Telomere length and health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies

Abstract

The aim of the present study was to map and grade evidence for the relationships between telomere length with a diverse range of health outcomes, using an umbrella review of systematic reviews with meta-analyses. We searched for meta-analyses of observational studies reporting on the association of telomere length with any health outcome (clinical disease outcomes and intermediate traits). For each association, random-effects summary effect size, 95% confidence interval (CI), and 95% prediction interval were calculated. To evaluate the credibility of the identified evidence, we assessed also heterogeneity, evidence for small-study effect and evidence for excess significance bias. Twenty-one relevant metaanalyses were identified reporting on 50 different outcomes and including a total of 326 observational studies. The level of evidence was high only for the association of short telomeres with higher risk of gastric cancer in the general population (relative risk, RR=1.95, 95%CI: 1.68-2.26), and moderate for the association of shorter telomeres with diabetes or with Alzheimer's disease, even if limited to meta-analyses of case-control studies. There was weak evidence for twenty outcomes and not significant association for 27 health outcomes.The present umbrella review demonstrates that shorter telomere length may have an important role in incidence gastric cancer and, probably, diabetes and Alzheimer's disease.At the same time, conversely to general assumptions, it does not find strong evidence supporting the notion that shorter telomere length plays an important role in many health outcomes that have been studied thus far.

Health Disparities in COVID-19: Addressing the Role of Social Determinants of Health in Immune System Dysfunction to Turn the Tide

“…A recent study from our lab using data from the National Health and Nutrition Examination Survey demonstrated that living in socioeconomically disadvantaged neighborhoods associated with shorter leukocyte telomere length among U.S. adults, indicating the potential impact of adverse neighborhood conditions on immune cells ( 63 ). It is important to note that leukocyte telomere length has also been reported to have inconclusive results for some diseases ( 64 ) and certainly warrants future research as racial/ethnic differences have been shown when comparing telomere length and/or telomere shortening rate of Blacks to those of Whites ( 65 – 67 ). Overall, urgent studies are needed to investigate cellular signaling mechanisms by which markers of social position, including socioeconomic position and the neighborhood environment of individuals ( 68 ), shape the transcriptional identity of immune cells ( 69 ) to further understand the disparities in COVID-19 outcomes and potential targets for therapeutic intervention.…”

Biological embedding of maternal postpartum depressive symptoms: The potential role of cortisol and telomere length

“…Short telomere length, therefore, has been associated with compromised adult all-cause mortality (Wang, Zhan, Pedersen, Fang, & Hägg, 2018) and morbidity, including physical disorders, such as gastric cancer and diabetes, as well as psychological disorders, such as depression (e.g. Desai et al, 2018;D'Mello et al, 2015;Gillis et al, 2019;Lin, Epel, & Blackburn, 2012;Ridout, Ridout, Price, Sen, & Tyrka, 2016;Smith et al, 2019).…”

Orthostatic hypotension and health outcomes: an umbrella review of observational studies

“…p<0.05) were categorized into convincing, highly suggestive, suggestive, or weak evidence (class I to IV), following a grading scheme that has already been applied in various fields of medicine. [21][22][23][24][25][26][27][28][29][30][31][32][33] These criteria are fully reported in Supplementary Table 2.…”