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

Clinical Biomarkers

Metabolic

  • Comprehensive metabolic panel
  • Fasting glucose
  • Fasting insulin
  • HOMA-IR
  • HbA1c
  • C-peptide
  • Uric acid
  • IGF-1

Lipid

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

Hormones

  • Total & free testosterone
  • SHBG
  • Estradiol
  • Progesterone
  • DHEA-S
  • TSH / Free T4 / Free T3
  • Reverse T3
  • Multi-point salivary cortisol

Blood Count

  • CBC with differential
  • Ferritin

Inflammation

  • hs-CRP
  • Homocysteine

Physiological Biomarkers

Cardiovascular 

  • VO₂ max
  • Resting heart rate
  • Blood pressure
  • Pulse Wave Velocity / Arterial Stiffness

Strength / Performance

  • Grip strength
  • Bench press 5-rep max 
  • Pull-up/chin-up max reps
  • Squat 5-rep max
  • Deadlift 5-rep max

Body Composition

  • DEXA scan: fat mass, lean mass, visceral fat, bone density, skeletal muscle index

Cellular & Molecular Biomarkers

Mitochondrial & Metabolic Function

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

Oxidative Stress

  • 8-OHdG
  • F2-isoprostanes
  • Lipid peroxides
  • Reduced / oxidized glutathione ratio

Nutrient Biomarkers

  • Vitamins
  • Minerals & trace elements
  • Amino acids
  • Fatty Acids (EPA, DHA, omega-6, and omega-6:omega-3 ratio)
  • Saturated vs monounsaturated balance

Antioxidant & Detox Markers

  • Glutathione
  • CoQ10
  • Alpha-lipoic acid
  • Phase I & II detox intermediates
  • Oxidative stress metabolites

Methylation

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

Genetic & Epigenetic Biomarkers

  • Epigenetic pace of aging: DunedinPACE
  • Biological age / methylation clocks: GrimAge, PhenoAge
  • Telomere length
  • Genetic risk: SNP (ApoE, MTHFR, COMT,  TNF-a)

Behavioral Biomarkers

Stress / Nervous System

Movement

  • Daily steps
  • Zone 1–3 time per week

Sleep

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