Genetics
Telomere length and all- and specific-cause mortality among U.S. adults and the role of age and race/ethnicity Hanish Kodali* Hanish Kodali Heidi E. Jones Katarzyna E Wyka Linda Valeri Luisa N. Borrell
Background: Studies of the relationship between telomere attrition and mortality risks, all and/or specific-causes, among U.S. adults has shown inconsistent findings. Additionally, the combined effect of age group and race/ethnicity on this association has rarely been investigated.
Methods: Using two publicly available datasets, the National Health and Nutrition Examination Survey (1999-2002) and the 2019 Linked Mortality File, we analyzed 6,516 adults (aged 25 years or older) with 2,163 deaths. We employed Cox proportional hazards regression to examine the association between TL (standardized as kilo base-pairs, kbp, and assessed continuously and categorically in quartiles), and all-cause, CVD- and cancer-specific mortality before and after adjusting for selected characteristics. We also tested for effect modification by age group and race/ethnicity.
Results: In the adjusted model, a one kbp decrease in TL was associated with 1.36 higher hazard rate of all-cause mortality (95%CI:1.17,1.58). Adults with the shortest TL (first quartile, Q1) had a 1.57 times higher all-cause mortality than their peers with longest TL (Q4, 95%CI:1.25,1.98). Similarly, CVD-specific mortality risk increased 1.49 times per kbp TL decrease (95%CI:1.17,1.91), increasing to 1.72 times in the shortest vs. the longest TL (95%CI:1.18,2.50). For cancer-specific mortality, Q1 had 1.85 times higher rates than Q4 (95% CI:1.15,2.98). No significant modifications of these associations were observed due to age or race/ethnicity.
Discussion: TL emerges as a promising biomarker for predicting all-cause, CVD-, and cancer-specific mortality risks among U.S. adults, particularly highlighting its inverse association with premature death. The consistent and strong links between shorter TL and higher mortality underscore its potential role in targeted interventions and preventive strategies for all ages and race/ethnicity.