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. 2022 Feb;65(2):375-386.
doi: 10.1007/s00125-021-05613-1. Epub 2021 Nov 22.

Relative leucocyte telomere length is associated with incident end-stage kidney disease and rapid decline of kidney function in type 2 diabetes: analysis from the Hong Kong Diabetes Register

Feifei Cheng  1 , Andrea O Luk  1   2   3 , Hongjiang Wu  1 , Claudia H T Tam  1   2   3 , Cadmon K P Lim  1   3 , Baoqi Fan  1   2 , Guozhi Jiang  1 , Luke Carroll  4 , Aimin Yang  1   2 , Eric S H Lau  1 , Alex C W Ng  1 , Heung Man Lee  1   3 , Elaine Chow  1   2 , Alice P S Kong  1   2   3 , Anthony C Keech  4 , Mugdha V Joglekar  4   5 , Wing Yee So  1   2 , Anandwardhan A Hardikar  4   5 , Juliana C N Chan  1   2   3   6 , Alicia J Jenkins  1   4 , Ronald C W Ma  7   8   9   10   11
Affiliations

Relative leucocyte telomere length is associated with incident end-stage kidney disease and rapid decline of kidney function in type 2 diabetes: analysis from the Hong Kong Diabetes Register

Feifei Cheng et al. Diabetologia. 2022 Feb.

Abstract

Aims/hypothesis: Few large-scale prospective studies have investigated associations between relative leucocyte telomere length (rLTL) and kidney dysfunction in individuals with type 2 diabetes. We examined relationships between rLTL and incident end-stage kidney disease (ESKD) and the slope of eGFR decline in Chinese individuals with type 2 diabetes.

Methods: We studied 4085 Chinese individuals with type 2 diabetes observed between 1995 and 2007 in the Hong Kong Diabetes Register with stored baseline DNA and available follow-up data. rLTL was measured using quantitative PCR. ESKD was diagnosed based on the ICD-9 code and eGFR.

Results: In this cohort (mean ± SD age 54.3 ± 12.6 years) followed up for 14.1 ± 5.3 years, 564 individuals developed incident ESKD and had shorter rLTL at baseline (4.2 ± 1.2 vs 4.7 ± 1.2, p < 0.001) than the non-progressors (n = 3521). On Cox regression analysis, each ∆∆Ct decrease in rLTL was associated with an increased risk of incident ESKD (HR 1.21 [95% CI 1.13, 1.30], p < 0.001); the association remained significant after adjusting for baseline age, sex, HbA1c, lipids, renal function and other risk factors (HR 1.11 [95% CI 1.03, 1.19], p = 0.007). Shorter rLTL at baseline was associated with rapid decline in eGFR (>4% per year) during follow-up (unadjusted OR 1.22 [95% CI 1.15, 1.30], p < 0.001; adjusted OR 1.09 [95% CI 1.01, 1.17], p = 0.024).

Conclusions/interpretation: rLTL is independently associated with incident ESKD and rapid eGFR loss in individuals with type 2 diabetes. Telomere length may be a useful biomarker for the progression of kidney function and ESKD in type 2 diabetes.

Keywords: Chinese; End-stage kidney disease; Kidney function; Telomere length; Type 2 diabetes.

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Figures

Fig. 1
Fig. 1
Cumulative survival probability of participants without new-onset kidney failure according to tertiles (T) of relative telomere length. p < 0.001 from the comparison across groups calculated by logrank test. T1, rLTL ≤ 4.20; T2, 4.20 < rLTL ≤ 5.13; T3, rLTL > 5.13
See this image and copyright information in PMC

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