Associations between RTL and age.

<p>A) Correlation between RTL (log-transformed) and age. B) RTL according to age strata.</p

Kaplan-Meier plots.

<p>Cumulative survival according to RTL quartiles (A), RTL quartile 1 versus all others quartiles (B).</p

RTL as a function of age according to follow-up.

<p>Surviving patients are shown as blue circles (r = -0.088; p<0.001), deceased patients as red triangles (r = -0.043; p = 0.20).</p

Telomere length and mortality in the Ludwigshafen Risk and Cardiovascular Health study

<div><p>Introduction</p><p>Short telomeres have been associated with adverse lifestyle factors, cardiovascular risk factors and age-related diseases, including cardiovascular disease (CVD), myocardial infarction, atherosclerosis, hypertension, diabetes, and also with mortality. However, previous studies report conflicting results.</p><p>Objectives</p><p>The aim of the present study has been to investigate the involvement of telomere length in all-cause and CVD mortality in subjects hospitalized for diagnostic coronary angiography of the Ludwigshafen Risk and Cardiovascular Health (LURIC) study.</p><p>Methods</p><p>Relative telomere length (RTL) was measured with a Q-PCR based method in 3,316 participants of the LURIC study. Age-corrected RTL was calculated as the ratio between RTL and age. Median follow-up was 9.9 years. Cox regression and Kaplan-Maier analyses were performed to evaluate the role of RTL for all-cause and cardiovascular mortality.</p><p>Results</p><p>RTL correlated negatively with age (r = -0.09; p<0.001). In surviving patients the correlation between age and RTL was statistically significant (r = -0.088; p<0.001), but not in patients who died during follow-up (r = -0.043; p = 0.20). Patients in quartiles 2–4 of RTL had a lower hazard ratio for all-cause mortality (HR:0.822; 95%CI 0.712–0.915; p = 0.008) and CVD-mortality (HR:0.836; 95%CI 0.722–0.969; p = 0.017) when compared to those in the 1^st quartile. Adjustment for major cardiovascular risk factors did not change this result, however additional adjustment for age attenuated this effect. Patients in the 4^th quartile of age-corrected RTL compared to those in the 1^st quartile had a lower hazard ratio for all-cause mortality, even with adjustment for major cardiovascular risk factors.</p><p>Conclusions</p><p>The present study supports the hypothesis that short telomere length increases the risk of all-cause and CVD mortality. Age appears to be an important co-variate that explains a substantial fraction of this effect. It remains unclear whether short telomeres contribute directly to the increase in mortality or if they are simply a surrogate marker for other adverse processes of aging.</p></div

Relationship between RTL and all-cause mortality.

<p>RTL was modelled as restricted cubic spline in Cox regression analysis and plotted against the log relative hazard with 95% confidence intervals.</p

Cox regression for all-cause and CVD-mortality according to RTL quartiles.

<p>Cox regression for all-cause and CVD-mortality according to RTL quartiles.</p