Leukocyte Telomere Length in Relation to 17 Biomarkers of Cardiovascular Disease Risk: A Cross-Sectional Study of US Adults

Abstract

BackgroundLeukocyte telomere length (LTL) is a putative biological marker of immune system age, and there are demonstrated associations between LTL and cardiovascular disease. This may be due in part to the relationship of LTL with other biomarkers associated with cardiovascular disease risk. However, the strength of associations between LTL and adiposity, metabolic, proinflammatory, and cardiovascular biomarkers has not been systematically evaluated in a United States nationally representative population.Methods and FindingsWe examined associations between LTL and 17 cardiovascular biomarkers, including lipoproteins, blood sugar, circulatory pressure, proinflammatory markers, kidney function, and adiposity measures, in adults ages 20 to 84 from the cross-sectional US nationally representative 1999–2002 National Health and Nutrition Examination Survey (NHANES) (n = 7,252), statistically adjusting for immune cell type distributions. We also examine whether these associations differed systematically by age, race/ethnicity, gender, education, and income. We found that a one unit difference in the following biomarkers were associated with kilobase pair differences in LTL: BMI -0.00478 (95% CI -0.00749–-0.00206), waist circumference -0.00211 (95% CI -0.00325–-0.000969), percentage of body fat -0.00516 (95% CI -0.00761–-0.0027), high density lipoprotein (HDL) cholesterol 0.00179 (95% CI 0.000571–0.00301), triglycerides -0.000285 (95% CI -0.000555–-0.0000158), pulse rate -0.00194 (95% CI -0.00317–-0.000705), C-reactive protein -0.0363 (95% CI 0.0601–-0.0124), cystatin C -0.0391 (95% CI -0.0772–-0.00107). When using clinical cut-points we additionally found associations between LTL and insulin resistance -0.0412 (95% CI -0.0685–-0.0139), systolic blood pressure 0.0455 (95% CI 0.00137–0.0897), and diastolic blood pressure -0.0674 (95% CI -0.126–-0.00889). These associations were 10%–15% greater without controlling for leukocyte cell types. There were very few differences in the associations by age, race/ethnicity, gender, education, or income. Our findings are relevant to the relationships between these cardiovascular biomarkers in the general population but not to cardiovascular disease as a clinical outcome.ConclusionsLTL is most strongly associated with adiposity, but is also associated with biomarkers across several physiological systems. LTL may thus be a predictor of cardiovascular disease through its association with multiple risk factors that are physiologically correlated with risk for development of cardiovascular disease. Our results are consistent with LTL being a biomarker of cardiovascular aging through established physiological mechanisms.

Metabolically healthy obese women have longer telomere length than obese women with metabolic syndrome

“…In addition, Njajou et al [36] published similar findings, where a seven years follow up was associated with smaller increases in BMI and body fat in those individuals who presented longer TL. Rehkopf et al [37] in a large nationally representative U.S. sample did not find an association between MetS and shorter TL. They did not report the prevalence of MetS in their population and not stratify the individuals in accordance to the variables of MetS, as we performed in our study.…”

Interpersonal-level discrimination indices, sociodemographic factors, and telomere length in African-Americans and Whites

“…Speculatively, the difference in telomere length across women with higher SES and younger adults, suggests a physiological age deterioration for these individuals when reporting greater exposure to particular types of discrimination. Thus, these subgroups may assume health trajectories that are paradoxical to what is expected as a function of social statuses they occupy (Rehkopf et al, 2016). In the absence of telomerase activity that would allow estimation of metric of years lost physiologically, the current findings are underscored by prior studies demonstrating that the difference in telomere length intimates impending health outcomes (Cherkas et al, 2006; Geronimus et al, 2010).…”

Examining the gender difference in the association between metabolic syndrome and the mean leukocyte telomere length

“…A previous study reported that an one unit difference in the following biomarkers were associated with kilobase pair differences in LTL, such as BMI, waist circumference, percentage of body fat, HDL, triglycerides, pulse rate, systolic blood pressure and diastolic blood pressure[15]. However, these studies only focused on the relationship between individual MetS components and telomere length.…”