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Epidemiology. 2015 Jul;26(4):528-35. doi: 10.1097/EDE.0000000000000299.

Leukocyte telomere length and mortality in the National Health and Nutrition Examination Survey, 1999-2002.

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From the aDepartment of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI; bDivision of General Medical Disciplines, Stanford University, Stanford, CA; cDepartment of Psychiatry, dDivision of General Internal Medicine, and eDepartment of Biochemistry and Biophysics, University of California, San Francisco, CA.



This study examined the association between leukocyte telomere length--a marker of cell aging--and mortality in a nationally representative sample of US adults ages 50-84 years. We also examined moderating effects of age, sex, race/ethnicity, and education.


Data were from the National Health and Nutrition Examination Survey, 1999-2002 (n = 3,091). Cox proportional hazards regression was used to estimate the risk of all-cause and cause- specific mortality adjusting for sociodemographic characteristics, smoking, body mass index, and chronic conditions.


Eight hundred and seventy deaths occurred over an average of 9.5 years of follow-up. In the full sample, a decrease of 1 kilobase pair in telomere length at baseline was marginally associated with a 10% increased hazard of all-cause mortality (hazard ratio [HR]: 1.1, 95% confidence interval [CI]: 0.9, 1.4) and a 30% increased hazard of death due to diseases other than cardiovascular disease or cancer (HR: 1.3, 95% CI: 0.9, 1.9). Among African-American but not white or Mexican-American respondents, a decrease of 1 kilobase pair in telomere length at baseline was associated with a two-fold increased hazard of cardiovascular mortality (HR: 2.0, 95% CI: 1.3, 3.1). There was no association between telomere length and cancer mortality.


The association between leukocyte telomere length and mortality differs by race/ethnicity and cause of death.

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