PFLPhysiological Fitness Landscape

Biomarkers: every measure with a risk of death curve

146 biomarkers have a curve from published studies, and 102 are catalogued without one yet. 57 also have our own fit in NHANES. For 34 of the 40 we could check, we found the same pattern (evidence).

Search all biomarkers

Each row is one biomarker. Shape shows the risk curve (a rising line means higher is worse, a U means both ends are worse) and the direction of the published pattern; the NHANES figure is the hazard ratio per standard deviation, adjusted for age and sex (1.30 = 30% higher risk of death per SD above average).
BiomarkerCategoryShapeNHANES HR per SDIn NHANESInterventions
3-Nitrotyrosine (3-NT)Oxidative StressNo
4-Hydroxynonenal (4-HNE)Oxidative StressNo
8-Hydroxy-2'-deoxyguanosine (8-OHdG)Oxidative StressNo3
Abdominal Aortic Calcification (AAC)Cardiac & HemodynamicsLower betterNo
Absolute Lymphocyte CountHematologyBoth ends worse0.96Yes2
Absolute Neutrophil CountHematologyLower better1.24Yes1
AdiponectinVitamins & EndocrineLower betterNo3
Alanine Aminotransferase (ALT)Liver & NutritionalHigher better0.90Yes8
Albumin-Adjusted Anion GapElectrolytes & MineralsLower betterNo
Albumin:Globulin Ratio (A/G)Liver & NutritionalHigher better0.76Yes
Alkaline Phosphatase (ALP)Liver & NutritionalLower better1.25Yes7
Alpha-1-Antichymotrypsin (AACT)InflammationLower betterNo1
Alpha-1-Antitrypsin (AAT)InflammationLower betterNo1
Alpha-1-MicroglobulinRenal & PurineLower betterNo2
Alpha-KlothoAging & SenescenceBoth ends worseNo2
Angiopoietin-2CoagulationLower betterNo2
Ankle-Brachial Index (ABI)Cardiac & HemodynamicsBoth ends worseNo1
Antinuclear Antibodies (ANA)InflammationNot clearNo
Apolipoprotein A1 (ApoA1)Lipids & ApolipoproteinsBoth ends worseNo5
Apolipoprotein B (ApoB)Lipids & ApolipoproteinsLower better0.95Yes11
Apolipoprotein B to A1 Ratio (ApoB/ApoA1)CardiometabolicLower betterNo1
Appendicular Lean Mass / Sarcopenia IndexAnthropometricHigher betterNo2
Aspartate Aminotransferase (AST)Liver & NutritionalNot clear1.06Yes8
Asymmetric Dimethylarginine (ADMA)CardiometabolicLower betterNo3
Basal Metabolic RateAnthropometricBoth ends worseNo2
Basophil CountHematologyNo
Beta-2 MicroglobulinRenal & PurineLower betterNo1
Beta-Trace Protein (BTP)Renal & PurineLower betterNo
Blood LeadElectrolytes & MineralsLower betterNo2
Blood Urea Nitrogen (BUN)Renal & PurineLower better1.18Yes4
Body Fat PercentageAnthropometricBoth ends worseNo8
Body Mass Index (BMI)AnthropometricBoth ends worse1.03Yes9
Body WeightAnthropometricBoth ends worse1.03Yes10
Bone Mineral Density T-score (DXA)Bone & MineralHigher betterNo1
Broadband Ultrasound Attenuation (Heel)Bone & MineralHigher betterNo8
C-Terminal Telopeptide of Type I Collagen (CTX)Bone & MineralLower betterNo1
C-peptideVitamins & EndocrineLower betterNo2
CD4:CD8 T-Cell RatioInflammationHigher betterNo1
CD8+ T-Cell CountInflammationBoth ends worseNo
Calf CircumferenceAnthropometricHigher betterNo1
Cardiac (Valvular/Annular) CalcificationCardiac & HemodynamicsLower betterNo1
Cardiorespiratory Fitness (VO2 Max)Functional FitnessHigher betterNo8
Carotid Intima-Media Thickness (CIMT)Cardiac & HemodynamicsLower betterNo2
Carotid-Femoral Pulse Wave Velocity (PWV)Cardiac & HemodynamicsLower betterNo9
Chronotropic IndexFunctional FitnessHigher betterNo
Coagulation Factor VIIICoagulationLower betterNo
Coagulation Factor VIIcCoagulationLower betterNo4
CopeptinCardiac & HemodynamicsLower betterNo7
Coronary Artery Calcium Score (Agatston)Cardiac & HemodynamicsLower betterNo3
Corrected QT Interval (QTc)Cardiac & HemodynamicsBoth ends worseNo9
D-dimerCoagulationNo1
DNA Methylation Age Acceleration (PhenoAge/GrimAge)Aging & SenescenceLower betterNo1
Daily Movement (Wrist Accelerometer, MIMS)Functional FitnessHigher better0.55Yes
Daily Step CountFunctional FitnessHigher betterNo4
De Ritis Ratio (AST/ALT)Liver & NutritionalLower better1.24Yes1
Dehydroepiandrosterone Sulfate (DHEA-S)Vitamins & EndocrineBoth ends worseNo2
Diastolic Blood Pressure (DBP)Cardiac & HemodynamicsBoth ends worse0.96Yes8
Eosinophil CountHematologyLower better1.04Yes3
Erythrocyte Sedimentation Rate (ESR)InflammationLower betterNo7
Estimated Glomerular Filtration Rate (eGFR)Renal & PurineHigher better0.76Yes9
Estradiol (17beta-Estradiol)EndocrineLower betterNo
Estradiol-to-SHBG RatioVitamins & EndocrineNo2
Exercise Capacity (METs)Functional FitnessHigher betterNo1
Extracoronary Calcification Site CountCardiac & HemodynamicsNo
FEV1/FEV6 RatioFunctional FitnessHigher betterNo
FIB-4 Index (NAFLD Fibrosis Score)Liver & NutritionalLower betterNo1
Fasting Plasma GlucoseGlycemic & MetabolicBoth ends worse1.18Yes12
Fasting Serum InsulinGlycemic & MetabolicNot clear1.06Yes5
Fat MassAnthropometricBoth ends worseNo8
Fat-Free MassAnthropometricHigher betterNo4
FibrinogenInflammationLower betterNo6
Follicle-Stimulating Hormone (FSH)EndocrineNo3
Forced Expiratory Volume in 1 Second (FEV1)Functional FitnessHigher betterNo3
Forced Vital Capacity (FVC)Functional FitnessHigher betterNo5
Free Triiodothyronine (Free T3)Vitamins & EndocrineHigher betterNo2
Gait SpeedAnthropometricHigher betterNo4
Galectin-3Cardiac & HemodynamicsLower betterNo
Gamma-Glutamyl Transferase (GGT)Liver & NutritionalLower better1.26Yes7
Glycated Hemoglobin (HbA1c)Glycemic & MetabolicBoth ends worse1.18Yes12
Growth Differentiation Factor-15 (GDF-15)InflammationLower betterNo2
Growth Hormone (GH)EndocrineLower betterNo2
HDL CholesterolLipids & ApolipoproteinsBoth ends worse0.95Yes9
Heart Rate Recovery (1 min)Functional FitnessHigher betterNo4
Heart Rate Variability (SDNN)AutonomicHigher betterNo
Heart-Type Fatty Acid-Binding Protein (H-FABP)Cardiac & HemodynamicsLower betterNo
HematocritHematologyNo4
Hemoglobin ConcentrationHematologyBoth ends worse0.80Yes8
High-Sensitivity C-Reactive Protein (hs-CRP)InflammationLower better1.30Yes11
High-Sensitivity Cardiac Troponin I (hs-cTnI)Cardiac & HemodynamicsLower betterNo5
High-Sensitivity Cardiac Troponin T (hs-cTnT)Cardiac & HemodynamicsLower betterNo4
Hip CircumferenceAnthropometricHigher betterNo4
Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)Glycemic & MetabolicLower better1.11Yes10
HomoarginineCardiometabolicHigher betterNo2
HomocysteineMetabolicLower betterNo3
Immature Reticulocyte FractionHematologyNo
Immunoglobulin A (IgA)InflammationLower betterNo
Immunoglobulin G (IgG)InflammationNot clearNo1
Immunoglobulin M (IgM)InflammationNot clearNo1
Insulin-like Growth Factor 1 (IGF-1)Vitamins & EndocrineBoth ends worseNo4
Interleukin-1 beta (IL-1b)InflammationLower betterNo2
Interleukin-10 (IL-10)InflammationNo1
Interleukin-18 (IL-18)InflammationLower betterNo
Interleukin-6 (IL-6)InflammationLower betterNo4
Interleukin-8 (IL-8)InflammationLower betterNo2
Interventricular Septum ThicknessCardiac & HemodynamicsLower betterNo4
Kidney Injury Molecule-1 (KIM-1)Renal & PurineLower betterNo1
LDL CholesterolLipids & ApolipoproteinsBoth ends worse0.89Yes11
Left Ventricular Diastolic Dysfunction GradeCardiac & HemodynamicsLower betterNo
Left Ventricular Ejection Fraction (LVEF)Cardiac & HemodynamicsHigher betterNo4
Left Ventricular Global Longitudinal Strain (GLS)Cardiac & HemodynamicsLower betterNo3
Leukocyte Telomere LengthAging & SenescenceHigher betterNo1
Lipid Accumulation Product (LAP)CardiometabolicLower betterNo
Lipoprotein(a) [Lp(a)]Lipids & ApolipoproteinsLower betterNo12
Lipoprotein-Associated Phospholipase A2 (Lp-PLA2)CardiometabolicLower betterNo2
Lymphocyte PercentageHematologyHigher better0.82Yes
Lymphocyte-to-Monocyte Ratio (LMR)InflammationHigher betterNo
Malondialdehyde (MDA)Oxidative StressNo1
Maximal Grip StrengthFunctional FitnessHigher better0.47Yes7
Mean Arterial PressureCardiac & HemodynamicsNot clear1.01Yes4
Mean Corpuscular Volume (MCV)HematologyBoth ends worse1.06Yes1
Mean Platelet Volume (MPV)HematologyHigher betterNo
Mean Reticulocyte VolumeHematologyNo
Mean Sphered Cell VolumeHematologyNo
Metabolic Syndrome (Harmonized Definition)CardiometabolicLower betterNo
Mid-Regional Pro-Adrenomedullin (MR-proADM)Cardiac & HemodynamicsLower betterNo2
Mid-Upper-Arm CircumferenceAnthropometricHigher betterNo3
Mitochondrial DNA Copy NumberAging & SenescenceHigher betterNo
Monocyte Chemoattractant Protein-1 (MCP-1 / CCL2)InflammationBoth ends worseNo
Monocyte CountHematologyLower betterNo
Monocyte PercentageHematologyLower better1.00Yes
Myeloperoxidase (MPO)InflammationLower betterNo1
N-Terminal Pro-B-Type Natriuretic Peptide (NT-proBNP)Cardiac & HemodynamicsLower betterNo8
NeopterinInflammationLower betterNo3
Neurofilament Light Chain (NfL)NeuroLower betterNo2
Neutrophil Gelatinase-Associated Lipocalin (NGAL)Renal & PurineLower betterNo3
Neutrophil PercentageHematologyLower better1.19Yes
Neutrophil-to-Lymphocyte Ratio (NLR)InflammationLower better1.22Yes6
Non-HDL CholesterolCardiometabolicBoth ends worse0.93Yes6
Orthostatic Blood Pressure DropAutonomicLower betterNo
OsteocalcinBone & MineralBoth ends worseNo3
Osteoprotegerin (OPG)Bone & MineralLower betterNo
PR IntervalCardiac & HemodynamicsLower betterNo3
Parathyroid Hormone (PTH)Bone & MineralLower betterNo6
Peak Expiratory Flow (PEF)Functional FitnessHigher betterNo4
Pentraxin-3 (PTX3)InflammationLower betterNo
Pericardial Fat VolumeCardiac & HemodynamicsLower betterNo1
Peroxiredoxin-4 (PRDX4)Oxidative StressLower betterNo
Plasma ViscosityCoagulationLower betterNo3
Plasminogen Activator Inhibitor-1 (PAI-1)CoagulationNo3
Platelet CountHematologyBoth ends worse0.99Yes3
Platelet Distribution WidthHematologyLower betterNo1
Plateletcrit (PCT)HematologyLower betterNo
Predicted Mass (UKB Impedance)AnthropometricNo
ProcalcitoninInflammationLower betterNo
ProinsulinGlycemic & MetabolicLower betterNo1
ProlactinEndocrineLower betterNo3
Protein carbonylsOxidative StressNo1
Proteinuria (Dipstick)Urine BiomarkersLower betterNo
Pulse PressureCardiac & HemodynamicsLower better1.11Yes3
QRS DurationCardiac & HemodynamicsLower betterNo2
QRS-T AngleCardiac & HemodynamicsLower betterNo
QT IntervalCardiac & HemodynamicsBoth ends worseNo4
Red Blood Cell CountHematologyBoth ends worse0.83Yes1
Red Cell Distribution Width (RDW)HematologyLower better1.40Yes5
Remnant CholesterolLipids & ApolipoproteinsLower betterNo3
Renal Artery CalcificationRenal & PurineLower betterNo
Resting Heart Rate (RHR)Cardiac & HemodynamicsLower better1.21Yes6
Reticulocyte Count (Absolute)HematologyNo1
Reticulocyte PercentageHematologyNo3
Rheumatoid FactorInflammationLower betterNo
ST2 Soluble (sST2)Cardiac & HemodynamicsLower betterNo1
Serum 25-Hydroxyvitamin DVitamins & EndocrineHigher better0.84Yes9
Serum AlbuminLiver & NutritionalHigher better0.72Yes7
Serum BicarbonateElectrolytes & MineralsHigher betterNo5
Serum CalciumElectrolytes & MineralsBoth ends worse0.95Yes5
Serum ChlorideElectrolytes & MineralsHigher betterNo5
Serum CitrateMetabolicLower betterNo
Serum CortisolVitamins & EndocrineNot clearNo1
Serum CotinineNutritionalLower better1.41Yes2
Serum CreatinineRenal & PurineBoth ends worse1.25Yes9
Serum Cystatin CRenal & PurineLower betterNo5
Serum FerritinInflammationLower better1.09Yes8
Serum FolateVitamins & EndocrineHigher betterNo5
Serum IronHematologyBoth ends worse0.88Yes1
Serum LeptinEndocrineNot clearNo1
Serum Lutein + ZeaxanthinNutritionalHigher betterNo1
Serum LycopeneNutritionalHigher betterNo1
Serum MagnesiumElectrolytes & MineralsHigher betterNo3
Serum PhosphateElectrolytes & MineralsLower better1.09Yes5
Serum PotassiumElectrolytes & MineralsBoth ends worse1.11Yes5
Serum SeleniumElectrolytes & MineralsHigher betterNo
Serum SodiumElectrolytes & MineralsBoth ends worse0.91Yes4
Serum Total BilirubinLiver & NutritionalHigher better0.92Yes5
Serum TriglyceridesLipids & ApolipoproteinsLower better1.06Yes11
Serum Uric AcidRenal & PurineBoth ends worse1.16Yes8
Serum Vitamin A (Retinol)NutritionalBoth ends worseNo3
Serum Vitamin C (Ascorbic Acid)NutritionalHigher betterNo4
Serum ZincElectrolytes & MineralsHigher betterNo4
Serum beta-CryptoxanthinNutritionalNot clearNo2
Serum trans-LycopeneNutritionalHigher betterNo2
Side-Step Test ScoreFunctional FitnessNo
Sit-Up Count (Timed)Functional FitnessHigher betterNo
Sitting Height (Rump-to-Crown)AnthropometricNo
Skeletal Muscle Fat InfiltrationAnthropometricLower betterNo
Skinfold ThicknessAnthropometricHigher betterNo1
Soluble CD14 (sCD14)InflammationLower betterNo4
Soluble CD163 (sCD163)InflammationLower betterNo1
Soluble ICAM-1 (sICAM-1)CoagulationLower betterNo
Soluble Tumor Necrosis Factor Receptor 1 (sTNFR1)InflammationLower betterNo1
Soluble Urokinase Plasminogen Activator Receptor (suPAR)InflammationLower betterNo
Standing HeightAnthropometricHigher better1.01Yes3
Stromal Cell-Derived Factor-1 (SDF-1/CXCL12)InflammationLower betterNo1
Symmetric Dimethylarginine (SDMA)Renal & PurineLower betterNo1
Systolic Blood Pressure (SBP)Cardiac & HemodynamicsBoth ends worse1.08Yes10
Testosterone-to-SHBG RatioVitamins & EndocrineHigher betterNo
Thoracic Aorta Calcification (TAC)Cardiac & HemodynamicsLower betterNo
Thyroid-Stimulating Hormone (TSH)Vitamins & EndocrineBoth ends worseNo1
Thyroxine (Total T4)EndocrineNo1
Total Body Water MassAnthropometricNo2
Total CholesterolLipids & ApolipoproteinsBoth ends worse0.91Yes8
Total Plasma ThiolsOxidative StressHigher betterNo2
Total ProteinLiver & NutritionalHigher betterNo
Total T-Cell CountInflammationNo
Total TestosteroneVitamins & EndocrineHigher betterNo2
Total thiol levelsOxidative StressNo
Transferrin SaturationHematologyLower betterNo2
Trefoil Factor 3 (TFF3)InflammationLower betterNo
Trimethylamine N-oxide (TMAO)CardiometabolicLower betterNo2
Tumor Necrosis Factor-alpha (TNF-alpha)InflammationNot clearNo3
Urinary 8-oxoGuoOxidative StressNo3
Urinary Creatinine ConcentrationUrine BiomarkersNo3
Urinary F2-isoprostanes (8-iso-PGF2α)Oxidative StressNo2
Urinary Flow RateUrine BiomarkersHigher betterNo3
Urine Albumin-to-Creatinine Ratio (uACR)Urine BiomarkersLower better1.40Yes8
Urine Specific GravityUrine BiomarkersNo8
Vertical Jump HeightFunctional FitnessNo4
Visceral Fat MassAnthropometricLower betterNo3
Vitamin B12 (Cobalamin)Vitamins & EndocrineBoth ends worseNo2
Vitamin E (Alpha-Tocopherol)Vitamins & EndocrineNo1
Waist CircumferenceAnthropometricLower better1.09Yes5
Waist-to-Height Ratio (WHtR)AnthropometricLower better1.09Yes1
Waist-to-Hip RatioAnthropometricLower betterNo1
Waist-to-Thigh RatioAnthropometricLower betterNo
White Blood Cell Count (WBC)HematologyLower better1.20Yes5
YKL-40 (CHI3L1)InflammationNo1
d-ROMs (reactive oxygen metabolites)Oxidative StressNo
d-ROMs / total thiol ratioOxidative StressNo
von Willebrand Factor (vWF)CoagulationLower betterNo

By body system

Physical capacities and tissue measures, grouped as on the retired capacities pages. Linked names have their own page.

Musculoskeletal

  • Muscle mass · Appendicular lean mass (DXA)
  • Muscle strength · Hand-grip strength
  • Muscle power · Leg-extensor power / chair-rise time
  • Muscle quality · Intramuscular fat / specific force
  • Bone density · Areal BMD (hip, spine)
  • Flexibility · Sit-and-reach / joint range of motion
  • Trabecular bone quality · Trabecular bone score / HR-pQCT microarchitecture

Muscle and nerve physiology

  • Type II fibre size · Type II muscle fibre cross-sectional area (biopsy)
  • Type I fibre size · Type I muscle fibre cross-sectional area (biopsy)
  • Motor unit number · Motor unit number estimate / firing rate
  • Muscle cross-sectional area · Quadriceps anatomical cross-sectional area / muscle thickness
  • Muscle oxidative capacity · 31P-MRS phosphocreatine recovery / mitochondrial respiration
  • Capillary density · Capillaries per fibre / capillary density (biopsy)
  • Voluntary activation · Central activation ratio / voluntary activation
  • Rate of force development · Isometric rate of force development
  • Tendon stiffness · Tendon stiffness / Young modulus
  • Knee-extensor torque · Isometric/isokinetic knee-extensor torque
  • Nerve conduction velocity · Motor/sensory nerve conduction velocity

Cardiorespiratory

  • Aerobic capacity · VO2max
  • Lung function · FEV1
  • Arterial stiffness · Carotid-femoral pulse wave velocity
  • Heart-rate recovery · HR drop at 1 min post-exercise
  • Forced vital capacity · FVC
  • Diffusing capacity · DLCO
  • Respiratory muscle strength · Maximal inspiratory pressure
  • Lactate / ventilatory threshold · Lactate threshold, % of VO2max

Cardiac structure and function

  • Left-ventricular ejection fraction · LVEF (echo / MRI)
  • Global longitudinal strain · LV global longitudinal strain
  • Left-ventricular mass · LV mass index
  • Diastolic function · Mitral E/e ratio / e velocity
  • Left-atrial volume · Indexed left-atrial volume
  • Stroke volume and cardiac output · Stroke volume / cardiac index
  • Maximal heart rate · Peak heart rate on exercise test

Vascular

Autonomic

  • Vagal tone · HRV RMSSD / high-frequency power
  • Baroreflex sensitivity · Baroreflex sensitivity
  • Orthostatic tolerance · Orthostatic BP drop

Brain structure

  • Hippocampal volume · Hippocampal volume (MRI)
  • Brain volume · Whole-brain volume / atrophy rate
  • White-matter hyperintensities · WMH volume
  • Cortical thickness · Mean cortical thickness (MRI)
  • Retinal nerve-fibre layer · RNFL thickness (OCT)

Sensory

  • Visual acuity · Best-corrected acuity (logMAR)
  • Contrast sensitivity · Pelli-Robson / log contrast sensitivity
  • Hearing · Pure-tone average threshold
  • Olfaction · Odor identification score (UPSIT / Sniffin' Sticks)
  • Proprioception · Joint position sense error
  • Vibration / touch · Vibration perception threshold

Cognitive

  • Processing speed · Digit-symbol substitution / simple reaction time
  • Working memory · Digit span / n-back
  • Episodic memory · Word-list delayed recall
  • Executive function · Trail Making B / Stroop
  • Learning · Learning rate / motor skill acquisition
  • Verbal fluency · Category fluency (animals, 60 s)

Emotional

  • Emotional stability · Affect variability / neuroticism
  • Stress reactivity · Cortisol / HR response to acute stressor
  • Resilience · Resilience scale (CD-RISC, BRS)
  • Depressive symptoms · PHQ-9 / CES-D

Motor performance

  • Gait speed · Usual gait speed
  • Balance · Single-leg stance / postural sway
  • Fine motor control · Purdue pegboard / finger tapping
  • Dual-task performance · Dual-task cost of gait
  • Endurance · 6-minute walk distance

Sleep and recovery

  • Sleep efficiency · Polysomnographic sleep efficiency / slow-wave sleep

Immune

  • Vaccine response · Seroconversion / antibody titre

Metabolic

  • Resting metabolic rate · Resting energy expenditure
  • Thermoregulation · Sweat rate / core-temperature rise in heat

Body composition and tissue

  • Visceral fat · Visceral adipose tissue (MRI/CT/DXA)
  • Liver fat · Hepatic fat fraction (MRI-PDFF / MRS)
  • Skin autofluorescence · Skin autofluorescence (AGE reader)

Submit a curve

Know a published study linking a biomarker to risk of death that we are missing, or a better one? Send it and we will review it for the catalogue.

See Privacy for how submissions are handled.