Skip to main content
Log in

The Relationship between Telomere Length and Cancer Mortality: Data from the 1999–2002 National Healthy and Nutrition Examination Survey (NHANES)

  • Published:
The journal of nutrition, health & aging

Abstract

Objectives

The association between telomeres length (TL) and cancer mortality is uncertain. We tested the hypotheses that long TL are associated with reduced cancer mortality.

Design

Prospective cohort study

Setting

the National Health and Nutrition Survey (NHANES, 1999–2002).

Participants

The analytic sample included adults (n = 7183) who had TL measurements.

Measurements

DNA was obtained via blood samples. Telomere length was assessed using the quantitative polymerase chain reaction method.

Results

During follow-up (0.08–12.7 person-years, median = 9.5 years), we observed 195 participants had cancer as causes of death. TL was negatively corelated with age, body mass index (BMI), systolic blood pressure (SBP), C-reactive protein (CRP), race, diabetes, hypertension, cardiovascular diseases (CVD) and cancer mortality, conversely, positively corelated with alcohol use, but not related to diastolic blood pressure (DBP) and smoking. Kaplan-Meier analysis revealed that TL was significantly associated with cancer mortality (log-rank, P <0.001).

Conclusions

Our study expands upon previous evidence of a relationship between TL and cancer mortality. TL may be a useful tool for evaluating risk of cancer mortality in American adults.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Figure 1
Figure 2

Similar content being viewed by others

References

  1. Blackburn EH. Switching and signaling at the telomere. Cell. 2001;106:661–73.

    CAS  PubMed  Google Scholar 

  2. Okamoto K, Seimiya H. Revisiting Telomere Shortening in Cancer. Cells. 2019;8.

    CAS  PubMed Central  Google Scholar 

  3. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144:646–74. doi:https://doi.org/10.1016/j.cell.2011.02.013

    CAS  PubMed  Google Scholar 

  4. Turner KJ, Vasu V, Griffin DK. Telomere Biology and Human Phenotype. Cells. 2019;8.

    CAS  PubMed Central  Google Scholar 

  5. Fyhrquist F, Tiitu A, Saijonmaa O, Forsblom C, Groop PH. Telomere length and progression of diabetic nephropathy in patients with type 1 diabetes. J Intern Med. 2010;267:278–86. doi: https://doi.org/10.1111/j.1365-2796.2009.02139.x

    CAS  PubMed  Google Scholar 

  6. Adaikalakoteswari A, Balasubramanyam M, Ravikumar R, Deepa R, Mohan V. Association of telomere shortening with impaired glucose tolerance and diabetic macroangiopathy. Atherosclerosis. 2007;195:83–9. doi: https://doi.org/10.1016/j.atherosclerosis.2006.12.003

    CAS  PubMed  Google Scholar 

  7. Weischer M, Bojesen SE, Cawthon RM, Freiberg JJ, Tybjaerg-Hansen A, Nordestgaard BG. Short telomere length, myocardial infarction, ischemic heart disease, and early death. Arterioscler Thromb Vasc Biol. 2012;32:822–9.

    CAS  PubMed  Google Scholar 

  8. Fyhrquist F, Saijonmaa O, Strandberg T. The roles of senescence and telomere shortening in cardiovascular disease. Nat Rev Cardiol. 2013;10:274–83. doi:https://doi.org/10.1038/nrcardio.2013.30

    CAS  PubMed  Google Scholar 

  9. Shammas MA. Telomeres, lifestyle, cancer, and aging. Curr Opin Clin Nutr Metab Care. 2011;14:28–34. doi:10.https://doi.org/1097/MCO.0b013e32834121b1

    CAS  PubMed  PubMed Central  Google Scholar 

  10. Rode L, Bojesen SE, Weischer M, Vestbo J, Nordestgaard BG. Short telomere length, lung function and chronic obstructive pulmonary disease in 46,396 individuals. Thorax. 2013;68:429–35. doi:https://doi.org/10.1136/thoraxjnl-2012-202544

    PubMed  Google Scholar 

  11. Heidenreich B, Kumar R. TERT promoter mutations in telomere biology. Mutat Res. 2017;771:15–31. doi:https://doi.org/10.1016/j.mrrev.2016.11.002

    CAS  Google Scholar 

  12. Jafri MA, Ansari SA, Alqahtani MH, Shay JW. Roles of telomeres and telomerase in cancer, and advances in telomerase-targeted therapies. Genome Med. 2016;8:69. doi:https://doi.org/10.1186/s13073-016-0324-x

    PubMed  PubMed Central  Google Scholar 

  13. Naderlinger E, Holzmann K. Epigenetic Regulation of Telomere Maintenance for Therapeutic Interventions in Gliomas. Genes (Basel). 2017;8. doi:https://doi.org/10.3390/genes8050145

  14. Fu X, Wan S, Hann HW, et al. Relative telomere length: a novel non-invasive biomarker for the risk of non-cirrhotic hepatocellular carcinoma in patients with chronic hepatitis B infection. Eur J Cancer. 2012;48:1014–22. doi:https://doi.org/10.1016/j.ejca.2012.02.066

    CAS  PubMed  PubMed Central  Google Scholar 

  15. Han J, Qureshi AA, Prescott J, et al. A prospective study of telomere length and the risk of skin cancer. J Invest Dermatol. 2009;129:415–21. doi:https://doi.org/10.1038/jid.2008.238

    CAS  PubMed  Google Scholar 

  16. Lan Q, Cawthon R, Shen M, et al. A prospective study of telomere length measured by monochrome multiplex quantitative PCR and risk of non-Hodgkin lymphoma. Clin Cancer Res. 2009;15:7429–33. doi:https://doi.org/10.1158/1078-0432.Ccr-09-0845

    CAS  PubMed  PubMed Central  Google Scholar 

  17. Lynch SM, Major JM, Cawthon R, et al. A prospective analysis of telomere length and pancreatic cancer in the alpha-tocopherol beta-carotene cancer (ATBC) prevention study. Int J Cancer. 2013;133:2672–80. doi:https://doi.org/10.1002/ijc.28272

    CAS  PubMed  PubMed Central  Google Scholar 

  18. Sanchez-Espiridion B, Chen M, Chang JY, et al. Telomere length in peripheral blood leukocytes and lung cancer risk: a large case-control study in Caucasians. Cancer Res. 2014;74:2476–86. doi:https://doi.org/10.1158/0008-5472.Can-13-2968

    CAS  PubMed  PubMed Central  Google Scholar 

  19. Xie H, Wu X, Wang S, et al. Long telomeres in peripheral blood leukocytes are associated with an increased risk of soft tissue sarcoma. Cancer. 2013;119:1885–91. doi:https://doi.org/10.1002/cncr.27984

    CAS  PubMed  Google Scholar 

  20. Ma H, Zhou Z, Wei S, et al. Shortened telomere length is associated with increased risk of cancer: a meta-analysis. PLoS One. 2011;6:e20466. doi:https://doi.org/10.1371/journal.pone.0020466

    CAS  PubMed  PubMed Central  Google Scholar 

  21. Prescott J, Wentzensen IM, Savage SA, De Vivo I. Epidemiologic evidence for a role of telomere dysfunction in cancer etiology. Mutat Res. 2012;730:75–84. doi:https://doi.org/10.1016/j.mrfmmm.2011.06.009

    CAS  PubMed  Google Scholar 

  22. Wentzensen IM, Mirabello L, Pfeiffer RM, Savage SA. The association of telomere length and cancer: a meta-analysis. Cancer Epidemiol Biomarkers Prev. 2011;20:1238–50. doi:https://doi.org/10.1158/1055-9965.Epi-11-0005

    CAS  PubMed  PubMed Central  Google Scholar 

  23. Willeit P, Willeit J, Mayr A, et al. Telomere length and risk of incident cancer and cancer mortality. JAMA. 2010;304:69–75.

    CAS  PubMed  Google Scholar 

  24. Needham BL, Rehkopf D, Adler N, et al. Leukocyte telomere length and mortality in the National Health and Nutrition Examination Survey, 1999–2002. Epidemiology. 2015;26:528–35.

    PubMed  PubMed Central  Google Scholar 

  25. Svensson J, Karlsson MK, Ljunggren O, Tivesten A, Mellstrom D, Moverare-Skrtic S. Leukocyte telomere length is not associated with mortality in older men. Exp Gerontol. 2014;57:6–12. doi:https://doi.org/10.1016/j.exger.2014.04.013

    CAS  PubMed  Google Scholar 

  26. Duggan C, Risques R, Alfano C, et al. Change in peripheral blood leukocyte telomere length and mortality in breast cancer survivors. J Natl Cancer Inst. 2014;106:dju035. doi:https://doi.org/10.1093/jnci/dju035

    PubMed  PubMed Central  Google Scholar 

  27. Kotsopoulos J, Prescott J, De Vivo I, et al. Telomere length and mortality following a diagnosis of ovarian cancer. Cancer Epidemiol Biomarkers Prev. 2014;23:2603–6. doi:https://doi.org/10.1158/1055-9965.Epi-14-0885

    PubMed  PubMed Central  Google Scholar 

  28. Mazidi M, Kengne AP, Vatanparast H. Food Security and Leukocyte Telomere Length in Adult Americans. Oxid Med Cell Longev. 2017;2017:5427657. doi:https://doi.org/10.1155/2017/5427657

    PubMed  PubMed Central  Google Scholar 

  29. Mazidi M, Kengne AP, Sahebkar A, Banach M. Telomere Length Is Associated With Cardiometabolic Factors in US Adults. Angiology. 2018;69:164–9. doi:https://doi.org/10.1177/0003319717712860

    CAS  PubMed  Google Scholar 

  30. Mazidi M, Penson P, Banach M. Association between telomere length and complete blood count in US adults. Arch Med Sci. 2017;13:601–5. doi:https://doi.org/10.5114/aoms.2017.67281

    PubMed  PubMed Central  Google Scholar 

  31. Needham BL, Adler N, Gregorich S, et al. Socioeconomic status, health behavior, and leukocyte telomere length in the National Health and Nutrition Examination Survey, 1999–2002. Soc Sci Med. 2013;85:1–8. doi:https://doi.org/10.1016/j.socscimed.2013.02.023

    PubMed  PubMed Central  Google Scholar 

  32. Kranz S, Mahood LJ, Wagstaff DA. Diagnostic criteria patterns of U.S. children with Metabolic Syndrome: NHANES 1999–2002. Nutr J. 2007;6:38.

    PubMed  PubMed Central  Google Scholar 

  33. Sathiakumar N, Delzell E, Abdalla O. Using the National Death Index to obtain underlying cause of death codes. J Occup Environ Med. 1998;40:808–13.

    CAS  PubMed  Google Scholar 

  34. Muezzinler A, Zaineddin AK, Brenner H. A systematic review of leukocyte telomere length and age in adults. Ageing Res Rev. 2013;12:509–19. doi:https://doi.org/10.1016/j.arr.2013.01.003

    PubMed  Google Scholar 

  35. Gardner M, Bann D, Wiley L, et al. Gender and telomere length: systematic review and meta-analysis. Exp Gerontol. 2014;51:15–27. doi:https://doi.org/10.1016/j.exger.2013.12.004

    CAS  PubMed  Google Scholar 

  36. Hansen ME, Hunt SC, Stone RC, et al. Shorter telomere length in Europeans than in Africans due to polygenetic adaptation. Hum Mol Genet. 2016;25:2324–30. doi:https://doi.org/10.1093/hmg/ddw070

    CAS  PubMed  PubMed Central  Google Scholar 

  37. Cassidy A, De Vivo I, Liu Y, et al. Associations between diet, lifestyle factors, and telomere length in women. Am J Clin Nutr. 2010;91:1273–80. doi:https://doi.org/10.3945/ajcn.2009.28947

    CAS  PubMed  PubMed Central  Google Scholar 

  38. Muezzinler A, Mons U, Dieffenbach AK, et al. Smoking habits and leukocyte telomere length dynamics among older adults: Results from the ESTHER cohort. Exp Gerontol. 2015;70:18–25. doi:https://doi.org/10.1016/j.exger.2015.07.002

    PubMed  Google Scholar 

  39. Muezzinler A, Zaineddin AK, Brenner H. Body mass index and leukocyte telomere length in adults: a systematic review and meta-analysis. Obes Rev. 2014;15:192–201. doi:https://doi.org/10.1111/obr.12126

    CAS  PubMed  Google Scholar 

  40. Zhu H, Wang X, Gutin B, et al. Leukocyte telomere length in healthy Caucasian and African-American adolescents: relationships with race, sex, adiposity, adipokines, and physical activity. J Pediatr. 2011;158:215–20. doi:https://doi.org/10.1016/j.jpeds.2010.08.007

    PubMed  Google Scholar 

  41. Mensa E, Latini S, Ramini D, Storci G, Bonafe M, Olivieri F. The telomere world and aging: Analytical challenges and future perspectives. Ageing Res Rev. 2019;50:27–42.

    CAS  PubMed  Google Scholar 

  42. Weischer M, Nordestgaard BG, Cawthon RM, Freiberg JJ, Tybjaerg-Hansen A, Bojesen SE. Short telomere length, cancer survival, and cancer risk in 47102 individuals. J Natl Cancer Inst. 2013;105:459–68.

    CAS  PubMed  Google Scholar 

  43. Rode L, Nordestgaard BG, Bojesen SE. Peripheral blood leukocyte telomere length and mortality among 64,637 individuals from the general population. J Natl Cancer Inst. 2015;107:djv074.

    PubMed  Google Scholar 

  44. Nomikos NN, Nikolaidis PT, Sousa CV, Papalois AE, Rosemann T, Knechtle B. Exercise, Telomeres, and Cancer: “The Exercise-Telomere Hypothesis”. Front Physiol. 2018;9:1798.

    PubMed  PubMed Central  Google Scholar 

  45. Fitzpatrick AL, Kronmal RA, Kimura M, et al. Leukocyte telomere length and mortality in the Cardiovascular Health Study. J Gerontol A Biol Sci Med Sci. 2011;66:421–9.

    PubMed  Google Scholar 

  46. Allsopp RC, Chang E, Kashefi-Aazam M, et al. Telomere shortening is associated with cell division in vitro and in vivo. Exp Cell Res. 1995;220:194–200. doi:https://doi.org/10.1006/excr.1995.1306

    CAS  PubMed  Google Scholar 

  47. Aragona M, Maisano R, Panetta S, et al. Telomere length maintenance in aging and carcinogenesis. Int J Oncol. 2000;17:981–9. doi:https://doi.org/10.3892/ijo.17.5.981

    CAS  PubMed  Google Scholar 

  48. Harley CB, Vaziri H, Counter CM, Allsopp RC. The telomere hypothesis of cellular aging. Exp Gerontol. 1992;27:375–82.

    CAS  PubMed  Google Scholar 

  49. Smith Sehdev AE, Hutchins GM. Problems with proper completion and accuracy of the cause-of-death statement. Arch Intern Med. 2001;161:277–84.

    CAS  PubMed  Google Scholar 

Download references

Acknowledgments

All of the time and effort expended by the thousands of participants of this study is sincerely appreciated.

Author information

Authors and Affiliations

Authors

Corresponding authors

Correspondence to Yu-Qing Huang or YingQing Feng.

Ethics declarations

Conflicts of Interest: The author has no conflicts of interests to report.

Ethical Standards: The National Center for Health Statistics’ Research Ethics Review Board reviewed and approved all data collection protocols.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Shen, G., Huang, JY., Huang, YQ. et al. The Relationship between Telomere Length and Cancer Mortality: Data from the 1999–2002 National Healthy and Nutrition Examination Survey (NHANES). J Nutr Health Aging 24, 9–15 (2020). https://doi.org/10.1007/s12603-019-1265-z

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12603-019-1265-z

Key words

Navigation