Elisabeth Steinhagen-Thiessen

• Professor
• Medical Doctor at Charité Universitätsmedizin Berlin

Background Elevated lipoprotein(a) (Lp[a]) is an inherited condition that increases cardiovascular disease (CVD) risk, independent of other factors, such as low-density lipoprotein C. Few attempts have been made to explore the life experiences of people with elevated Lp(a). Objective To explore the experiences of people living with or caring for a...

The current study examined cross-sectional and longitudinal associations between nocturia and frailty in a cohort of men and women aged 60 years and older, as evidence on this topic was lacking. We analyzed baseline and follow-up data (n = 1671) from the Berlin Aging Study II (BASE-II), a prospective longitudinal cohort study focusing on the factor...

Aging is a complex process influenced by mechanisms operating at numerous levels of functioning. Multiple biomarkers of age have been identified, yet we know little about how the different alternative age indicators are intertwined. In the Berlin Aging Study II (nmin= 328; nmax= 1,517, women = 51%; 14.27 years of education), we examined how levels...

Background & Aim The current study examined cross-sectional and longitudinal associations between nocturia and frailty in a cohort of men and women aged 60 years and older, as evidence on this topic was lacking. Methods Baseline and follow-up data from the Berlin Aging Study II (n=1671) assessed on average 7.1 (IQR 6.2-8.7) years apart were analyze...

Nucleic acid-based therapies are being rapidly developed for prevention and management of cardiovascular diseases (CVD). Remarkable advancements have been achieved in the delivery, safety, and effectiveness of these therapeutics in the past decade. These therapies can also modulate therapeutic targets that cannot be sufficiently addressed using tra...

While numerous studies have confirmed a causal association between lipoprotein(a) [Lp(a)] and cardiovascular diseases, only a few studies have assessed the relationship between Lp(a) and pulmonary health, with inconsistent findings regarding this topic. This study’s aim was to examine whether levels of serum Lp(a) are associated with lung function...

Background The microbially generated amino acid-derived metabolite imidazole propionate (ImP) contributes to the pathogenesis of type 2 diabetes. However, the effect of ImP on endothelial cell physiology and its role in atherosclerotic coronary artery disease (CAD) is unknown. Using both human and animal model studies, we investigated the potential...

To check claims of a “loneliness epidemic,” we examined whether current cohorts of older adults report higher levels and/or steeper age-related increases in loneliness than earlier-born peers. Specifically, we used 1,068 age-matched longitudinal reports (Mage observations = 79 years, 49% women) of loneliness provided by independent samples recruite...

Background and Aims High serum thyroid-stimulating hormone (TSH) levels have previously been associated with a low estimated glomerular filtration rate (eGFR), but studies associating thyroid hormone levels with albuminuria revealed inconsistent results. The aim of our study was to investigate associations of serum levels of TSH, fT3 and fT4 with e...

Introduction Biological age reflects inter-individual differences in biological function and capacity beyond chronological age. Biological age can be estimated by DNA methylation age (DNAmA) and its deviation from chronological age, DNAmA acceleration (DNAmAA). Low levels of serum selenium, selenoprotein P (SELENOP), and the selenocysteine-containi...

Introduction Growing evidence suggests a causal role for atherosclerotic vascular disease in cognitive impairment and dementia. Atherosclerosis may present as monovascular disease (monoVD) or as widespread polyvascular atherosclerotic disease (polyVD). Evidence on the relationship between monoVD or polyVD and cognitive impairment is limited. Metho...

Despite intensive preventive cardiovascular disease (CVD) efforts, substantial residual CVD risk remains even for individuals receiving all guideline-recommended interventions. Niacin is an essential micronutrient fortified in food staples, but its role in CVD is not well understood. In this study, untargeted metabolomics analysis of fasting plasma...

Background and aims Previous studies have shown that lipoprotein apheresis can modify the plasma lipidome and pro-inflammatory and pro-thrombotic lipid mediators. This has not been examined for treatment with protein convertase subtilisin/kexin type 9 inhibitors such as evolocumab, which are increasingly used instead of lipoprotein apheresis in tre...

OBJECTIVE Determining the cause of severe insulin resistance and early-onset diabetes in the case of a young woman in which a wide range of differential diagnoses did not apply. RESEARCH DESIGN AND METHODS Diagnostic workup including medical history, physical examination, specialist consultations, imaging methods, laboratory assessment, and geneti...

Introduction: Growing evidence suggests a causal role for atherosclerotic vascular disease in cognitive impairment and dementia. Atherosclerosis may present as monovascular disease (monoVD) or as widespread polyvascular atherosclerotic disease polyVD). Evidence on the relationship between monoVD or polyVD and cognitive impairment is limited. Method...

Aging is a complex process influenced by mechanisms operating at numerous levels of functioning. Multiple biomarkers of age have been identified, yet we know little about how the different alternative age indicators are intertwined. In the Berlin Aging Study II, we examined how levels and seven-year changes in indicators derived from blood assays,...

High serum thyroid-stimulating hormone (TSH) levels have previously been associated with a low estimated glomerular filtration rate (eGFR), but studies associating thyroid hormone levels with albuminuria revealed inconsistent results. We used cross-sectional data from 7933 individuals aged 20 to 93 years of the Berlin Aging Study II and the Study o...

Aims: Precision microbiome modulation as a novel treatment strategy is a rapidly evolving and sought goal. The aim of this study is to determine relationships among systemic gut microbial metabolite levels and incident cardiovascular disease risks to identify gut microbial pathways as possible targets for personalized therapeutic interventions. M...

Background and aims: Familial hypercholesterolemia (FH) is among the most common genetic disorders in primary care. However, only 15% or less of patients are diagnosed, and few achieve the goals for low-density lipoprotein cholesterol (LDL-C). In this analysis of the German Cascade Screening and Registry for High Cholesterol (CaRe High), we examin...

Nutritional interventions in healthy individuals may be particularly informative if high, but not excessive, amounts of specific healthy foods are taken to maximize effects without sacrificing safety. We hypothesized that high amounts of polyphenols taken on single days may eliminate senescent blood cells. We conducted a ten-week parallel-group con...

Aim: Aim of the current study was to describe the prevalence, incidence, and severity of T2D in a cohort of older men and women aged 60 years and above over the course of on average seven years, since longitudinal data on this topic are scarce for this age group in Germany. Methods: Baseline data of 1,671 participants of the Berlin Aging Study I...

Artificial sweeteners are widely used sugar substitutes, but little is known about their long-term effects on cardiometabolic disease risks. Here we examined the commonly used sugar substitute erythritol and atherothrombotic disease risk. In initial untargeted metabolomics studies in patients undergoing cardiac risk assessment (n = 1,157; discovery...

Phytosterols (PSs) have been proposed as dietary means to lower plasma LDL-C. However, concerns are raised that PSs may exert atherogenic effects, which would offset this benefit. Phytosterolemia was thought to mimic increased plasma PSs observed after the consumption of PS-enriched foods. This expert statement examines the possibility of specific...

Background: Lipoprotein(a) [Lp(a)] has recently been gaining increasing interest, with numerous studies pointing to a causal relationship with cardiovascular disease, coronary heart disease, as well as aortic valve stenosis. However, so far only a few studies have assessed the association between Lp(a) and pulmonary health and there have been some...

Recent studies published by our group1–4 showed that low cardiorespiratory1,2,4 and muscular fitness,³ usually related to decreased physical activity levels, were significantly associated with a smaller and stiffer heart, which we have called ‘the sedentary’s heart’. We believe that the mechanisms involved in this atrophic process might have been p...

Domains of social privilege are predictive of a number of key aging outcomes, such as physical and cognitive functioning. However, less is known about the dynamic interplay of - related but distinct- domains of privilege and how they are associated with cognitive and physical functioning. In the following project, we aim to close this gap by examin...

Background Although an inverse association between type II diabetes mellitus and Lipoprotein (a) [LP(a)] has already been well researched, there is sparse data on the association between metabolic syndrome (MetS) with Lp(a). MetS is highly prevalent in older people and insulin resistance in MetS might link Lp(a) with MetS. Thus, we analyzed the ass...

Metabolic syndrome (MetS) refers to risk factors for cardiovascular disease associated with reduced physical fitness, higher disease burden, and impaired cognitive functions. Available evidence indicates that metabolic functioning is related to brain structure at the level of specific indicators, such as hypertension and voxel-based morphometry, re...

Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular disease associated with reduced physical fitness, higher disease burden, and impaired cognitive functions in late life. Thus investigating antecedents, outcomes and correlates of metabolic health is a priority in order to promote healthier lifestyles and successful aging. Thi...

High-quality biomarkers are needed to predict age-related phenotypes and evaluate health-related interventions. Telomere length has been known as a biomarker of aging for some time, however, its potential for clinical use is limited. Epigenetic age estimators and biological age (bioage) composites have been developed and refined over the past decad...

Age-related elevations in inflammation are associated with both neurodegeneration and increased frailty in older adults. Here we used state-of-the-art diffusion-MRI (dMRI) methods to examine how specific markers of white matter (WM), including fiber density [FD], fiber cross-section [FC], and extracellular cerebral spinal fluid [CSF] are linked to...

The diagnosis of metabolic syndrome (MetS) relies on cut-off values for five cardiovascular risk factors, three of which must be met to make the diagnosis. While this approach has certain advantages in the clinical setting, it only allows a binary classification relying on cut-off values. Thus, individuals receiving the same MetS diagnosis may diff...

Background: The gut microbiota-dependent metabolite phenylacetylgutamine (PAGln) is both associated with atherothrombotic heart disease in humans, and mechanistically linked to cardiovascular disease pathogenesis in animal models via modulation of adrenergic receptor signaling. Methods: Here we examined both clinical and mechanistic relationship...

Background Although potent lipid-lowering therapies are available, patients commonly fall short of recommended low-density lipoprotein cholesterol (LDL-C) levels. The aim of this study was to examine the relationship between familial hypercholesterolemia (FH) and elevated lipoprotein(a) [Lp(a)] and LDL-C goal attainment, as well as the prevalence a...

Biomarkers defining biological age are typically laborious or expensive to assess. Instead, in the current study, we identified parameters based on standard laboratory blood tests across metabolic, cardiovascular, inflammatory, and kidney functioning that had been assessed in the Berlin Aging Study (BASE) (n = 384) and Berlin Aging Study II (BASE-I...

Aim: The PERI-DYS study aims to characterize two groups of patients with dyslipidaemia at very high CV risk: PCSK9i receivers and patients qualifying for but not receiving PCSK9i. Methods: This is an observational study by office-based and clinic-based physicians, mainly cardiologists and other internists in Germany, with data extracted from pat...

History-graded increases in older adults’ levels of cognitive performance are well documented, but little is known about historical shifts in within-person change: cognitive decline and onset of decline. We combined harmonized perceptual-motor speed data from independent samples recruited in 1990 and 2010 to age-match 2,008 longitudinal observation...

From a biological perspective, humans differ in the speed they age, and this may manifest in both mental and physical health disparities. The discrepancy between an individual’s biological and chronological age of the brain (“brain age gap”) can be assessed by applying machine learning techniques to Magnetic Resonance Imaging (MRI) data. Here, we e...

Introduction: There is evidence of an association between markers of cardiac injury and cognition in patients with cardiovascular disease. We hypothesized that levels of high-sensitivity cardiac troponin T (hs-cTnT) are associated with cognitive performance and cognitive decline in a population of predominantly healthy older adults. Methods: We...

Background: An inverse association between lipoprotein(a) (Lp[a]) and type 2 diabetes mellitus is well documented. However, data on the association of the metabolic syndrome (MetS) with Lp(a) are sparse. Methods: Cross-sectional data for MetS and Lp(a) were available for 5743 BASE-II and SHIP-0 participants (48.7% men; age 58 [20-85]|years) (BAS...

Background and aims Elevated concentrations of Lipoprotein (a) [Lp(a)] is an inherited, causal risk factor for atherosclerotic cardiovascular disease (ASCVD). This study aims to investigate the clinical utility for patients, and the economic benefit to healthcare systems and society of measuring Lp(a) concentrations more widely today. Methods We c...

Objective: Thyroid dysfunction is associated with relevant disturbances in glucose metabolism. Moreover, thyroid function undergoes important changes with aging. The objective of this study was to investigate the association of thyroid function with insulin resistance with particular consideration of possible age-related effect modifications. Desig...

Beside their beneficial effects on cardiovascular events, statins are thought to contribute to insulin resistance and type-2 diabetes. It is not known whether these effects are long-term events from statin-treatment or already triggered with the first statin-intake. Skeletal muscle is considered the main site for insulin-stimulated glucose uptake a...

Biomarkers defining biological age are typically laborious or expensive to assess. Instead, in the current study, we identified parameters based on standard laboratory blood tests across metabolic, cardiovascular, inflammatory, and kidney functioning that had been assessed in the Berlin Aging Study (BASE; n = 384) and Berlin Aging Study II (BASE-II...

Background: Inflammatory processes are a cause of accelerated loss of muscle mass. Metabolic syndrome (MetS) is a highly prevalent age-related condition, which may promote and be promoted by inflammation. However, whether inflammation in MetS (metaflammation) is associated with lower muscle mass is still unclear. Methods: Complete cross-sectiona...

Aim: To describe the prevalence, incidence, and severity of diabetes mellitus type 2 (T2D) and antidiabetic medication in older people and to assess the prognostic value of diagnostic laboratory parameters. Methods: Baseline data of 1,671 participants of the Berlin Aging Study II (68.8 ±3.7 years) and follow-up data assessed 7.4 ±1.5 years later we...

Aim: To describe the prevalence, incidence, and severity of diabetes mellitus type 2 (T2D) and antidiabetic medication in older people and to assess the prognostic value of diagnostic laboratory parameters. Methods: Baseline data of 1,671 participants of the Berlin Aging Study II (68.8 ±3.7 years) and follow-up data assessed 7.4 ±1.5 years later we...

Background/Aims The ability to climb stairs is an important prerequisite for activities of daily living and social participation in older adults, and is therefore an important part of rehabilitation. However, there is no consensus on how to measure stair-climbing ability. The aim of this study was to investigate the test–retest reliability of the m...

A large body of empirical evidence has accumulated showing that the experience of old age is "younger," more "agentic," and "happier" than ever before. However, it is not yet known whether historical improvements in well-being, control beliefs, cognitive functioning, and other outcomes generalize to individuals' views on their own aging process. To...

Altered lipid metabolism has been shown to be of major importance in a range of metabolic diseases, with particular importance in cardiovascular disease (CVD). As a key metabolic product, altered lipoprotein(a) (Lp(a)) levels may be associated with adverse clinical outcomes in high-risk cardiovascular patients undergoing cardiac surgery. We aimed t...

Patients undergoing cardiac surgery are at increased cardiovascular risk, which includes altered lipid status. However, data on the effect of cardiac surgery and cardiopulmonary bypass (CPB) on plasma levels of key lipids are scarce. We investigated potential effects of CPB on plasma lipid levels and associations with early postoperative clinical o...

Background The heart has the capacity to adapt to different demands. The pathophysiological mechanisms involved with sedentarism are not fundamentally the opposite of those related with physical activity and regular exercise. We investigated the impact of lower cardiorespiratory fitness (CRF) on heart's plasticity and function in a population-based...

Background: The cardiac muscle has the ability to adapt to different loading conditions. We analyzed the associations of the age-related decreasing handgrip strength (HGS), a marker of muscular fitness, on cardiac structure and function in a community-based sample. Methods: We performed cross-sectional analyses of 4646 subjects (2554 women; 55.0...

Abstract Background Compared to individuals without type 2 diabetes mellitus, the relative increase in cardiovascular mortality is much higher in women than in men in individuals with type 2 diabetes mellitus. Methods We evaluated data from 7443 individuals (3792 women, 50.9%), aged 20 to 81 years, from two independent population-based investigatio...

Aims Lipoprotein (a) [Lp(a)] is a lipoprotein species causatively associated with atherosclerosis. Unlike statins, PCSK9 inhibitors (PCSK9i) reduce Lp(a), but this reduction is highly variable. Levels of Lp(a) are chiefly governed by the size of its signature protein, apolipoprotein (a) [apo(a)]. Whether this parameter determines some of the reduct...

Objectives Perceptions of time are shaped by sociohistorical factors. Specifically, economic growth and modernization often engender a sense of acceleration. Research has primarily focused on one time perception dimension (perceived time pressure) in one subpopulation (working-age adults), but it is not clear whether historical changes extend to ot...

Statins are among the most frequently prescribed drugs in Germany. Their benefits in lowering cardiovascular risk are beyond dispute. Nevertheless, many patients complain of side effects from statin therapy, including statin-associated muscle symptoms (SAMS) in particular. Despite their relative frequency, it is difficult to objectively diagnose th...

Purpose The study ‘Sex- and gender-sensitive prevention of cardiovascular and metabolic disease in older adults in Germany’, the GendAge study, focuses on major risk factors for cardiovascular and metabolic diseases and on the development of major outcomes from intermediate phenotypes in the context of sex and gender differences. It is based on a f...

Background Adequate total and meal-specific protein intake is considered an important prerequisite to preserve appendicular lean mass (ALM) in older adults and to prevent sarcopenia. Objectives We analyzed the meal-specific protein intake across the main meals between participants with normal vs. low ALM to BMI ratio (ALMBMI). Methods 782 partici...

Purpose: Age-related changes affect vitamin D absorption and metabolism. Low 25-hydroxyvitamin D concentrations have been reported as risk factor for the development of metabolic syndrome (MetS). However, recent evaluations suggest this association might be explained by obesity or insulin resistance in subjects with MetS. Our aim was to analyze as...

Aims: Coronary artery disease (CAD) has a strong genetic predisposition. However, despite substantial discoveries made by genome-wide association studies (GWAS), a large proportion of heritability awaits identification. Non-additive genetic-effects might be responsible for part of the unaccounted genetic variance. Here we attempted a proof-of-conc...

Background Volanesorsen is an antisense oligonucleotide that targets hepatic apolipoprotein C-III synthesis and reduces plasma triglyceride concentration. The aim of this study was to explore the safety and efficacy of volanesorsen in patients with multifactorial chylomicronaemia syndrome. Methods The COMPASS trial was a randomised, placebo-contro...

Citation: Fudickar, S.; Kiselev, J.; Stolle, C.; Frenken, T.; Steinhagen-Thiessen, E.; Wegel, S.; Hein, A.

Low handgrip strength and increased arterial stiffness are both associated with poor health outcomes, but evidence on the relationship between handgrip strength and arterial stiffness is limited. In this cross-sectional analysis of combined baseline datasets from the LipidCardio and Berlin Aging Study II cohorts we aimed to examine whether handgrip...

Serum BDNF concentrations in 2053 participants of the Berlin Aging Study II (BASE-II; 1572 individuals from the older age group [60 - 85 years], 481 individuals from the younger-age reference group [22 - 37 years]) were studied. There was no effect of age, sex, body mass index (BMI), self-reported depression, or BDNF Val66Met variant on serum BDNF...

Background Obesity is associated with chronic low-grade inflammation leading to metabolic and cardiovascular diseases, but a subset of obese individuals is considered insulin sensitive (IS). The underlying pathophysiologic mechanisms remain elusive and clinical studies on the relationship between inflammatory markers and metabolically healthy obesi...

Background: Proprotein Convertase Subtilisin/Kexin type 9 inhibitors (PCSK9-I) have been reported to cause a moderate increase in high-density lipoprotein (HDL) cholesterol in human studies. We thus evaluated the effect of two approved PCSK9-I on the concentration and lipid composition of HDL particle subclasses. Subjects and methods: 95 patient...

Autosomal‐dominant familial hypercholesterolemia (FH) is characterized by increased plasma concentrations of low‐density lipoprotein cholesterol (LDL‐C) and a substantial risk to develop cardiovascular disease. Causative mutations in three major genes are known: the LDL receptor gene (LDLR), the apolipoprotein B gene (APOB) and the proprotein conve...

Zusammenfassung Hintergrund Diabetes mellitus Typ 2 (T2DM) und Sarkopenie nehmen mit steigendem Alter in ihrer Prävalenz zu und können langfristig betrachtet jeweils zu erheblichen gesundheitlichen und funktionellen Einschränkungen führen. Während eine zunehmende Insulinresistenz bei abnehmender Muskelmasse plausibel erscheint, sind umgekehrt auch...

Background Obesity is associated with chronic low-grade inflammation leading to metabolic and cardiovascular diseases, but a subset of obese individuals is considered metabolically healthy. The underlying pathophysiologic mechanisms remain elusive and clinical studies on the relationship between inflammatory markers and metabolically healthy obesit...

Background Obesity is associated with chronic low-grade inflammation leading to metabolic and cardiovascular diseases, but a subset of obese individuals is considered insulin sensitive (IS) and metabolically healthy. The underlying pathophysiologic mechanisms remain elusive and clinical studies on the relationship between inflammatory markers and m...

Background Obesity is associated with chronic low-grade inflammation leading to metabolic and cardiovascular diseases, but a subset of obese individuals is considered insulin sensitive (IS). The underlying pathophysiologic mechanisms remain elusive and clinical studies on the relationship between inflammatory markers and metabolically healthy obesi...

It has been suggested that an age-related loss of cognitive function might be driven by atherosclerotic effects associated with altered lipid patterns. However, the relationship between Lipoprotein (a) [Lp(a)] and healthy cognitive aging has not yet been sufficiently investigated. For the current analysis we used the cross-sectional data of 1,380 B...

AimsSeveral the use of proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i) for patients at high/very high cardiovascular risk who are inadequately treated with maximally tolerated lipid-lowering therapies (LLTs).Objectives We assessed the effectiveness and safety of the PCSK9i alirocumab and evolocumab in a single-center clinical prac...

Background: Hyperlipidemias are common and the last decades have seen substantially growing evidence of their causative role in the development of atherosclerosis and subsequent cardiovascular diseases. Since hyperlipidemias usually do not cause direct clinical symptoms, they often remain undiagnosed until a serious cardiovascular event occurs. Es...

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Adequate hydration is essential for health, with even mild forms of dehydration often having negative effects on cognition and well-being. Despite evidence of higher risk for dehydration among older adults, links between dehydration and cognitive or well-being outcomes have not been established in old age. In this study, we used longitudinal data f...

Subjective well-being is often characterized by average stability across old age, but individual differences are substantial and not yet fully understood. This study targets physical and cognitive health and personality as individual difference characteristics and examines their unique and interactive roles for level and change in a number of diffe...

Background: Arterial stiffness is tightly linked to hypertension. Sex differences in hypertension and arterial stiffness have already been established, yet the role of sex hormones is not precisely defined. This study examined age and sex differences of arterial wave reflection and associations with endogenous and exogenous sex hormones in women....

Statin-related muscle side effects are a constant healthcare problem since patient compliance is dependent on side effects. Statins reduce plasma cholesterol levels and can prevent secondary cardiovascular diseases. Although statin-induced muscle damage has been studied, preventive or curative therapies are yet to be reported. We exposed primary hu...

Regular consumption of fruits and vegetables, which is related to high plasma levels of lipid-soluble micronutrients such as carotenoids and tocopherols, is linked to lower incidences of various age-related diseases. Differences in lipid-soluble micronutrient blood concentrations seem to be associated with age. Our retrospective analysis included m...