U-Shaped Relationship of Leukocyte Telomere Length With All-Cause and Cancer-Related Mortality in Older Men.


Journal

The journals of gerontology. Series A, Biological sciences and medical sciences
ISSN: 1758-535X
Titre abrégé: J Gerontol A Biol Sci Med Sci
Pays: United States
ID NLM: 9502837

Informations de publication

Date de publication:
01 01 2021
Historique:
received: 06 12 2019
pubmed: 8 8 2020
medline: 16 7 2021
entrez: 8 8 2020
Statut: ppublish

Résumé

Telomeres are essential DNA-protein complexes whose attrition results in cellular dysfunction and senescence. Leukocyte telomere length (LTL) correlates with tissue telomere length, representing a biomarker for biological age. However, its predictive value for mortality risk, and for cardiovascular versus cancer deaths, in older adults remains uncertain. We studied 3608 community-dwelling men aged 77.0 ± 3.6 years. Leukocyte telomere length was measured using multiplex quantitative PCR, expressed as amount of telomeric DNA relative to single-copy control gene (T/S ratio). Deaths from any cause, cardiovascular disease (CVD), and cancer were ascertained using data linkage. Curve fitting used restricted cubic splines and Cox regression analyses adjusted for age, cardiometabolic risk factors, and prevalent disease. There was a U-shaped association of LTL with all-cause mortality. Men with T/S ratio in the middle quartiles had lower mortality (quartiles, Q2 vs Q1, hazard ratio [HR] = 0.86, 95% confidence interval [CI] 0.77-0.97, p = .012; Q3 vs Q1 HR = 0.88, CI 0.79-0.99, p = .032). There was no association of LTL with CVD mortality. There was a U-shaped association of LTL with cancer mortality. Men with LTL in the middle quartiles had lower risk of cancer death (Q2 vs Q1, HR = 0.73, CI 0.59-0.90, p = .004; Q3 vs Q1, HR = 0.75, CI 0.61-0.92, p = .007). In older men, both shorter and longer LTL are associated with all-cause mortality. A similar U-shaped association was seen with cancer deaths, with no association found for cardiovascular deaths. Further research is warranted to explore the prognostic utility of LTL in ageing.

Sections du résumé

BACKGROUND
Telomeres are essential DNA-protein complexes whose attrition results in cellular dysfunction and senescence. Leukocyte telomere length (LTL) correlates with tissue telomere length, representing a biomarker for biological age. However, its predictive value for mortality risk, and for cardiovascular versus cancer deaths, in older adults remains uncertain.
METHOD
We studied 3608 community-dwelling men aged 77.0 ± 3.6 years. Leukocyte telomere length was measured using multiplex quantitative PCR, expressed as amount of telomeric DNA relative to single-copy control gene (T/S ratio). Deaths from any cause, cardiovascular disease (CVD), and cancer were ascertained using data linkage. Curve fitting used restricted cubic splines and Cox regression analyses adjusted for age, cardiometabolic risk factors, and prevalent disease.
RESULTS
There was a U-shaped association of LTL with all-cause mortality. Men with T/S ratio in the middle quartiles had lower mortality (quartiles, Q2 vs Q1, hazard ratio [HR] = 0.86, 95% confidence interval [CI] 0.77-0.97, p = .012; Q3 vs Q1 HR = 0.88, CI 0.79-0.99, p = .032). There was no association of LTL with CVD mortality. There was a U-shaped association of LTL with cancer mortality. Men with LTL in the middle quartiles had lower risk of cancer death (Q2 vs Q1, HR = 0.73, CI 0.59-0.90, p = .004; Q3 vs Q1, HR = 0.75, CI 0.61-0.92, p = .007).
CONCLUSIONS
In older men, both shorter and longer LTL are associated with all-cause mortality. A similar U-shaped association was seen with cancer deaths, with no association found for cardiovascular deaths. Further research is warranted to explore the prognostic utility of LTL in ageing.

Identifiants

pubmed: 32761187
pii: 5881858
doi: 10.1093/gerona/glaa190
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

164-171

Informations de copyright

© The Author(s) 2020. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Auteurs

Bu B Yeap (BB)

Medical School, University of Western Australia, Perth, Australia.
Department of Endocrinology and Diabetes, Fiona Stanley Hospital, Perth, Western Australia, Australia.

Jennie Hui (J)

PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Matthew W Knuiman (MW)

School of Population and Global Health, University of Western Australia, Perth, Australia.

Leon Flicker (L)

Medical School, University of Western Australia, Perth, Australia.
Department of Endocrinology, Sydney Medical School, University of Sydney, New South Wales, Australia.

Mark L Divitini (ML)

School of Population and Global Health, University of Western Australia, Perth, Australia.

Gillian M Arscott (GM)

PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

Stephen M Twigg (SM)

Department of Endocrinology, Sydney Medical School, University of Sydney, New South Wales, Australia.

Osvaldo P Almeida (OP)

Medical School, University of Western Australia, Perth, Australia.
WA Centre for Health & Ageing, University of Western Australia, Perth, Australia.

Graeme J Hankey (GJ)

Medical School, University of Western Australia, Perth, Australia.

Jonathan Golledge (J)

Queensland Research Centre for Peripheral Vascular Disease, James Cook University, and Department of Vascular and Endovascular Surgery, Townsville Hospital, Queensland, Australia.

Paul E Norman (PE)

Medical School, University of Western Australia, Perth, Australia.

John P Beilby (JP)

PathWest Laboratory Medicine, Sir Charles Gairdner Hospital, Perth, Western Australia, Australia.

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