基于衰老生物学标志物的生理心理社会三维健康人体衰老度指标体系构建和衰老度综合评价研究

The assessment of human body aging comprehensively and scientifically had become an urgent demand in establishing the judgment standard of aging degree and judging anti-aging measures specifically. Studies indicated that there was complex correlation between senescence and these factors including physiology, psychology, society and so on.Currently, there was no ideal and recognized method to evaluate aging degree comprehensively. Domestic and foreign scholars showed great identification to the view that telomere length was closely related to aging, but using telomere length to test human aging degree cost much and operated complexly, so it didn't apply to a large sample population .In this project, the peripheral blood leukocyte telomere length which is selected as the basis of body's aging degree will be measured by Southern Blot. Human body aging degree entries are screened from three dimensions from physiology, psychology, society and assessed qualitatively by Delphi method. The weight of each dimension is ascertained by the method of analytic hierarchy process and then the aging degree indicator system in three-dimension of physiology-psychology-society is built through the field epidemiological studies, et al. At last the "Three-Dimension Scale of Individual Aging Degree" and "Tool Table of the Individual Natural Aging Judgment" are formulated. In a word, the relationship will be first clarified between the aging biological biomarkers (telomere length) and scores of the aging degree scale; it will reform the traditional aging measuring techniques and methods. Meanwhile, there will be great significant in assessing the quality of life in the population of different chronological age, establishing the judgment standard of natural aging of population in our country, predicting and preventing chronic diseases, evaluating the efficacy of anti-aging measurements.

全面科学地评价人体衰老是建立人体衰老判断标准、有针对性地评判抗衰老措施的迫切要求。研究认为衰老与生理、心理和社会等关系复杂，目前尚无理想的公认的衰老度综合评价方法。国内外学者就端粒长度与衰老关系密切的认同度较高，本项目拟通过Southern Blot法测量外周血白细胞端粒长度做为衰老度依据，从生理心理社会三维度筛选人体衰老条目，采用Delphi法做定性评价、层次分析法确定各维度的权重且经现场流行病学研究等，构建生理心理社会三维衰老指标体系，制订《人体衰老度三维量表》和《人体自然衰老判断工具表》。该工具表较实验室检测端粒长度评价衰老度而言具有简便、经济、综合性强、适用于大面积人群使用的特点。本研究首次阐明衰老生物学标志即端粒长度与衰老度量表得分的关系，将改革传统的衰老度测量方法。它对评估不同时序年龄人群的生命质量、建立我国人口自然衰老判断标准、预测和预防慢病、评价抗衰老措施均有重要意义。

本研究立足于现代人体衰老学，从衰老的复杂性、综合性、多因性出发比较了不同时期、不同学科领域的衰老认知，分析衰老评估方法的不足，提出集生理—心理—社会等多学科知识的人体衰老量表和工具表的构建，并佐证端粒长度随年龄变化的规律。以深化和拓展对人体生命规律与本质的认识，为人们选择与其相适应的生活和工作方式作提供参考，为延缓衰老和慢病防控措施的效果提供评价工具。研究采用文献搜寻、Delphi、层次分析、探索性或验证性因子分析等系列统计学技术与方法，构建三维人体衰老度量表等；采用Q—PCR法检测外周白细胞端粒长度。主要结果：①构建了三维人体衰老度量表，其包括3个维度10个方面51个条目；量表的信度Conbach’s ɑ系数为0.930，重测信度系数为0.856；条目的内容效度指数范围为0.82~1.00，量表的内容效度指数S-CVI/UA=0.82，＞0.80，平均S-CVI/Ave=0.982，＞0.90；结构效度的累积贡献率为59.17%；量表的维度权重（Wi）生理为0.571、心理为0.286、社会为0.143，还分配了二三级权重，对量表的系列技术指标和条目进行科学释义；②提出了20岁以上的10个年龄段人群（3184人）衰老度标准化平均分值和离散趋势，总分值在20~至30~岁段变化平稳，40~至50~岁段上升明显，随后各年龄段呈持续的上升趋势；衰老分值与年龄呈正相关，r为0.785（p<0.01），生理维度r=0.824，心理维度r=0.579，社会维度r=0.548；③制作了两种与量表配套使用的个体化衰老判断分值表，即百分位数法、ROC曲线法衰老度判段分值表；④完成了1022人份端粒检测，显示端粒长度为1.338±0.512，男性为1.311±0.499，女性为1.364±0.523，不同年龄段人群端粒长度差异有显著性（p=0.000），它与年龄呈负相关， r=-0.325（p<0.01），还提示端粒长度显著改变在3个年龄段，即20~岁、30~岁和60岁及以上。研究结论：①构建的量表和工具表通过了国家二级学会认证，该技术具有客观、简单、经济之特点，有广泛的适应性，创新性强；②佐证了端粒长度随年龄增加而缩短，两者呈负相关；③揭示了衰老度分值、端粒长度在不同年龄段的变化特点与规律；④提出了人体衰老测量技术的理论思维和方法。