Summary Background Leukocyte telomere length (LTL) is associated with obesity and obesity‐related traits, and there are ethnic‐specific determinants of LTL. Objective To evaluate LTL associations with obesity and metabolic parameters in Asian children with early‐onset obesity. Methods Genomic DNA was extracted from peripheral blood leukocytes of a cohort of children with (N = 371) and without obesity (N = 23), and LTL was measured using quantitative PCR (qPCR). Blood plasma was used for metabolic phenotyping. Statistical analysis was performed using SPSS and STATA. Results Children with obesity had shorter LTL (coefficient = −0.683, PAdj = 1.24 × 10−3) as compared to children who were lean. LTL was found to be associated with waist circumference (coefficient = −0.326, PAdj = 0.044) and skin‐fold measures (coefficient between 0.267 and 0.301, PAdj between 4.27 × 10−4 and 7.06 × 10−7) in children with obesity. However, no significant associations were observed between LTL and metabolic parameters, and between LTL and inflammatory cytokines. LTL also did not significantly mediate the risk of non‐alcoholic fatty liver disease (NAFLD) in children with obesity. Conclusions We showed for the first time that Asian children with severe obesity had shorter LTL, and the shortening of LTL was associated with other adiposity measures including waist circumference and skin‐fold measurements.

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