title: Can skin wrinkling in a site that has received limited sun exposure be used as a marker of health status and biological age?
abstract: OBJECTIVE
  to determine if skin wrinkling in a site that had received limited sun exposure may be a marker of health status and biological age.
  
  
  METHODS
  population-based, cross-sectional study.
  
  
  METHODS
  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 (r(s)=0.27, P<0.0001) and negatively with body mass index (r(s)=-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 (r(s)=-0.13, P<0.01) and activities of daily living score (r(s)=-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 (r(s)=-0.12, P=0.06) after adjusting for age, smoking and sex.
  
  
  CONCLUSIONS
  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.
authors.affiliation: International Health and Development Unit, Faculty of Medicine and Asia Pacific Health and Nutrition Centre, Monash University, Melbourne, Victoria, Australia.
authors.forename: M B
authors.initials: MB
authors.lastname: Purba
authors.forename: A
authors.initials: A
authors.lastname: Kouris-Blazos
authors.forename: N
authors.initials: N
authors.lastname: Wattanapenpaiboon
authors.forename: W
authors.initials: W
authors.lastname: Lukito
authors.forename: E
authors.initials: E
authors.lastname: Rothenberg
authors.forename: B
authors.initials: B
authors.lastname: Steen
authors.forename: M L
authors.initials: ML
authors.lastname: Wahlqvist
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000097:blood / Q000502:physiology*; D003430:Cross-Sectional Studies; D003687:Dehydroepiandrosterone / Q000097:blood; D005260:Female; D015577:Geriatric Assessment; D006304:Health Status; D006801:Humans; D008297:Male; D015595:Skin Aging; D016082:Solar System; D013472:Sunlight; D011795:Surveys and Questionnaires
chemical_list: D003687:Dehydroepiandrosterone