Can skin wrinkling in a site that has received limited sun exposure be used as a marker of health status and biological age?

Abstract

Objectives: to determine if skin wrinkling in a site that had received limited sun exposure may be a marker of health status and biological age. Design: population-based, cross-sectional study. Participants: we evaluated the health status of representative samples of elderly Greek-born people living in Melbourne, Greeks living in rural Greece, Anglo-Celtic Australians living in Melbourne and Swedes living in Sweden. We carried out microtopographic assessment of their skin and measured plasma dehydroepiandrosterone concentrations. Methods: we derived activities of daily living, well-being, memory and general health status scores from a cross-cultural questionnaire. We measured skin wrinkling using cutaneous microtopographic methods and plasma dehydroepiandrosterone by enzyme immuno-assay. Results: skin wrinkling was positively correlated with age (rs=0.27, P<0.0001) and negatively with body mass index (rs=-0.19, P<0.0001). Therefore, all analyses were controlled for these variables. Plasma dehydroepiandrosterone was higher in smokers than non-smokers (2.86 vs 2.08; P<0.001) and men had significantly higher plasma dehydroepiandrosterone than women (2.74 vs 1.69; P<0.0001). In the pooled data, skin wrinkling was negatively associated with general health score (rs=-0.13, P<0.01) and activities of daily living score (rs=-0.14, P<0.05) after controlling for age, body mass index and smoking. These associations were more pronounced in women. Finally, those with the least skin wrinkling had the highest dehydroepiandrosterone level (rs=-0.12, P=0.06) after adjusting for age, smoking and sex. Conclusion: skin wrinkling in a site with limited sun exposure might be used as a marker of health status and, to some extent, biological age-particularly for women.