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Telomere Length and Risk of Incident Fracture and Arthroplasty: Findings From UK Biobank
Author(s) -
Curtis Elizabeth M.,
Codd Veryan,
Nelson Christopher,
D'Angelo Stefania,
Wang Qingning,
Allara Elias,
Kaptoge Stephen,
Matthews Paul M.,
Tobias Jonathan H.,
Danesh John,
Cooper Cyrus,
Samani Nilesh J.,
Harvey Nicholas C.
Publication year - 2022
Publication title -
journal of bone and mineral research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.882
H-Index - 241
eISSN - 1523-4681
pISSN - 0884-0431
DOI - 10.1002/jbmr.4664
Subject(s) - medicine , hazard ratio , confidence interval , hip fracture , osteoporosis , confounding , proportional hazards model , arthroplasty , periprosthetic , surgery
We investigated independent associations between telomere length and risk of fracture and arthroplasty in UK Biobank participants. Leukocyte telomere length (LTL) was measured in baseline samples using a validated polymerase chain reaction (PCR) method. We used, in men and women separately, Cox proportional hazards models to calculate the hazard ratio (HR) for incident fracture (any, osteoporotic) or arthroplasty (hip or knee) over 1,186,410 person‐years of follow‐up. Covariates included age, white cell count, ethnicity, smoking, alcohol, physical activity, and menopause (women). In further analyses we adjusted for either estimated bone mineral density (eBMD) from heel quantitative ultrasound, handgrip strength, gait speed, total fat mass (bioimpedance), or blood biomarkers, all measured at baseline (2006–2010). We studied 59,500 women and 51,895 men, mean ± standard deviation (SD) age 56.4 ± 8.0 and 57.0 ± 8.3 years, respectively. During follow‐up there were 5619 fractures; 5285 hip and 4261 knee arthroplasties. In confounder‐adjusted models, longer LTL was associated with reduced risk of incident knee arthroplasty in both men (HR/SD 0.93; 95% confidence interval [CI], 0.88–0.97) and women (0.92; 95% CI, 0.88–0.96), and hip arthroplasty in men (0.91; 95% CI, 0.87–0.95), but not women (0.98; 95% CI, 0.94–1.01). Longer LTL was weakly associated with reduced risk of any incident fracture in women (HR/SD 0.96; 95% CI, 0.93–1.00) with less evidence in men (0.98; 95% CI, 0.93–1.02). Associations with incident outcomes were not materially altered by adjustment for heel eBMD, grip strength, gait speed, fat mass, or blood biomarker measures. In this, the largest study to date, longer LTL was associated with lower risk of incident knee or hip arthroplasty, but only weakly associated with lower risk of fracture. The relative risks were low at a population level, but our findings suggest that common factors acting on the myeloid and musculoskeletal systems might influence later life musculoskeletal outcomes. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).