GlycanAge dynamics and their relationship to SCORE2 risk change over six months: a secondary analysis of a randomized controlled trial

Chronological age dominates cardiovascular (CVD) risk prediction, but glycan-based measures may better reflect biological ageing. In this secondary analysis of a six-month randomized controlled trial in Slovenia, we examined whether IgG glycosylation–derived biological age (GlycanAge) tracked short-term changes in estimated CVD risk. Adults without diagnosed CVD but with at least one risk factor (119 enrolled; 101 completed the final assessment) received digital risk visualization, continuous glucose monitoring, their combination, or usual care. SCORE2 showed small numerical changes in some intervention groups, but GlycanAge remained largely stable, with only modest and inconsistent change across groups, and no association between change in SCORE2 and change in the GlycanAge–chronological age gap was detectable. Over this short timeframe, GlycanAge did not behave as a surrogate of conventional risk modification; whether it instead reflects slower immune-inflammatory ageing processes complementary to established CVD risk algorithms will require longer studies to establish.