Chen Shufeng, Lin Jue, Matsuguchi Tet, Blackburn Elizabeth, Yeh Fawn, Best Lyle G, Devereux Richard B, Lee Elisa T, Howard Barbara V, Roman Mary J, Zhao Jinying
Department of Epidemiology, School of Public Health and Tropical Medicine, Tulane University, New Orleans, LA 70112, USA;
Aging (Albany NY). 2014 May;6(5):414-27. doi: 10.18632/aging.100671.
Short leukocyte telomere length (LTL) has been associated with atherosclerosis in cross-sectional studies, but the prospective relationship between telomere shortening and risk of developing carotid atherosclerosis has not been well-established. This study examines whether LTL at baseline predicts incidence and progression of carotid atherosclerosis in American Indians in the Strong Heart Study. The analysis included 2,819 participants who were free of overt cardiovascular disease at baseline (2001-2003) and were followed through the end of 2006-2009 (average 5.5-yr follow-up). Discrete atherosclerotic plaque was defined as focal protrusion with an arterial wall thickness ≥50% the surrounding wall. Carotid progression was defined as having a higher plaque score at the end of study follow-up compared to baseline. Associations of LTL with incidence and progression of carotid plaque were examined using Cox proportional hazard regression, adjusting for standard coronary risk factors. Compared to participants in the highest LTL tertile, those in the lowest tertile had significantly elevated risk for both incident plaque (HR, 1.49; 95% CI, 1.09-2.03) and plaque progression (HR, 1.61; 95% CI, 1.26-2.07). Our results provide initial evidence for a potential prognostic utility of LTL in risk prediction for atherosclerosis.
在横断面研究中，短白细胞端粒长度（LTL）与动脉粥样硬化有关，但端粒缩短与颈动脉粥样硬化发生风险之间的前瞻性关系尚未完全确立。本研究在强心研究中调查了美国印第安人基线时的LTL是否能预测颈动脉粥样硬化的发生率和进展情况。分析纳入了2819名在基线时（2001 - 2003年）无明显心血管疾病且随访至2006 - 2009年底（平均随访5.5年）的参与者。离散性动脉粥样硬化斑块定义为动脉壁厚度≥周围管壁50%的局灶性突出。颈动脉进展定义为研究随访结束时的斑块评分高于基线。使用Cox比例风险回归分析LTL与颈动脉斑块发生率和进展的关联，并对标准冠状动脉危险因素进行校正。与LTL最高三分位数的参与者相比，最低三分位数的参与者发生斑块（风险比[HR]，1.49；95%置信区间[CI]，1.09 - 2.03）和斑块进展（HR，1.61；95% CI，1.26 - 2.07）的风险均显著升高。我们的结果为LTL在动脉粥样硬化风险预测中的潜在预后效用提供了初步证据。
