or analyzed in accredited laboratories based on standardized methods, such as blood pressure readings, cholesterol levels, and HbA1c.
 

Physiological Biomarkers

Measurable characteristics related to the functioning of organs and systems within the body. Examples include changes in muscle mass and strength, bone density, cardiovascular function (VO2max), respiratory capacity, and cognitive function.

Cellular Biomarkers

Changes that occur within individual cells as a result of aging. This may include cellular senescence (the process by which cells stop dividing and become dysfunctional), alterations in mitochondrial function, and changes in cellular metabolism.

Molecular Biomarkers

Molecules in biological samples assessing aging-related changes, including inflammation markers like CRP, oxidative stress indicators such as ROS, and metabolic dysfunction markers like insulin resistance.

Genetic Biomarkers

Variations in genes related to aging and disease, such as changes in telomere length (e.g., TERT gene) and DNA repair mechanisms (e.g., BRCA1 gene).

Epigenetic Biomarkers

Changes in DNA or associated proteins regulate gene activity without altering the DNA sequence, like DNA methylation and histone modifications. Many new epigenetic clocks, including third-generation ones like Dunedin Pace, have emerged recently.

Behavioral Biomarkers

Lifestyle factors and behaviors influencing aging and health outcomes, including physical activity levels, dietary patterns, sleep quality, stress levels, and social connectedness.

Composite Aging Biomarkers

Combination of various measures like physical, cognitive, and clinical indicators (e.g., frailty indices) to assess overall health and aging, aiding in predicting health outcomes and evaluating interventions for healthy aging.

Biomarkers in Practice

Cardiometabolic Health

Glucose–Insulin Axis

  • Fasting glucose
  • Fasting insulin
  • HOMA-IR
  • HbA1c
  • C-peptide

Lipid & Atherogenic Risk

  • ApoB
  • LDL-C
  • HDL-C
  • TG
  • Lp(a)

Systemic Risk

  • hs-CRP
  • Homocysteine
  • Uric acid

Cardiovascular Performance

Hemodynamics

  • Blood pressure

Cardiorespiratory Fitness

  • VO₂ max
  • Resting (sleep) heart rate

Vascular Health

  • Pulse wave velocity / arterial stiffness

Strength / Performance

Mitochondrial & Metabolic Function

  • Grip strength
  • Bench press 5RM
  • Pull-up max reps
  • Squat 5RM
  • Deadlift 5RM

Body Composition

  • Fat mass
  • Lean mass
  • Visceral fat
  • Bone density
  • Skeletal muscle index

Hormonal & Endocrine

Sex Hormones

  • Total testosterone
  • Free testosterone
  • SHBG
  • Estradiol
  • Progesterone

Adrenal

  • DHEA-S
  • Multi-point salivary cortisol

Thyroid

  • TSH
  • Free T4
  • Free T3
  • Reverse T3

Growth / Anabolic

  • IGF-1

Nervous System & Stress Resilience

  • HRV trends
  • Perceived Stress Scale (PSS)

Lifestyle Outputs

Movement

  • Daily steps
  • Zone 1–3 time
  • Zone 4–5 time

Sleep

  • Sleep duration
  • Sleep efficiency
  • Sleep consistency
  • Restorative sleep (REM + deep)

Organ Function

Liver & Metabolic Panel

  • Comprehensive metabolic panel

Hematologic

  • CBC with differential
  • Ferritin

Renal

  • Urinalysis
  • Albumin/creatinine ratio

Mitochondrial & Metabolic Function

  • Lactate / Pyruvate
  • Krebs cycle intermediates
  • β-oxidation markers
  • Carnitine metabolites
  • Organic acids (FMV urine)
  • Neurotransmitter metabolites

Oxidative Stress & Redox Balance

Damage

  • 8-OHdG
  • F2-isoprostanes
  • Lipid peroxides

Defense

  • Reduced / oxidized glutathione ratio
  • Glutathione

Nutrient Status

Micronutrients

  • Vitamins
  • Minerals & trace elements

Macronutrient Biomarkers

  • Amino acids
  • Fatty acids (EPA, DHA, omega-6, ratio)
  • Saturated vs monounsaturated balance

Key Cofactors

  • CoQ10
  • Alpha-lipoic acid

Methylation / One-Carbon Metabolism

  • SAM / SAH balance
  • Homocysteine-related metabolites
  • Methylmalonic acid

Genetics & Biological Aging

Genetics

  • SNPs (ApoE, MTHFR, COMT, TNF-α)

Epigenetics / Aging

  • DunedinPACE
  • GrimAge / PhenoAge
  • Telomere length
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