Research Paper Volume 10, Issue 10 pp 3005—3016

Longitudinal changes in leukocyte telomere length and mortality in elderly Swedish men

Xiaotian Yuan1, , Magnus Kronström2, , Mai-Lis Hellenius3, , Tommy Cederholm2, , Dawei Xu1, , Per Sjögren2, ,

  • 1 Department of Medicine, Division of Hematology, and Center for Molecular Medicine, Karolinska Institutet and Karolinska University Hospital Solna, SE-171 76 Stockholm, Sweden
  • 2 Department of Public Health and Caring Sciences, Unit of Clinical Nutrition and Metabolism, Uppsala University, Uppsala, Sweden
  • 3 Karolinska Institutet, Department of Medicine, Karolinska University Hospital, Solna, SE-171 76 Stockholm, Sweden
* Equal contribution

Received: June 12, 2018       Accepted: October 19, 2018       Published: October 29, 2018
How to Cite

Copyright: © 2018 Yuan et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.


Telomere length (TL) is considered an indicator of aging and age-related diseases, but longitudinal studies on TL changes and mortality are few. We therefore analyzed TL and longitudinal changes in TL in relation to all-cause, cardiovascular, and cancer mortality in 247 elderly Swedish men. TL was determined by the qPCR method at ages 71 and 81 and subsequent mortality cases were identified from the Swedish cause-of-death registry. Cox proportional hazard ratios were calculated during a mean follow-up of 7.4 years, during which 178 deaths occurred. Short telomeres at baseline was strongly associated with mortality risks, with a 40 to 70% increased risk of all-cause mortality, and a 2-fold increased risk of cancer mortality. Longitudinal changes in TL revealed shortening in 83% of individuals, whilst 10% extended their telomeres. TL attrition did not predict all-cause or cancer mortality, but we found a 60% decreased risk for cardiovascular mortality in those who shortened their telomeres. Our data show an increased risk of mortality in individuals with short baseline telomeres, but no relations to all-cause, and cancer mortality for changes in TL. Intriguingly, our data indicate lower risk of cardiovascular mortality with shortening of telomeres. The latter should be interpreted cautiously.


BMI: body mass index; CV: coefficient of variation; CVD: Cardiovascular disease; DNA: deoxyribonucleic acid; HR: hazard ratio; ICD: international statistical classification of diseases and related health problems; qPCR: quantitative polymerase chain reaction; TL: telomere length.