Abstract

Leucocyte telomere length (LTL) has been associated with nonalcoholic fatty liver disease (NAFLD), but the evidence is imperfect. Furthermore, liver fibrosis has been shown to correlate with mortality and recent studies have also found associations with LTL and fibrosis suggesting that LTL may have additional prognostic value in liver diseases. Our objective was to study the association of LTL and NAFLD and evaluate the association of LTL in prognosis of NAFLD subjects. Study subjects (n = 847) were middle-aged hypertensive patients. All participants were evaluated for NAFLD and their LTL was measured at baseline. Outcomes were obtained from Finnish Causes-of-Death Register and the Care Register for Health Care in Statistics Finland to the end of 2014. An inverse association with NAFLD prevalence and LTL length was observed (p < .001 for trend). Shortest telomere tertile possessed statistically significantly more NAFLD subjects even with multivariate analysis (shortest vs. middle tertile HR 1.98 p = .006 and shortest vs. longest tertile HR 2.03 p = .007). For the study period, mortality of the study group showed statistically significant relation with telomere length in univariate but not for multivariate analysis. In subgroup analysis, LTL did not associate with prognosis of non-NAFLD subjects. However, LTL was inversely associated with overall mortality in the subjects with NAFLD in both univariate (HR 0.16 p = .007) and multivariate analysis (HR 0.20 p = .045). In middle-aged Caucasian cohort, shorter leucocyte telomeres associated independently with increased prevalence of NAFLD. Shorter LTL was not associated with mortality in non-NAFLD patients whereas it predicted mortality of NAFLD patients independently.

摘要

白细胞端粒长度 (LTL) 与非酒精性脂肪性肝病 (NAFLD) 相关，但证据不完善。此外，肝纤维化已被证明与死亡率相关，最近的研究还发现与 LTL 和纤维化有关，这表明 LTL 可能对肝病具有额外的预后价值。我们的目的是研究 LTL 和 NAFLD 的关联，并评估 LTL 在 NAFLD 受试者预后中的关联。学习科目（n = 847) 是中年高血压患者。所有参与者都接受了 NAFLD 评估，并在基线时测量了他们的 LTL。结果来自芬兰死亡原因登记册和芬兰统计局的医疗保健登记册，截至 2014 年底。观察到与 NAFLD 患病率和 LTL 长度呈负相关（趋势p  < .001）。即使进行多变量分析，最短端粒三分位数的 NAFLD 受试者在统计学上也显着增加（最短与中间三分位数 HR 1.98 p  = .006，最短与最长三分位数 HR 2.03 p = .007)。在研究期间，研究组的死亡率在单变量中显示出与端粒长度的统计学显着关系，但在多变量分析中没有。在亚组分析中，LTL 与非 NAFLD 受试者的预后无关。然而，在单变量（HR 0.16 p  = .007）和多变量分析（HR 0.20 p  = .045）中，LTL 与 NAFLD 受试者的总死亡率呈负相关。在中年高加索人群中，较短的白细胞端粒与 NAFLD 患病率的增加独立相关。较短的 LTL 与非 NAFLD 患者的死亡率无关，但它独立预测 NAFLD 患者的死亡率。