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      Leukocyte telomere length associates with prospective mortality independent of immune-related parameters and known genetic markers

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          Abstract

          Background: Human leukocyte telomere length (LTL) decreases with age and shorter LTL has previously been associated with increased prospective mortality. However, it is not clear whether LTL merely marks the health status of an individual by its association with parameters of immune function, for example, or whether telomere shortening also contributes causally to lifespan variation in humans.

          Methods: We measured LTL in 870 nonagenarian siblings (mean age 93 years), 1580 of their offspring and 725 spouses thereof (mean age 59 years) from the Leiden Longevity Study (LLS).

          Results: We found that shorter LTL is associated with increased prospective mortality in middle (30–80 years; hazard ratio (HR) = 0.75, P = 0.001) and highly advanced age (≥90 years; HR = 0.92, P = 0.028), and show that this association cannot be explained by the association of LTL with the immune-related markers insulin-like growth factor 1 to insulin-like growth factor binding protein 3 molar ratio, C-reactive protein, interleukin 6, cytomegalovirus serostatus or white blood cell counts. We found no difference in LTL between the middle-aged LLS offspring and their spouses (β = 0.006, P = 0.932). Neither did we observe an association of LTL-associated genetic variants with mortality in a prospective meta-analysis of multiple cohorts ( n = 8165).

          Conclusions: We confirm LTL to be a marker of prospective mortality in middle and highly advanced age and additionally show that this association could not be explained by the association of LTL with various immune-related markers. Furthermore, the approaches performed here do not further support the hypothesis that LTL variation contributes to the genetic propensity for longevity.

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          Most cited references30

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          Oxidative stress shortens telomeres.

          Telomeres in most human cells shorten with each round of DNA replication, because they lack the enzyme telomerase. This is not, however, the only determinant of the rate of loss of telomeric DNA. Oxidative damage is repaired less well in telomeric DNA than elsewhere in the chromosome, and oxidative stress accelerates telomere loss, whereas antioxidants decelerate it. I suggest here that oxidative stress is an important modulator of telomere loss and that telomere-driven replicative senescence is primarily a stress response. This might have evolved to block the growth of cells that have been exposed to a high risk of mutation.
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            C-reactive protein: a critical update.

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              Telomere end-replication problem and cell aging.

              Since DNA polymerase requires a labile primer to initiate unidirectional 5'-3' synthesis, some bases at the 3' end of each template strand are not copied unless special mechanisms bypass this "end-replication" problem. Immortal eukaryotic cells, including transformed human cells, apparently use telomerase, an enzyme that elongates telomeres, to overcome incomplete end-replication. However, telomerase has not been detected in normal somatic cells, and these cells lose telomeres with age. Therefore, to better understand the consequences of incomplete replication, we modeled this process for a population of dividing cells. The analysis suggests four things. First, if single-stranded overhangs generated by incomplete replication are not degraded, then mean telomere length decreases by 0.25 of a deletion event per generation. If overhangs are degraded, the rate doubles. Data showing a decrease of about 50 base-pairs per generation in fibroblasts suggest that a full deletion event is 100 to 200 base-pairs. Second, if cells senesce after 80 doublings in vitro, mean telomere length decreases about 4000 base-pairs, but one or more telomeres in each cell will lose significantly more telomeric DNA. A checkpoint for regulation of cell growth may be signalled at that point. Third, variation in telomere length predicted by the model is consistent with the abrupt decline in dividing cells at senescence. Finally, variation in length of terminal restriction fragments is not fully explained by incomplete replication, suggesting significant interchromosomal variation in the length of telomeric or subtelomeric repeats. This analysis, together with assumptions allowing dominance of telomerase inactivation, suggests that telomere loss could explain cell cycle exit in human fibroblasts.
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                Author and article information

                Journal
                Int J Epidemiol
                Int J Epidemiol
                ije
                intjepid
                International Journal of Epidemiology
                Oxford University Press
                0300-5771
                1464-3685
                June 2014
                13 January 2014
                13 January 2014
                : 43
                : 3
                : 878-886
                Affiliations
                1Department of Molecular Epidemiology, Leiden University Medical Center, Leiden, The Netherlands, 2Netherlands Consortium for Healthy Ageing, Leiden University Medical Center, Leiden, The Netherlands, 3Department of Cardiovascular Sciences, University of Leicester, Leicester, UK, 4Department of Cardiology, Leiden University Medical Center, Leiden, The Netherlands, 5Department of Gerontology and Geriatrics, Leiden University Medical Center, Leiden, The Netherlands, 6Department of Epidemiology, Erasmus Medical Center, Rotterdam, The Netherlands, 7Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden, 8Estonian Genome Center, University of Tartu, Tartu, Estonia, 9Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands, 10Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands and 11Department of Medical Statistics, Leiden University Medical Center, Leiden, The Netherlands
                Author notes
                *Corresponding author. Leiden University Medical Center, Department of Molecular Epidemiology, PO Box 9600, 2300 RC Leiden, The Netherlands. E-mail: j.deelen@ 123456lumc.nl
                Article
                dyt267
                10.1093/ije/dyt267
                4052133
                24425829
                4266abc3-d96c-48cc-bd60-82311fd8f156
                © The Author 2014. Published by Oxford University Press on behalf of the International Epidemiological Association.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/3.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is properly cited. For commercial re-use, please contact journals.permissions@oup.com

                History
                : 03 December 2013
                Page count
                Pages: 9
                Categories
                Other Markers and Risk Factors

                Public health
                leukocyte telomere length,prospective mortality,immune-related markers,familial longevity,genetics,human

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