Leukocyte 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 Findings
We 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.
LTL 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.
David Rehkopf and colleagues analyze the association of leukocyte telomere length with cardiovascular disease risk biomarkers.
Why Was This Study Done?
Leukocyte telomere length (LTL) is a biomarker of white blood cell division and is strongly associated with age.
There are still mixed findings on how LTL is related to different types of mortality.
Observational evidence and quasi-experimental studies suggest that there is an association between shorter LTL and cardiovascular disease mortality.
It is unclear, however, whether or not LTL is completely independent of already known biological pathways of cardiovascular disease.
What Did the Researchers Do and Find?
We examined US nationally representative data on participants ages 25 to 84 that had LTL measured along with 17 other cardiovascular risk biomarkers.
We found associations between LTL and measures of adiposity (BMI, waist circumference, percentage of body fat), along with C-reactive protein, cystatin C, high-density lipoprotein (HDL) cholesterol, triglycerides, insulin resistance, systolic blood pressure, diastolic blood pressure, and pulse rate.
We did not find that there were a meaningful number of differences in these relationships by age, race/ethnicity, or socioeconomic position, suggesting that the associations we find are generally consistent across different population groups.
What Do These Findings Mean?
Our findings suggest that LTL is associated with cardiovascular risk factors across different physiological systems.
The study findings do not have any implications for whether LTL is a cause of cardiovascular disease.