Needham Belinda L, Rehkopf David, Adler Nancy, Gregorich Steven, Lin Jue, Blackburn Elizabeth H, Epel Elissa S
From the aDepartment of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI; bDivision of General Medical Disciplines, Stanford University, Stanford, CA; cDepartment of Psychiatry, dDivision of General Internal Medicine, and eDepartment of Biochemistry and Biophysics, University of California, San Francisco, CA.
Epidemiology. 2015 Jul;26(4):528-35. doi: 10.1097/EDE.0000000000000299.
This study examined the association between leukocyte telomere length--a marker of cell aging--and mortality in a nationally representative sample of US adults ages 50-84 years. We also examined moderating effects of age, sex, race/ethnicity, and education.
Data were from the National Health and Nutrition Examination Survey, 1999-2002 (n = 3,091). Cox proportional hazards regression was used to estimate the risk of all-cause and cause- specific mortality adjusting for sociodemographic characteristics, smoking, body mass index, and chronic conditions.
Eight hundred and seventy deaths occurred over an average of 9.5 years of follow-up. In the full sample, a decrease of 1 kilobase pair in telomere length at baseline was marginally associated with a 10% increased hazard of all-cause mortality (hazard ratio [HR]: 1.1, 95% confidence interval [CI]: 0.9, 1.4) and a 30% increased hazard of death due to diseases other than cardiovascular disease or cancer (HR: 1.3, 95% CI: 0.9, 1.9). Among African-American but not white or Mexican-American respondents, a decrease of 1 kilobase pair in telomere length at baseline was associated with a two-fold increased hazard of cardiovascular mortality (HR: 2.0, 95% CI: 1.3, 3.1). There was no association between telomere length and cancer mortality.
The association between leukocyte telomere length and mortality differs by race/ethnicity and cause of death.
本研究在美国50 - 84岁成年人的全国代表性样本中,考察了细胞衰老标志物白细胞端粒长度与死亡率之间的关联。我们还研究了年龄、性别、种族/族裔和教育程度的调节作用。
数据来自1999 - 2002年的全国健康和营养检查调查(n = 3091)。采用Cox比例风险回归来估计全因死亡率和特定原因死亡率的风险,并对社会人口学特征、吸烟、体重指数和慢性病进行了调整。
在平均9.5年的随访期内发生了870例死亡。在整个样本中,基线时端粒长度每减少1千碱基对,与全因死亡率风险略有增加10%相关(风险比[HR]:1.1,95%置信区间[CI]:0.9,1.4),以及非心血管疾病或癌症导致的死亡风险增加30%(HR:1.3,95% CI:0.9,1.9)。在非裔美国受访者中,而非白人或墨西哥裔美国受访者中,基线时端粒长度每减少1千碱基对,与心血管死亡率风险增加两倍相关(HR:2.0,95% CI:1.3,3.1)。端粒长度与癌症死亡率之间无关联。
白细胞端粒长度与死亡率之间的关联因种族/族裔和死亡原因而异。