Elevated 1-hour Post Load Glucose as a Predictor for Telomere Attrition: A Study Based on a Chinese Community Population

Abstract

Context: One-hour post-load glucose (1h-PG) detects dysglycemia-related disorders more effectively than traditional glycemic parameters. Hyperglycemia accelerates aging, but whether 1h-PG outperforms in predicting aging remains unclear.

Objective: To compare the effectiveness of 1h-PG with other glycemic parameters in identifying and predicting telomere attrition.

Methods: We conducted a cross-sectional and longitudinal study based on a Chinese community cohort. Multivariate linear regression and logistic regression were used to analyze the associations between glycemic parameters and telomere length. The area under the receiver operating characteristic (AUROC) curve were used to compare the differentiating and predictive ability. Populations were regrouped by glucose tolerance status and 1h-PG to compare telomere length. Analyses were separately conducted in nondiabetic and diabetic populations.

Results: The cross-sectional study included 715 participants. Only 1h-PG was significantly negatively associated with relative telomere length in both nondiabetic [β = -.106, 95% confidence interval (CI) -0.068 to -0.007, P = .017] [odds ratio (OR) = 1.151, 95% CI 1.069 to 1.239, P = .005] and diabetic (β = -.222, 95% CI -0.032 to -0.007, P = .002) (OR = 1.144, 95% CI 1.041 to 1.258, P = .035) populations. The longitudinal study recruited 437 populations and 112 remained in 7-years follow-up. 1h-PG was associated with telomere shortening in the nondiabetic group (β = -.314, 95% CI -0.276 to -0.032, P = .016) (OR = 2.659, 95% CI 1.158 to 6.274, P = .021). AUROC analysis showed that 1h-PG outperformed other glycemic parameters in identifying and predicting telomere attrition. Reclassification revealed that normal glucose tolerance and prediabetic individuals with elevated 1h-PG had telomere lengths comparable to prediabetic and diabetic populations, respectively.

Conclusion: 1h-PG outperforms other glycemic parameters in predicting telomere attrition and can be a valuable marker for early aging detection.

Keywords: 1-hour post-load plasma glucose; aging; glycemic parameters; leukocyte telomere length; telomere attrition.

Figure 1.

Flowchart of participants included in the study. (1A) Flowchart of cross-sectional study; (1B) flowchart of prospective study. *Proportion of individuals with elevated 1-hour plasma glucose (≥8.6 mmol/L). Abbreviations: DM, diabetic group; LTL, leukocyte telomere length; NGT, normal glucose tolerance; Pre-DM, prediabetic group.

Figure 2.

AUROCs of the glycemic parameters for telomere attrition. (2A) Total population in cross-sectional study; (2B) non-DM population in cross-sectional study; (2C) DM population in cross-sectional study; (2D) total population in prospective study; (2E) non-DM population in prospective study; (2F) DM population in prospective study. P < .05 indicates statistical difference. Abbreviations: 1h-PG, 1-hour post-load plasma glucose; 2h-PG, 2-hour post-load plasma glucose; 30′-PG, 30-minute post-load plasma glucose; AUROC, area under the receiver operating characteristic; DM, diabetic; FPG, fasting plasma glucose; HbA1c, glycated hemoglobin; non-DM, nondiabetic.

Figure 3.

Comparison of LTL across groups sorted by glucose tolerance status and 1h-PG. (3A) Comparison of RTL across NGT with 1h-PG < 8.6 mmol/L, NGT with 1h-PG ≥ 8.6 mmol/L, pre-DM, and DM groups; (3B) comparison of RTL across NGT, pre-DM with 1h-PG < 11.6 mmol/L, pre-DM with 1h-PG ≥ 11.6 mmol/L, and DM groups; (3C) comparison of RTL across NGT, pre-DM with 1h-PG < 8.6 mmol/L, pre-DM with 8.6 ≤ 1h-PG < 11.6 mmol/L, pre-DM with 1h-PG ≥ 11.6 mmol/L, and DM groups. *P < .05; **P < .01; ****P < .0001; P < .05 indicates statistical difference. The vertical axis units in panels 3A, 3B, and 3C are the same, representing the level of RTL. Abbreviations: 1h-PG, 1-hour post-load plasma glucose; DM, diabetic group; NGT, normal glucose tolerance; ns, no significance; pre-DM, prediabetic group; RTL, relative telomere length.

Figure 4.

The association between age and RTL across different glucose tolerance groups. (A) Normal glucose tolerance group; (B) prediabetic group; (C) diabetic group. Spearman correlation analysis was used to examine the relationship between age and RTL. P < .05 indicates statistical difference. The vertical axis units in panels A, B, and C are the same, representing the level of RTL. Abbreviation: RTL, relative telomere length.