Association Between Shortened Leukocyte Telomere Length and Cardiometabolic Outcomes Systematic Review and Meta-Analysis
Association Between Shortened Leukocyte Telomere Length and Cardiometabolic Outcomes Systematic Review and Meta-Analysis
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DOI：
10.1161/circgenetics.113.000485
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发表时间：
2015-02-01
影响因子：
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通讯作者：
Pare, Guillaume
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文献类型：
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作者：
D'Mello, Matthew J. J.;Ross, Stephanie A.;Pare, Guillaume
背景-端粒是重复的，基因贫乏的区域，覆盖DNA的末端，帮助维持染色体的完整性。它们的缩短是由细胞环境中的炎症和氧化应激引起的，最终导致细胞衰老。缩短的白细胞端粒长度被假设为年龄和年龄相关疾病的一种新的生物标志物，但其与心脏代谢结果在literature.Methods和Results-MEDLINE（1966年至今）和EMBASE（1980年至今）的相关性的报告是相互矛盾的，最后一次检索于2013年9月9日。手动检索检索到的引文的参考文献列表，以查找相关研究。对样本量、语言或出版物类型或日期没有限制。15个队列研究和12个病例对照研究报告白细胞端粒长度与中风，心肌梗死和2型糖尿病之间的关系，由2名评审员独立选择纳入。数据提取和偏倚风险评估由2名评审员使用预定义的标准独立完成。使用通用逆方差法以及固定和随机效应模型汇总研究。白细胞端粒长度减少1-SD与卒中显著相关（比值比，1.21; 95%置信区间，1.06-1.37; I-2=61%），心肌梗死（比值比，1.24; 95%置信区间，1.04-1.47; I-2=68%），和2型糖尿病（比值比，1.37; 95%置信区间，1.10-1.72; I-2=91%）。分层的测量技术，研究设计，研究规模和种族解释异质性在某些cardiometabolic outcomes. Conclusions缩短白细胞端粒长度与中风，心肌梗死和2型糖尿病表现出显着的关联。需要更大的、设计良好的研究来证实这些发现并探索异质性的来源。
Background-Telomeres are repetitive, gene-poor regions that cap the ends of DNA and help maintain chromosomal integrity. Their shortening is caused by inflammation and oxidative stress within the cellular environment and ultimately leads to cellular senescence. Shortened leukocyte telomere length is hypothesized to be a novel biomarker for age and age-related diseases, yet reports on its association with cardiometabolic outcomes in the literature are conflicting.Methods and Results-MEDLINE (1966 to present) and EMBASE (1980 to present) were last searched on September 9, 2013. Reference lists of retrieved citations were hand searched for relevant studies. No restrictions were placed on sample size, language, or publication type or date. Fifteen cohort and 12 case-control studies reporting the association between leukocyte telomere length and stroke, myocardial infarction, and type 2 diabetes mellitus were independently selected for inclusion by 2 reviewers. Data extraction and risk of bias assessment were completed independently by 2 reviewers using predefined criteria. Studies were pooled using the generic inverse variance method and both fixed and random effects models. A 1-SD decrease in leukocyte telomere length was significantly associated with stroke (odds ratio, 1.21; 95% confidence interval, 1.06-1.37; I-2=61%), myocardial infarction (odds ratio, 1.24; 95% confidence interval, 1.04-1.47; I-2=68%), and type 2 diabetes mellitus (odds ratio, 1.37; 95% confidence interval, 1.10-1.72; I-2=91%). Stratification by measurement technique, study design, study size, and ethnicity explained heterogeneity in certain cardiometabolic outcomes.Conclusions-Shortened leukocyte telomere length demonstrates a significant association with stroke, myocardial infarction, and type 2 diabetes mellitus. Larger, well-designed studies are needed to confirm these findings and explore sources of heterogeneity.