Leukocyte Telomere Length and All-Cause, Cardiovascular Disease, and Cancer Mortality: Results From Individual-Participant-Data Meta-Analysis of 2 Large Prospective Cohort Studies.
Level 3 - non-randomized controlled study
Individual-participant-data meta-analysis of prospective cohort studies
PubMed 28459963 · doi:10.1093/aje/kww210
What was done
Individual-participant-data meta-analysis of 12,199 adults aged 43–75 years from two prospective cohort studies: the Nurses' Health Study (United States, blood collected 1989–1990, followed through 2010) and ESTHER (Europe, blood collected 2000–2002, followed through 2015). Leukocyte telomere length (LTL) was measured via quantitative polymerase chain reaction (qPCR) and standardized to z scores within cohorts. Cox proportional hazards regression models estimated hazard ratios for all-cause, cardiovascular disease, and cancer mortality across LTL quintiles and continuous z scores, pooled using random-effects meta-analysis.
What was found
Across 2,882 total recorded deaths, LTL was inversely correlated with chronological age in both cohorts. After adjusting for age, comparing the shortest to the longest LTL quintile yielded: - All-cause mortality: HR 1.23 (95% CI: 1.04, 1.46) - Cardiovascular mortality: HR 1.29 (95% CI: 0.83, 2.00) - Cancer mortality: HR 1.10 (95% CI: 0.88, 1.37)
Why it matters
It provides pooled prospective evidence that shorter telomere length modestly predicts higher all-cause mortality beyond chronological age alone, though cause-specific mortality associations were imprecise.
Limits
Analysis was restricted to two cohorts (one exclusively female, NHS), limiting demographic generalizability. LTL was measured from a single baseline blood sample via qPCR, precluding evaluation of telomere attrition rates over time. The effect size for all-cause mortality was modest, and point estimates for cardiovascular and cancer mortality lacked statistical precision with 95% confidence intervals crossing the null. Confounder adjustments beyond age are not specified in the abstract.
Cited by
- supports Shorter telomeres are associated with aging and potentially worse health outcomes.