Su Yijia, Yin Lei, Zhao Yujie, Zhao Yang, Zhang Wenkai, Ke Yamin, Wang Mengdi, He Xinxin, Liu Mengna, Liu Ge, Qin Pei, Hu Fulan, Zhang Ming, Hu Dongsheng
Department of Epidemiology and Biostatistics, College of Public Health, Zhengzhou University, Zhengzhou, Henan, People's Republic of China.
Department of Cardiovascular Medicine, The Seventh People's Hospital of Zhengzhou, Zhengzhou, Henan, People's Republic of China; Henan Provincial Key Laboratory of Cardiac Remodeling and Transplantation, Zhengzhou, Henan, People's Republic of China.
Nutr Metab Cardiovasc Dis. 2025 Apr;35(4):103830. doi: 10.1016/j.numecd.2024.103830. Epub 2024 Dec 12.
The association of telomere length (TL) and coronary heart disease (CHD) is still debated, and there is a lack of dose-response meta-analyses on this issue. The aim is therefore to integrate existing evidence on the association between TL and CHD risk and explore the dose-response relationship between them.
PubMed, EMBASE, and Web of Science were searched for relevant studies up to September 2024. Meta-analysis was performed using a random-effects model, with data presented as RRs and 95 % CIs. Restricted cubic splines were used to assess linear and nonlinear associations. Subgroup analysis and meta-regression were performed to explore sources of heterogeneity. Fourteen articles (8 prospective cohort studies, 2 case-cohort studies, 2 case-control studies, and 2 cross-sectional studies) were finally included in the meta-analysis, with a total sample size of 199,562 participants and 25,752 cases. For CHD, the total RR for the highest TL group compared to the lowest TL group was 0.69 (95 % CI: 0.61, 0.78, I = 64.5 %). For every 1 kilobase pair (kbp) increase in TL, the CHD risk decreased by 23 % (RR = 0.77, 95 % CI: 0.69, 0.87, I = 89.0 %). The nonlinearity test indicated a linear association between TL and CHD risk (P = 0.930). Sensitivity analyses indicated that the results were robust.
The meta-analysis showed a linear relationship between TL and CHD. People with low TL may be more likely to develop CHD than those with high TL. The association between the two did not change in a wide range of populations.
端粒长度（TL）与冠心病（CHD）之间的关联仍存在争议，且缺乏关于此问题的剂量反应荟萃分析。因此，目的是整合关于TL与CHD风险关联的现有证据，并探索它们之间的剂量反应关系。
检索了截至2024年9月的PubMed、EMBASE和Web of Science上的相关研究。使用随机效应模型进行荟萃分析，数据以相对风险（RRs）和95%置信区间（CIs）表示。采用受限立方样条来评估线性和非线性关联。进行亚组分析和荟萃回归以探索异质性来源。最终有14篇文章（8项前瞻性队列研究、2项病例队列研究、2项病例对照研究和2项横断面研究）纳入荟萃分析，总样本量为199,562名参与者和25,752例病例。对于冠心病，最高TL组与最低TL组相比的总RR为0.69（95%CI：0.61，0.78，I² = 64.5%）。TL每增加1千碱基对（kbp），冠心病风险降低23%（RR = 0.77，95%CI：0.69，0.87，I² = 89.0%）。非线性检验表明TL与冠心病风险之间存在线性关联（P = 0.930）。敏感性分析表明结果具有稳健性。
荟萃分析显示TL与CHD之间存在线性关系。TL低的人可能比TL高的人更易患CHD。两者之间的关联在广泛的人群中没有变化。
