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

Objectives: to determine if skin wrinkling in a site that had received limi ted 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 e lderly 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 plas ma dehydroepiandrosterone concentrations. Methods: we derived activities of daily living, well-being, memory, and gen eral health status scores from a crosscultural questionnaire. We measured s kin wrinkling using cutaneous microtopographic methods and plasma dehydroep iandrosterone 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 , ail analyses were controlled for these variables. Plasma dehydroepiandros terone was higher in smokers than non-smokers (2.86 vs 2.08; P<0.001) and m en had significantly higher plasma dehydroepiandrosterone than women (2.74 vs 1.69; P<0.0001). In the pooled data, skin wrinkling was negatively assoc iated with general health score (r(s)=-0.13, P<0.01) and activities of dail y living score (r(s)=-0.14, P<0.05) after controlling for age, body mass in dex 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. Conclusion: skin wrinkling in a site with limited sun exposure might be use d as a marker of health status and, to some extent, biological age-particul arly for women.