Figure 1. Associations between epigenetic aging measures and COPD in KORA and NAS. Associations were performed independently in KORA and NAS using the adjustment models laid out in Table 2 (including adjustment for baseline epigenetic age in the ΔAAD and ΔEEAD models) and are presented per 5-year change in the epigenetic aging measure. A fixed effect meta-analysis was used to combine results across cohorts. Only ΔEEAD is considered to have replicated as it had association with P < 0.05 in the discovery cohort (KORA) and in the replication cohort (NAS). For all epigenetic aging measures we consistently observe a 1-2% increase in the odds of COPD per 5-year change (elevation) in epigenetic aging. AAD = age acceleration difference; ΔAAD = change in age acceleration difference; EEAD = extrinsic epigenetic age acceleration difference; ΔEEAD = change in extrinsic epigenetic age acceleration difference; FE = Fixed effect.