Shortened Relative Leukocyte Telomere Length Is Associated With Prevalent and Incident Cardiovascular Complications in Type 2 Diabetes: Analysis From the Hong Kong Diabetes Register
Several studies support potential links between relative leukocyte telomere length (rLTL), a biomarker of biological aging, and type 2 diabetes. This study investigates relationships between rLTL and incident cardiovascular disease (CVD) in patients with type 2 diabetes. Consecutive Chinese patients...
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| Veröffentlicht in: | Diabetes care 2020-09, Vol.43 (9), p.2257-2265 |
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| creator | Cheng, Feifei Luk, Andrea O Tam, Claudia H T Fan, Baoqi Wu, Hongjiang Yang, Aimin Lau, Eric S H Ng, Alex C W Lim, Cadmon K P Lee, Heung Man Chow, Elaine Kong, Alice P Keech, Anthony C Joglekar, Mugdha V So, Wing Yee Jenkins, Alicia J Chan, Juliana C N Hardikar, Anandwardhan A Ma, Ronald C W |
| description | Several studies support potential links between relative leukocyte telomere length (rLTL), a biomarker of biological aging, and type 2 diabetes. This study investigates relationships between rLTL and incident cardiovascular disease (CVD) in patients with type 2 diabetes.
Consecutive Chinese patients with type 2 diabetes (
= 5,349) from the Hong Kong Diabetes Register for whom DNA obtained at baseline was stored and follow-up data were available were studied. rLTL was measured by using quantitative PCR. CVD was diagnosed on the basis of ICD-9 code.
Mean follow-up was 13.4 years (SD 5.5 years). rLTL was correlated inversely with age, diabetes duration, blood pressure, HbA
, and urine albumin-to-creatinine ratio (ACR), and positively with estimated glomerular filtration rate (eGFR) (all
< 0.001). Subjects with CVD at baseline had a shorter rLTL (4.3 ± 1.2 ΔΔCt) than did subjects without CVD (4.6 ± 1.2 ΔΔCt) (
< 0.001). Of the 4,541 CVD-free subjects at baseline, the 1,140 who developed CVD during follow-up had a shorter rLTL (4.3 ± 1.2 ΔΔCt) than those who remained CVD-free after adjusting for age, sex, smoking, and albuminuria status (4.7 ± 1.2 ΔΔCt) (
< 0.001). In Cox regression models, shorter rLTL was associated with higher risk of incident CVD (for each unit decrease, hazard ratio 1.252 [95% CI 1.195-1.311],
< 0.001), which remained significant after adjusting for age, sex, BMI, systolic blood pressure, LDL cholesterol, HbA
, eGFR, and ACR (hazard ratio 1.141 [95% CI 1.084-1.200],
< 0.001).
rLTL is significantly shorter in patients with type 2 diabetes and CVD, is associated with cardiometabolic risk factors, and is independently associated with incident CVD. Telomere length may be a useful biomarker for CVD risk in patients with type 2 diabetes. |
| doi_str_mv | 10.2337/dc20-0028 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2441603892</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2441603892</sourcerecordid><originalsourceid>FETCH-LOGICAL-c348t-6b7fe73c12d9e3999ae597e11c864c5c7a50fd653d47abe18130a794a7f6df5e3</originalsourceid><addsrcrecordid>eNpdkcGO0zAQhi0EYsvCgRdAlrjAIWDHdhxzqwrLVlQCQRHHyLUnrZfELrZTqQ_G--GwuxzwYawZffPPjH6EnlPypmZMvrWmJhUhdfsALahiohKCtw_RglCuKqFUfYGepHRDCOG8bR-jC1Y3DS1vgX5_O4SYwYPFX2HQ2Z0Ab2D6Gcw5A97CEEaIc8nv8wGvE16mFIzTuTT8cKX0JcJJD-Az1t7itTfOzslKR-vCSSczDTriVRiPgzNFP_iEncfb8xFwjd87vYMM6R1eej2ck0v4KoYR5wPg6-D3-NMc7qmy4t6lDPEpetTrIcGzu_8Sfb_6sF1dV5vPH9er5aYyjLe5anayB8kMra0CppTSIJQESk3bcCOM1IL0thHMclkm0JYyoqXiWvaN7QWwS_TqVvcYw68JUu5GlwwMg_YQptTVnNOGsFbVBX35H3oTpliO-kvxRoqGqEK9vqVMDClF6LtjdKOO546Sbvaym73sZi8L--JOcdqNYP-R9-axP2H6m3c</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2444675609</pqid></control><display><type>article</type><title>Shortened Relative Leukocyte Telomere Length Is Associated With Prevalent and Incident Cardiovascular Complications in Type 2 Diabetes: Analysis From the Hong Kong Diabetes Register</title><source>MEDLINE</source><source>Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals</source><creator>Cheng, Feifei ; Luk, Andrea O ; Tam, Claudia H T ; Fan, Baoqi ; Wu, Hongjiang ; Yang, Aimin ; Lau, Eric S H ; Ng, Alex C W ; Lim, Cadmon K P ; Lee, Heung Man ; Chow, Elaine ; Kong, Alice P ; Keech, Anthony C ; Joglekar, Mugdha V ; So, Wing Yee ; Jenkins, Alicia J ; Chan, Juliana C N ; Hardikar, Anandwardhan A ; Ma, Ronald C W</creator><creatorcontrib>Cheng, Feifei ; Luk, Andrea O ; Tam, Claudia H T ; Fan, Baoqi ; Wu, Hongjiang ; Yang, Aimin ; Lau, Eric S H ; Ng, Alex C W ; Lim, Cadmon K P ; Lee, Heung Man ; Chow, Elaine ; Kong, Alice P ; Keech, Anthony C ; Joglekar, Mugdha V ; So, Wing Yee ; Jenkins, Alicia J ; Chan, Juliana C N ; Hardikar, Anandwardhan A ; Ma, Ronald C W</creatorcontrib><description>Several studies support potential links between relative leukocyte telomere length (rLTL), a biomarker of biological aging, and type 2 diabetes. This study investigates relationships between rLTL and incident cardiovascular disease (CVD) in patients with type 2 diabetes.
Consecutive Chinese patients with type 2 diabetes (
= 5,349) from the Hong Kong Diabetes Register for whom DNA obtained at baseline was stored and follow-up data were available were studied. rLTL was measured by using quantitative PCR. CVD was diagnosed on the basis of ICD-9 code.
Mean follow-up was 13.4 years (SD 5.5 years). rLTL was correlated inversely with age, diabetes duration, blood pressure, HbA
, and urine albumin-to-creatinine ratio (ACR), and positively with estimated glomerular filtration rate (eGFR) (all
< 0.001). Subjects with CVD at baseline had a shorter rLTL (4.3 ± 1.2 ΔΔCt) than did subjects without CVD (4.6 ± 1.2 ΔΔCt) (
< 0.001). Of the 4,541 CVD-free subjects at baseline, the 1,140 who developed CVD during follow-up had a shorter rLTL (4.3 ± 1.2 ΔΔCt) than those who remained CVD-free after adjusting for age, sex, smoking, and albuminuria status (4.7 ± 1.2 ΔΔCt) (
< 0.001). In Cox regression models, shorter rLTL was associated with higher risk of incident CVD (for each unit decrease, hazard ratio 1.252 [95% CI 1.195-1.311],
< 0.001), which remained significant after adjusting for age, sex, BMI, systolic blood pressure, LDL cholesterol, HbA
, eGFR, and ACR (hazard ratio 1.141 [95% CI 1.084-1.200],
< 0.001).
rLTL is significantly shorter in patients with type 2 diabetes and CVD, is associated with cardiometabolic risk factors, and is independently associated with incident CVD. Telomere length may be a useful biomarker for CVD risk in patients with type 2 diabetes.</description><identifier>ISSN: 0149-5992</identifier><identifier>EISSN: 1935-5548</identifier><identifier>DOI: 10.2337/dc20-0028</identifier><identifier>PMID: 32661111</identifier><language>eng</language><publisher>United States: American Diabetes Association</publisher><subject>Adult ; Age ; Aged ; Aging ; Albumins ; Biomarkers ; Biomarkers - blood ; Blood pressure ; Cardiovascular diseases ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - diagnosis ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - etiology ; Cholesterol ; Complications ; Creatinine ; Deoxyribonucleic acid ; Diabetes ; Diabetes mellitus ; Diabetes mellitus (non-insulin dependent) ; Diabetes Mellitus, Type 2 - blood ; Diabetes Mellitus, Type 2 - complications ; Diabetes Mellitus, Type 2 - diagnosis ; Diabetes Mellitus, Type 2 - epidemiology ; Diabetic Angiopathies - blood ; Diabetic Angiopathies - diagnosis ; Diabetic Angiopathies - epidemiology ; Diabetic Angiopathies - etiology ; DNA ; Epidermal growth factor receptors ; Female ; Follow-Up Studies ; Glomerular filtration rate ; Health hazards ; Health risks ; Heart diseases ; Hong Kong - epidemiology ; Humans ; Incidence ; Leukocytes ; Leukocytes - metabolism ; Leukocytes - pathology ; Low density lipoprotein ; Male ; Middle Aged ; Prevalence ; Registries ; Regression analysis ; Regression models ; Research design ; Risk analysis ; Risk Factors ; Sex ; Telomere - metabolism ; Telomere - physiology ; Telomere Shortening - physiology ; Telomeres</subject><ispartof>Diabetes care, 2020-09, Vol.43 (9), p.2257-2265</ispartof><rights>2020 by the American Diabetes Association.</rights><rights>Copyright American Diabetes Association Sep 1, 2020</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c348t-6b7fe73c12d9e3999ae597e11c864c5c7a50fd653d47abe18130a794a7f6df5e3</citedby><cites>FETCH-LOGICAL-c348t-6b7fe73c12d9e3999ae597e11c864c5c7a50fd653d47abe18130a794a7f6df5e3</cites><orcidid>0000-0003-1325-1194 ; 0000-0002-1227-803X ; 0000-0002-5244-6069 ; 0000-0001-8927-6764 ; 0000-0002-9426-9136 ; 0000-0002-8541-8734 ; 0000-0003-0583-3717</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32661111$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Cheng, Feifei</creatorcontrib><creatorcontrib>Luk, Andrea O</creatorcontrib><creatorcontrib>Tam, Claudia H T</creatorcontrib><creatorcontrib>Fan, Baoqi</creatorcontrib><creatorcontrib>Wu, Hongjiang</creatorcontrib><creatorcontrib>Yang, Aimin</creatorcontrib><creatorcontrib>Lau, Eric S H</creatorcontrib><creatorcontrib>Ng, Alex C W</creatorcontrib><creatorcontrib>Lim, Cadmon K P</creatorcontrib><creatorcontrib>Lee, Heung Man</creatorcontrib><creatorcontrib>Chow, Elaine</creatorcontrib><creatorcontrib>Kong, Alice P</creatorcontrib><creatorcontrib>Keech, Anthony C</creatorcontrib><creatorcontrib>Joglekar, Mugdha V</creatorcontrib><creatorcontrib>So, Wing Yee</creatorcontrib><creatorcontrib>Jenkins, Alicia J</creatorcontrib><creatorcontrib>Chan, Juliana C N</creatorcontrib><creatorcontrib>Hardikar, Anandwardhan A</creatorcontrib><creatorcontrib>Ma, Ronald C W</creatorcontrib><title>Shortened Relative Leukocyte Telomere Length Is Associated With Prevalent and Incident Cardiovascular Complications in Type 2 Diabetes: Analysis From the Hong Kong Diabetes Register</title><title>Diabetes care</title><addtitle>Diabetes Care</addtitle><description>Several studies support potential links between relative leukocyte telomere length (rLTL), a biomarker of biological aging, and type 2 diabetes. This study investigates relationships between rLTL and incident cardiovascular disease (CVD) in patients with type 2 diabetes.
Consecutive Chinese patients with type 2 diabetes (
= 5,349) from the Hong Kong Diabetes Register for whom DNA obtained at baseline was stored and follow-up data were available were studied. rLTL was measured by using quantitative PCR. CVD was diagnosed on the basis of ICD-9 code.
Mean follow-up was 13.4 years (SD 5.5 years). rLTL was correlated inversely with age, diabetes duration, blood pressure, HbA
, and urine albumin-to-creatinine ratio (ACR), and positively with estimated glomerular filtration rate (eGFR) (all
< 0.001). Subjects with CVD at baseline had a shorter rLTL (4.3 ± 1.2 ΔΔCt) than did subjects without CVD (4.6 ± 1.2 ΔΔCt) (
< 0.001). Of the 4,541 CVD-free subjects at baseline, the 1,140 who developed CVD during follow-up had a shorter rLTL (4.3 ± 1.2 ΔΔCt) than those who remained CVD-free after adjusting for age, sex, smoking, and albuminuria status (4.7 ± 1.2 ΔΔCt) (
< 0.001). In Cox regression models, shorter rLTL was associated with higher risk of incident CVD (for each unit decrease, hazard ratio 1.252 [95% CI 1.195-1.311],
< 0.001), which remained significant after adjusting for age, sex, BMI, systolic blood pressure, LDL cholesterol, HbA
, eGFR, and ACR (hazard ratio 1.141 [95% CI 1.084-1.200],
< 0.001).
rLTL is significantly shorter in patients with type 2 diabetes and CVD, is associated with cardiometabolic risk factors, and is independently associated with incident CVD. Telomere length may be a useful biomarker for CVD risk in patients with type 2 diabetes.</description><subject>Adult</subject><subject>Age</subject><subject>Aged</subject><subject>Aging</subject><subject>Albumins</subject><subject>Biomarkers</subject><subject>Biomarkers - blood</subject><subject>Blood pressure</subject><subject>Cardiovascular diseases</subject><subject>Cardiovascular Diseases - blood</subject><subject>Cardiovascular Diseases - diagnosis</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - etiology</subject><subject>Cholesterol</subject><subject>Complications</subject><subject>Creatinine</subject><subject>Deoxyribonucleic acid</subject><subject>Diabetes</subject><subject>Diabetes mellitus</subject><subject>Diabetes mellitus (non-insulin dependent)</subject><subject>Diabetes Mellitus, Type 2 - blood</subject><subject>Diabetes Mellitus, Type 2 - complications</subject><subject>Diabetes Mellitus, Type 2 - diagnosis</subject><subject>Diabetes Mellitus, Type 2 - epidemiology</subject><subject>Diabetic Angiopathies - blood</subject><subject>Diabetic Angiopathies - diagnosis</subject><subject>Diabetic Angiopathies - epidemiology</subject><subject>Diabetic Angiopathies - etiology</subject><subject>DNA</subject><subject>Epidermal growth factor receptors</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Glomerular filtration rate</subject><subject>Health hazards</subject><subject>Health risks</subject><subject>Heart diseases</subject><subject>Hong Kong - epidemiology</subject><subject>Humans</subject><subject>Incidence</subject><subject>Leukocytes</subject><subject>Leukocytes - metabolism</subject><subject>Leukocytes - pathology</subject><subject>Low density lipoprotein</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Prevalence</subject><subject>Registries</subject><subject>Regression analysis</subject><subject>Regression models</subject><subject>Research design</subject><subject>Risk analysis</subject><subject>Risk Factors</subject><subject>Sex</subject><subject>Telomere - metabolism</subject><subject>Telomere - physiology</subject><subject>Telomere Shortening - physiology</subject><subject>Telomeres</subject><issn>0149-5992</issn><issn>1935-5548</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkcGO0zAQhi0EYsvCgRdAlrjAIWDHdhxzqwrLVlQCQRHHyLUnrZfELrZTqQ_G--GwuxzwYawZffPPjH6EnlPypmZMvrWmJhUhdfsALahiohKCtw_RglCuKqFUfYGepHRDCOG8bR-jC1Y3DS1vgX5_O4SYwYPFX2HQ2Z0Ab2D6Gcw5A97CEEaIc8nv8wGvE16mFIzTuTT8cKX0JcJJD-Az1t7itTfOzslKR-vCSSczDTriVRiPgzNFP_iEncfb8xFwjd87vYMM6R1eej2ck0v4KoYR5wPg6-D3-NMc7qmy4t6lDPEpetTrIcGzu_8Sfb_6sF1dV5vPH9er5aYyjLe5anayB8kMra0CppTSIJQESk3bcCOM1IL0thHMclkm0JYyoqXiWvaN7QWwS_TqVvcYw68JUu5GlwwMg_YQptTVnNOGsFbVBX35H3oTpliO-kvxRoqGqEK9vqVMDClF6LtjdKOO546Sbvaym73sZi8L--JOcdqNYP-R9-axP2H6m3c</recordid><startdate>202009</startdate><enddate>202009</enddate><creator>Cheng, Feifei</creator><creator>Luk, Andrea O</creator><creator>Tam, Claudia H T</creator><creator>Fan, Baoqi</creator><creator>Wu, Hongjiang</creator><creator>Yang, Aimin</creator><creator>Lau, Eric S H</creator><creator>Ng, Alex C W</creator><creator>Lim, Cadmon K P</creator><creator>Lee, Heung Man</creator><creator>Chow, Elaine</creator><creator>Kong, Alice P</creator><creator>Keech, Anthony C</creator><creator>Joglekar, Mugdha V</creator><creator>So, Wing Yee</creator><creator>Jenkins, Alicia J</creator><creator>Chan, Juliana C N</creator><creator>Hardikar, Anandwardhan A</creator><creator>Ma, Ronald C W</creator><general>American Diabetes Association</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0003-1325-1194</orcidid><orcidid>https://orcid.org/0000-0002-1227-803X</orcidid><orcidid>https://orcid.org/0000-0002-5244-6069</orcidid><orcidid>https://orcid.org/0000-0001-8927-6764</orcidid><orcidid>https://orcid.org/0000-0002-9426-9136</orcidid><orcidid>https://orcid.org/0000-0002-8541-8734</orcidid><orcidid>https://orcid.org/0000-0003-0583-3717</orcidid></search><sort><creationdate>202009</creationdate><title>Shortened Relative Leukocyte Telomere Length Is Associated With Prevalent and Incident Cardiovascular Complications in Type 2 Diabetes: Analysis From the Hong Kong Diabetes Register</title><author>Cheng, Feifei ; Luk, Andrea O ; Tam, Claudia H T ; Fan, Baoqi ; Wu, Hongjiang ; Yang, Aimin ; Lau, Eric S H ; Ng, Alex C W ; Lim, Cadmon K P ; Lee, Heung Man ; Chow, Elaine ; Kong, Alice P ; Keech, Anthony C ; Joglekar, Mugdha V ; So, Wing Yee ; Jenkins, Alicia J ; Chan, Juliana C N ; Hardikar, Anandwardhan A ; Ma, Ronald C W</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c348t-6b7fe73c12d9e3999ae597e11c864c5c7a50fd653d47abe18130a794a7f6df5e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Age</topic><topic>Aged</topic><topic>Aging</topic><topic>Albumins</topic><topic>Biomarkers</topic><topic>Biomarkers - blood</topic><topic>Blood pressure</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - blood</topic><topic>Cardiovascular Diseases - diagnosis</topic><topic>Cardiovascular Diseases - epidemiology</topic><topic>Cardiovascular Diseases - etiology</topic><topic>Cholesterol</topic><topic>Complications</topic><topic>Creatinine</topic><topic>Deoxyribonucleic acid</topic><topic>Diabetes</topic><topic>Diabetes mellitus</topic><topic>Diabetes mellitus (non-insulin dependent)</topic><topic>Diabetes Mellitus, Type 2 - blood</topic><topic>Diabetes Mellitus, Type 2 - complications</topic><topic>Diabetes Mellitus, Type 2 - diagnosis</topic><topic>Diabetes Mellitus, Type 2 - epidemiology</topic><topic>Diabetic Angiopathies - blood</topic><topic>Diabetic Angiopathies - diagnosis</topic><topic>Diabetic Angiopathies - epidemiology</topic><topic>Diabetic Angiopathies - etiology</topic><topic>DNA</topic><topic>Epidermal growth factor receptors</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Glomerular filtration rate</topic><topic>Health hazards</topic><topic>Health risks</topic><topic>Heart diseases</topic><topic>Hong Kong - epidemiology</topic><topic>Humans</topic><topic>Incidence</topic><topic>Leukocytes</topic><topic>Leukocytes - metabolism</topic><topic>Leukocytes - pathology</topic><topic>Low density lipoprotein</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Prevalence</topic><topic>Registries</topic><topic>Regression analysis</topic><topic>Regression models</topic><topic>Research design</topic><topic>Risk analysis</topic><topic>Risk Factors</topic><topic>Sex</topic><topic>Telomere - metabolism</topic><topic>Telomere - physiology</topic><topic>Telomere Shortening - physiology</topic><topic>Telomeres</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Cheng, Feifei</creatorcontrib><creatorcontrib>Luk, Andrea O</creatorcontrib><creatorcontrib>Tam, Claudia H T</creatorcontrib><creatorcontrib>Fan, Baoqi</creatorcontrib><creatorcontrib>Wu, Hongjiang</creatorcontrib><creatorcontrib>Yang, Aimin</creatorcontrib><creatorcontrib>Lau, Eric S H</creatorcontrib><creatorcontrib>Ng, Alex C W</creatorcontrib><creatorcontrib>Lim, Cadmon K P</creatorcontrib><creatorcontrib>Lee, Heung Man</creatorcontrib><creatorcontrib>Chow, Elaine</creatorcontrib><creatorcontrib>Kong, Alice P</creatorcontrib><creatorcontrib>Keech, Anthony C</creatorcontrib><creatorcontrib>Joglekar, Mugdha V</creatorcontrib><creatorcontrib>So, Wing Yee</creatorcontrib><creatorcontrib>Jenkins, Alicia J</creatorcontrib><creatorcontrib>Chan, Juliana C N</creatorcontrib><creatorcontrib>Hardikar, Anandwardhan A</creatorcontrib><creatorcontrib>Ma, Ronald C W</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Diabetes care</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Cheng, Feifei</au><au>Luk, Andrea O</au><au>Tam, Claudia H T</au><au>Fan, Baoqi</au><au>Wu, Hongjiang</au><au>Yang, Aimin</au><au>Lau, Eric S H</au><au>Ng, Alex C W</au><au>Lim, Cadmon K P</au><au>Lee, Heung Man</au><au>Chow, Elaine</au><au>Kong, Alice P</au><au>Keech, Anthony C</au><au>Joglekar, Mugdha V</au><au>So, Wing Yee</au><au>Jenkins, Alicia J</au><au>Chan, Juliana C N</au><au>Hardikar, Anandwardhan A</au><au>Ma, Ronald C W</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Shortened Relative Leukocyte Telomere Length Is Associated With Prevalent and Incident Cardiovascular Complications in Type 2 Diabetes: Analysis From the Hong Kong Diabetes Register</atitle><jtitle>Diabetes care</jtitle><addtitle>Diabetes Care</addtitle><date>2020-09</date><risdate>2020</risdate><volume>43</volume><issue>9</issue><spage>2257</spage><epage>2265</epage><pages>2257-2265</pages><issn>0149-5992</issn><eissn>1935-5548</eissn><abstract>Several studies support potential links between relative leukocyte telomere length (rLTL), a biomarker of biological aging, and type 2 diabetes. This study investigates relationships between rLTL and incident cardiovascular disease (CVD) in patients with type 2 diabetes.
Consecutive Chinese patients with type 2 diabetes (
= 5,349) from the Hong Kong Diabetes Register for whom DNA obtained at baseline was stored and follow-up data were available were studied. rLTL was measured by using quantitative PCR. CVD was diagnosed on the basis of ICD-9 code.
Mean follow-up was 13.4 years (SD 5.5 years). rLTL was correlated inversely with age, diabetes duration, blood pressure, HbA
, and urine albumin-to-creatinine ratio (ACR), and positively with estimated glomerular filtration rate (eGFR) (all
< 0.001). Subjects with CVD at baseline had a shorter rLTL (4.3 ± 1.2 ΔΔCt) than did subjects without CVD (4.6 ± 1.2 ΔΔCt) (
< 0.001). Of the 4,541 CVD-free subjects at baseline, the 1,140 who developed CVD during follow-up had a shorter rLTL (4.3 ± 1.2 ΔΔCt) than those who remained CVD-free after adjusting for age, sex, smoking, and albuminuria status (4.7 ± 1.2 ΔΔCt) (
< 0.001). In Cox regression models, shorter rLTL was associated with higher risk of incident CVD (for each unit decrease, hazard ratio 1.252 [95% CI 1.195-1.311],
< 0.001), which remained significant after adjusting for age, sex, BMI, systolic blood pressure, LDL cholesterol, HbA
, eGFR, and ACR (hazard ratio 1.141 [95% CI 1.084-1.200],
< 0.001).
rLTL is significantly shorter in patients with type 2 diabetes and CVD, is associated with cardiometabolic risk factors, and is independently associated with incident CVD. Telomere length may be a useful biomarker for CVD risk in patients with type 2 diabetes.</abstract><cop>United States</cop><pub>American Diabetes Association</pub><pmid>32661111</pmid><doi>10.2337/dc20-0028</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1325-1194</orcidid><orcidid>https://orcid.org/0000-0002-1227-803X</orcidid><orcidid>https://orcid.org/0000-0002-5244-6069</orcidid><orcidid>https://orcid.org/0000-0001-8927-6764</orcidid><orcidid>https://orcid.org/0000-0002-9426-9136</orcidid><orcidid>https://orcid.org/0000-0002-8541-8734</orcidid><orcidid>https://orcid.org/0000-0003-0583-3717</orcidid><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0149-5992 |
| ispartof | Diabetes care, 2020-09, Vol.43 (9), p.2257-2265 |
| issn | 0149-5992 1935-5548 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2441603892 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals |
| subjects | Adult Age Aged Aging Albumins Biomarkers Biomarkers - blood Blood pressure Cardiovascular diseases Cardiovascular Diseases - blood Cardiovascular Diseases - diagnosis Cardiovascular Diseases - epidemiology Cardiovascular Diseases - etiology Cholesterol Complications Creatinine Deoxyribonucleic acid Diabetes Diabetes mellitus Diabetes mellitus (non-insulin dependent) Diabetes Mellitus, Type 2 - blood Diabetes Mellitus, Type 2 - complications Diabetes Mellitus, Type 2 - diagnosis Diabetes Mellitus, Type 2 - epidemiology Diabetic Angiopathies - blood Diabetic Angiopathies - diagnosis Diabetic Angiopathies - epidemiology Diabetic Angiopathies - etiology DNA Epidermal growth factor receptors Female Follow-Up Studies Glomerular filtration rate Health hazards Health risks Heart diseases Hong Kong - epidemiology Humans Incidence Leukocytes Leukocytes - metabolism Leukocytes - pathology Low density lipoprotein Male Middle Aged Prevalence Registries Regression analysis Regression models Research design Risk analysis Risk Factors Sex Telomere - metabolism Telomere - physiology Telomere Shortening - physiology Telomeres |
| title | Shortened Relative Leukocyte Telomere Length Is Associated With Prevalent and Incident Cardiovascular Complications in Type 2 Diabetes: Analysis From the Hong Kong Diabetes Register |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-09T23%3A17%3A56IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Shortened%20Relative%20Leukocyte%20Telomere%20Length%20Is%20Associated%20With%20Prevalent%20and%20Incident%20Cardiovascular%20Complications%20in%20Type%202%20Diabetes:%20Analysis%20From%20the%20Hong%20Kong%20Diabetes%20Register&rft.jtitle=Diabetes%20care&rft.au=Cheng,%20Feifei&rft.date=2020-09&rft.volume=43&rft.issue=9&rft.spage=2257&rft.epage=2265&rft.pages=2257-2265&rft.issn=0149-5992&rft.eissn=1935-5548&rft_id=info:doi/10.2337/dc20-0028&rft_dat=%3Cproquest_cross%3E2441603892%3C/proquest_cross%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2444675609&rft_id=info:pmid/32661111&rfr_iscdi=true |