1
|
Mao R, Wang F, Zhong Y, Meng X, Zhang T, Li J. Association of biological age acceleration with cardiac morphology, function, and incident heart failure: insights from UK Biobank participants. Eur Heart J Cardiovasc Imaging 2024; 25:1315-1323. [PMID: 38747402 DOI: 10.1093/ehjci/jeae126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Revised: 05/02/2024] [Accepted: 05/03/2024] [Indexed: 08/28/2024] Open
Abstract
AIMS Advanced age is associated with an increased risk of adverse cardiovascular events. The relationship between biological age acceleration (BAA), cardiac size, cardiac function, and heart failure (HF) is not well-defined. METHODS AND RESULTS Utilizing the UK Biobank cohort, we assessed biological age using the Klemera-Doubal and PhenoAge methods. BAA was quantified by residual analysis compared with chronological age. Cardiovascular magnetic resonance (CMR) imaging provided detailed insights into cardiac structure and function. We employed multivariate regression to examine links between BAA and CMR-derived cardiac phenotypes. Cox proportional hazard regression models analysis was applied to explore the causative relationship between BAA and HF. Additionally, Mendelian randomization was used to investigate the genetic underpinnings of these associations. A significant correlation was found between increased BAA and deleterious changes in cardiac structure, such as diminished left ventricular mass, lower overall ventricular volume, and reduced stroke volumes across ventricles and atria. Throughout a median follow-up of 13.8 years, participants with greater biological aging showed a heightened risk of HF [26% per standard deviation (SD) increase in KDM-BA acceleration, 95% confidence intervals (CI): 23-28%; 33% per SD increase in PhenoAge acceleration, 95% CI: 32-35%]. Mendelian randomization analysis suggests a likely causal link between BAA, vital cardiac metrics, and HF risk. CONCLUSION In this cohort, accelerated biological aging may serve as a risk indicator for altered cardiac dimensions, functionality, and the onset of heart failure among middle-aged and elderly adults. It holds promise as a focal point for evaluating risk and developing targeted interventions.
Collapse
Affiliation(s)
- Rui Mao
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Fan Wang
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Yun Zhong
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Xin Meng
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| | - Tongtong Zhang
- The Center of Gastrointestinal and Minimally Invasive Surgery, The Third People's Hospital of Chengdu, 82 Qinglong Street, Chengdu, Sichuan Province 610031, China
- Medical Research Center, The Third People's Hospital of Chengdu, The Affiliated Hospital of Southwest Jiaotong University, The Second Chengdu Hospital Affiliated to Chongqing Medical University, 82 Qinglong Street, Chengdu, Sichuan Province 610031, China
| | - Ji Li
- Department of Dermatology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- Hunan Key Laboratory of Aging Biology, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, No. 87, Xiangya Road, Changsha City, Hunan Province 410008, China
| |
Collapse
|
2
|
Wong JYY, Blechter B, Liu Z, Shi J, Roger VL. Genetic susceptibility to chronic diseases leads to heart failure among Europeans: the influence of leukocyte telomere length. Hum Mol Genet 2024; 33:1262-1272. [PMID: 38676403 PMCID: PMC11227624 DOI: 10.1093/hmg/ddae063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 03/07/2024] [Accepted: 03/25/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Genetic susceptibility to various chronic diseases has been shown to influence heart failure (HF) risk. However, the underlying biological pathways, particularly the role of leukocyte telomere length (LTL), are largely unknown. We investigated the impact of genetic susceptibility to chronic diseases and various traits on HF risk, and whether LTL mediates or modifies the pathways. METHODS We conducted prospective cohort analyses on 404 883 European participants from the UK Biobank, including 9989 incident HF cases. Multivariable Cox regression was used to estimate associations between HF risk and 24 polygenic risk scores (PRSs) for various diseases or traits previously generated using a Bayesian approach. We assessed multiplicative interactions between the PRSs and LTL previously measured in the UK Biobank using quantitative PCR. Causal mediation analyses were conducted to estimate the proportion of the total effect of PRSs acting indirectly through LTL, an integrative marker of biological aging. RESULTS We identified 9 PRSs associated with HF risk, including those for various cardiovascular diseases or traits, rheumatoid arthritis (P = 1.3E-04), and asthma (P = 1.8E-08). Additionally, longer LTL was strongly associated with decreased HF risk (P-trend = 1.7E-08). Notably, LTL strengthened the asthma-HF relationship significantly (P-interaction = 2.8E-03). However, LTL mediated only 1.13% (P < 0.001) of the total effect of the asthma PRS on HF risk. CONCLUSIONS Our findings shed light onto the shared genetic susceptibility between HF risk, asthma, rheumatoid arthritis, and other traits. Longer LTL strengthened the genetic effect of asthma in the pathway to HF. These results support consideration of LTL and PRSs in HF risk prediction.
Collapse
Affiliation(s)
- Jason Y Y Wong
- Epidemiology and Community Health Branch, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, United States
| | - Batel Blechter
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, United States
| | - Zhonghua Liu
- Department of Biostatistics, Mailman School of Public Health, Columbia University, 722 W 168th St, New York, NY 10032, United States
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rockville, MD 20850, United States
| | - Véronique L Roger
- Epidemiology and Community Health Branch, National Heart Lung and Blood Institute, 10 Center Drive, Bethesda, MD 20892, United States
| |
Collapse
|
3
|
Chung HG, Yang PS, Cho S, Jang E, Kim D, Yu HT, Kim TH, Uhm JS, Sung JH, Pak HN, Lee MH, Joung B. The associations of leukocyte telomere length and intermediary cardiovascular phenotype with adverse cardiovascular outcomes in the white population. Sci Rep 2024; 14:13975. [PMID: 38886520 PMCID: PMC11183248 DOI: 10.1038/s41598-024-64997-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
The evidence about the associations of leukocyte telomere length (LTL) and intermediary cardiovascular phenotypes with adverse cardiovascular outcomes is inconclusive. This study assessed these relationships with cardiovascular imaging, electrocardiography, and the risks of sudden cardiac death (SCD), coronary events, and heart failure (HF) admission. We conducted a cross-sectional analysis of UK Biobank participants enrolled between 2006 and 2010. LTL was measured using quantitative polymerase chain reactions. Electronic health records were used to determine the incidence of SCD, coronary events, and HF admission. Cardiovascular measurements were made using cardiovascular magnetic resonance imaging and machine learning. The associations of LTL with SCD, coronary events, and HF admission and cardiac magnetic resonance imaging, electrocardiogram parameters of 33,043 and 19,554 participants were evaluated by multivariate regression. The median (interquartile range) follow-up period was 11.9 (11.2-12.6) years. Data was analyzed from January to May 2023. Among the 403,382 white participants without coronary artery disease or HF, 181,637 (45.0%) were male with a mean age of 57.1 years old. LTL was independently negatively associated with a risk of SCD (LTL third quartile vs first quartile: hazard ratio [HR]: 0.81, 95% confidence interval [CI]: 0.72-0.92), coronary events (LTL third quartile vs first quartile: HR: 0.88, 95% CI: 0.84-0.92), and HF admission (LTL fourth quartile vs first quartile: HR: 0.84, 95% CI: 0.74-0.95). LTL was also independently positively associated with cardiac remodeling, specifically left ventricular mass index, left-ventricular-end systolic and diastolic volumes, mean left ventricular myocardial wall thickness, left ventricular stroke volume, and with electrocardiogram changes along the negative degree of T-axis. Cross-sectional study results showed that LTL was positively associated with heart size and cardiac function in middle age, but electrocardiography results did not show these associations, which could explain the negative association between LTL and risk of SCD, coronary events, and HF admission in UK Biobank participants.
Collapse
Affiliation(s)
- Ho-Gi Chung
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Pil-Sung Yang
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Seunghoon Cho
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Eunsun Jang
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Daehoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Hee Tae Yu
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Tae-Hoon Kim
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jae-Sun Uhm
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Jung-Hoon Sung
- Department of Cardiology, CHA Bundang Medical Center, CHA University, Seongnam, South Korea
| | - Hui-Nam Pak
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Moon-Hyoung Lee
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea
| | - Boyoung Joung
- Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul, 03722, South Korea.
| |
Collapse
|
4
|
Raisi-Estabragh Z, Szabo L, Schuermans A, Salih AM, Chin CWL, Vágó H, Altmann A, Ng FS, Garg P, Pavanello S, Marwick TH, Petersen SE. Noninvasive Techniques for Tracking Biological Aging of the Cardiovascular System: JACC Family Series. JACC Cardiovasc Imaging 2024:S1936-878X(24)00082-2. [PMID: 38597854 DOI: 10.1016/j.jcmg.2024.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 03/01/2024] [Accepted: 03/01/2024] [Indexed: 04/11/2024]
Abstract
Population aging is one of the most important demographic transformations of our time. Increasing the "health span"-the proportion of life spent in good health-is a global priority. Biological aging comprises molecular and cellular modifications over many years, which culminate in gradual physiological decline across multiple organ systems and predispose to age-related illnesses. Cardiovascular disease is a major cause of ill health and premature death in older people. The rate at which biological aging occurs varies across individuals of the same age and is influenced by a wide range of genetic and environmental exposures. The authors review the hallmarks of biological cardiovascular aging and their capture using imaging and other noninvasive techniques and examine how this information may be used to understand aging trajectories, with the aim of guiding individual- and population-level interventions to promote healthy aging.
Collapse
Affiliation(s)
- Zahra Raisi-Estabragh
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom.
| | - Liliana Szabo
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - Art Schuermans
- Faculty of Medicine, KU Leuven, Leuven, Belgium; Program in Medical and Population Genetics, Broad Institute of Harvard and Massachusetts Institute of Technology, Cambridge, Massachusetts, USA; Cardiovascular Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Ahmed M Salih
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Department of Population Health Sciences, University of Leicester, Leicester UK; Department of Computer Science, Faculty of Science, University of Zakho, Zakho, Kurdistan Region, Iraq
| | - Calvin W L Chin
- Department of Cardiology, National Heart Centre Singapore, Singapore, Singapore; Cardiovascular Academic Clinical Programme, Duke National University of Singapore Medical School, Singapore, Singapore
| | - Hajnalka Vágó
- Semmelweis University, Heart and Vascular Center, Budapest, Hungary
| | - Andre Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Fu Siong Ng
- National Heart and Lung Institute, Imperial College London, London, United Kingdom
| | - Pankaj Garg
- University of East Anglia, Norwich Medical School, Norwich, United Kingdom; Norfolk and Norwich University Hospitals NHS Foundation Trust, Norwich, United Kingdom
| | - Sofia Pavanello
- Occupational Medicine, Department of Cardio-Thoraco-Vascular Sciences and Public Health, University of Padua, Padua, Italy; Padua Hospital, Occupational Medicine Unit, Padua, Italy; University Center for Space Studies and Activities "Giuseppe Colombo" - CISAS, University of Padua, Padua, Italy
| | | | - Steffen E Petersen
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, London, United Kingdom; Barts Heart Centre, St. Bartholomew's Hospital, Barts Health NHS Trust, London, United Kingdom; Health Data Research UK, London, United Kingdom
| |
Collapse
|
5
|
Lim J, Hashemian M, Blechter B, Roger VL, Wong JY. Pre-diagnostic free androgen and estradiol levels influence heart failure risk in both women and men: A prospective cohort study in the UK Biobank. Eur J Heart Fail 2024; 26:540-550. [PMID: 38528787 PMCID: PMC11096034 DOI: 10.1002/ejhf.3189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/31/2024] [Accepted: 02/22/2024] [Indexed: 03/27/2024] Open
Abstract
AIMS Serum sex hormones have been linked to cardiovascular disease risk. However, their roles in the pathogenesis of heart failure (HF) in both men and women are unclear. We investigated the associations between free androgen, testosterone, and estradiol, and future risk of HF. METHODS AND RESULTS This prospective cohort study evaluated UK Biobank participants free of prevalent cardiovascular disease and HF at baseline. Unitless free androgen, testosterone, and estradiol indices were generated using serum concentrations of total testosterone (nmol/L), estradiol (pmol/L), sex hormone binding globulin (SHBG, nmol/L), and albumin (g/L) in blood collected at enrolment. Multivariable Cox regression was used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) of incident HF in relation to quartiles (Q) of free androgen (FAI), testosterone (FTI), estradiol (FEI) indices, and potential confounders. There were 180 712 men (including 5585 HF cases with FAI and 571 HF cases with FEI), and 177 324 women (including 2858 HF cases with FAI and 314 HF cases with FEI) with complete data. Increased FAI was associated with decreased HF risk in both men (HRQ4 vs. Q1: 0.86, 95% CI 0.79-0.94, p-trendcontinuous < 0.0001) and post-menopausal women (HRQ4 vs. Q1: 0.83, 95% CI 0.73-0.95). Similar inverse associations were observed for FTI only in men (HRQ4 vs. Q1: 0.91, 95% CI 0.83-0.98). Higher FEI was significantly associated with decreased HF risk among men (HRQ4 vs. Q1: 0.76, 95% CI 0.59-0.98), but was positively associated among pre-menopausal women (HRQ4 vs. Q1: 2.16, 95% CI 1.11-4.18). CONCLUSIONS Sex hormones potentially influence HF pathogenesis and may offer pathways for interventions.
Collapse
Affiliation(s)
- Jungeun Lim
- Epidemiology and Community Health Branch, National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - Maryam Hashemian
- Epidemiology and Community Health Branch, National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - Batel Blechter
- Occupational and Environmental Health Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - Véronique L. Roger
- Epidemiology and Community Health Branch, National Heart Lung and Blood Institute, Bethesda, MD, USA
| | - Jason Y.Y. Wong
- Epidemiology and Community Health Branch, National Heart Lung and Blood Institute, Bethesda, MD, USA
| |
Collapse
|
6
|
Koh JYP, Li S, Koh AS. Precision Measurement of Telomere Length as a Future Guide to Improve CVD Interventions. JAMA Cardiol 2024; 9:305. [PMID: 38198169 DOI: 10.1001/jamacardio.2023.5006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2024]
Affiliation(s)
- Javier Yu Peng Koh
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
| | - Shang Li
- Cancer and Stem Cell Biology Program, Duke-NUS Medical School, Singapore
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Angela S Koh
- National Heart Centre Singapore, Duke-NUS Medical School, Singapore
| |
Collapse
|
7
|
Qiao H, Chen Y, Qian C, Guo Y. Clinical data mining: challenges, opportunities, and recommendations for translational applications. J Transl Med 2024; 22:185. [PMID: 38378565 PMCID: PMC10880222 DOI: 10.1186/s12967-024-05005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 02/18/2024] [Indexed: 02/22/2024] Open
Abstract
Clinical data mining of predictive models offers significant advantages for re-evaluating and leveraging large amounts of complex clinical real-world data and experimental comparison data for tasks such as risk stratification, diagnosis, classification, and survival prediction. However, its translational application is still limited. One challenge is that the proposed clinical requirements and data mining are not synchronized. Additionally, the exotic predictions of data mining are difficult to apply directly in local medical institutions. Hence, it is necessary to incisively review the translational application of clinical data mining, providing an analytical workflow for developing and validating prediction models to ensure the scientific validity of analytic workflows in response to clinical questions. This review systematically revisits the purpose, process, and principles of clinical data mining and discusses the key causes contributing to the detachment from practice and the misuse of model verification in developing predictive models for research. Based on this, we propose a niche-targeting framework of four principles: Clinical Contextual, Subgroup-Oriented, Confounder- and False Positive-Controlled (CSCF), to provide guidance for clinical data mining prior to the model's development in clinical settings. Eventually, it is hoped that this review can help guide future research and develop personalized predictive models to achieve the goal of discovering subgroups with varied remedial benefits or risks and ensuring that precision medicine can deliver its full potential.
Collapse
Affiliation(s)
- Huimin Qiao
- Medical Big Data and Bioinformatics Research Centre, First Affiliated Hospital of Gannan Medical University, Ganzhou, China
| | - Yijing Chen
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China
| | - Changshun Qian
- School of Information Engineering, Jiangxi University of Science and Technology, Ganzhou, China
| | - You Guo
- Medical Big Data and Bioinformatics Research Centre, First Affiliated Hospital of Gannan Medical University, Ganzhou, China.
- School of Public Health and Health Management, Gannan Medical University, Ganzhou, China.
- School of Information Engineering, Jiangxi University of Science and Technology, Ganzhou, China.
- Ganzhou Key Laboratory of Medical Big Data, Ganzhou, China.
| |
Collapse
|
8
|
Salih AM, Galazzo IB, Menegaz G, Altmann A. Leukocyte Telomere Length and Cardiac Structure and Function: A Mendelian Randomization Study. J Am Heart Assoc 2024; 13:e032708. [PMID: 38293941 PMCID: PMC11056120 DOI: 10.1161/jaha.123.032708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 01/04/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Existing research demonstrates the association of shorter leukocyte telomere length with increased risk of age-related health outcomes including cardiovascular diseases. However, the direct causality of these relationships has not been definitively established. Cardiovascular aging at an organ level may be captured using image-derived phenotypes of cardiac anatomy and function. METHODS AND RESULTS In the current study, we use 2-sample Mendelian randomization to assess the causal link between leukocyte telomere length and 54 cardiac magnetic resonance imaging measures representing structure and function across the 4 cardiac chambers. Genetically predicted shorter leukocyte telomere length was causally linked to smaller ventricular cavity sizes including left ventricular end-systolic volume, left ventricular end-diastolic volume, lower left ventricular mass, and pulmonary artery. The association with left ventricular mass (β =0.217, Pfalse discovery rate=0.016) remained significant after multiple testing adjustment, whereas other associations were attenuated. CONCLUSIONS Our findings support a causal role for shorter leukocyte telomere length and faster cardiac aging, with the most prominent relationship with left ventricular mass.
Collapse
Affiliation(s)
- Ahmed M. Salih
- William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of LondonUK
- Department of Population Health SciencesUniversity of LeicesterUK
- Department of Computer ScienceUniversity of ZakhoKurdistan of IraqIraq
| | | | | | - André Altmann
- Centre for Medical Image Computing, Department of Medical Physics and Biomedical EngineeringUniversity College LondonUK
| |
Collapse
|
9
|
Chi Z, Bai X, Zhang Z. Risk relationship between leukocyte telomere length and constipation: a Mendelian randomization study. Front Med (Lausanne) 2023; 10:1177785. [PMID: 37780571 PMCID: PMC10533926 DOI: 10.3389/fmed.2023.1177785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 08/18/2023] [Indexed: 10/03/2023] Open
Abstract
Objective Some epidemiological studies have investigated the associations between aging and constipation, yet their outcomes are inconclusive, so we strive to ascertain whether aging is the cause of constipation. Methods We conducted a two-sample Mendelian randomization (MR) analysis using publicly accessible genome-wide association study (GWAS) summary statistics. As a marker of cellular and biological aging, we employed 15 single-nucleotide polymorphisms as instrumental variables for leukocyte telomere length (LTL) as exposure and a GWAS for constipation in the Finnish database as an outcome. To select the instrumental variables strongly associated with the phenotype, we eliminated confounding factors and direct effects outcomes to determine the causal relationship of exposure factors on the outcome; the analysis was mainly performed using the random-effect inverse variance weighting method, MR-Egger, weighted median, and sensitivity analysis of the results. Results Random effect inverse variance weighted odds ratio = 1.035 (95% CI 0.907-1.180), but p = 0.612, which was not statistically significant. Other statistical methods, such as MR-Egger and weighted median, also yielded non-significant results. Conclusion LTL as a proxy for aging does not necessarily indicate an increased likelihood of constipation. Further research is needed to explore the specific mechanisms of constipation.
Collapse
Affiliation(s)
- Zhenfei Chi
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Xuesong Bai
- Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| | - Zhe Zhang
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
- Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning, China
| |
Collapse
|