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,Diabetologia

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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
Diabetologia ( IF 8.4 ) Pub Date : 2021-11-22 , DOI: 10.1007/s00125-021-05613-1
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 _{1,

2,

3,

4,

6}

Affiliation

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 ∆∆C_t 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, HbA_1c, 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.

Graphical abstract

更新日期：2022-01-08

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