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First, we enrolled participants, namely, native highlanders (NHs, Highland Tibetan Chinese), acclimatized newcomers (ANs, Highland Han Chinese), and native lowlanders (NLs, Lowland Han Chinese). Second, we conducted MWAS to investigate DNAm alterations associated with high-altitude STA and LTA. DMSs of long-term adaptation were identified by comparing NHs and ANs. DMSs of short-term acclimatization were identified by comparing ANs and NLs. Third, epigenetic clock analysis was utilized to assess ageing acceleration in the three groups. Eight categories of behavioral and biomedical phenotypes were tested for associations with ageing acceleration in the subjects living in the Tibetan Plateau. Fourth, with the availability of genotype and DNAm data, we performed meQTL analysis and investigated the role of genetic differentiation in driving the LTA DMSs.
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