The Effect Of Leukocyte Telomere Length On Prevalent Primary Osteoporosis Risk In Chinese Elderly Population

Objective: Telomere erosion is believed to act as a mitotic clock to eventually signal cellular senescence.Telomere length is regarded as a marker of aging.Osteoporosis is an age-related disease.The purpose of our study is to examine the association between leukocyte telomere length(LTL),and bone mineral density(BMD)and osteoporosis prevalence risk among an elderly Chinese population.The findings may provide new choice for osteoporosis screening and diagnosis in future.Methods: A total of 1017 participants,consisting of 433 men and 584 postmenopausal women,were enrolled from a health check-up center and two community centers in Wuhan City,central China,from April 2016 to August 2017.Dual-energy X-ray absorptiometry was used for BMD measurement at skeleton sites of lumbar spine(LS),femoral neck(FN),and total hip(TH).LTL was measured using quantitative real-time polymerase chain reaction.All analyses were performed separately among men and women.Student's t-test and Chi-square test were used.In this study,the putative interaction between age and LTL was considered.Multiple linear,ordinal and multinomial logistic regression models were fitted to explore the associations between LTL,and BMD and osteoporosis prevalence risk as appropriate.The interaction between age and LTL was measured on an additive scale with the relative excess risk due to interaction(RERI)provided.Results: For all subjects,mean LTL is 0.99.Mean LTL in men is 0.94 which is significantly shorter(t =-3.63,p = 0.0003)than that in women with mean LTL of 1.01.Mean BMD at each site of LS,FN and TH in men is significantly higher(t = 15.43,p<0.0001;t = 12.93,p<0.0001;t = 13.79,p<0.0001)than the counterpart in women.Among women,age significantly modified the effect of LTL on BMD at FN.Additionally,significant age modification was observed for the association between LTL and LS BMD category(indicative of control or osteopenia or osteoporosis),and the number of osteoporotic sites at LS or TH.The corresponding estimates for RERIs(95% CI)were-0.07(-0.11,-0.01)and-0.11(-0.16,-0.03)sequentially in ordinal logistic regression models.The estimated RERIs(95% CI)were-0.11(-0.25,-0.02)and-0.23(-0.39,-0.10)in multinomial logistic regression models for LS/FN/TH BMD category,and-0.20(-0.31,-0.09)and-0.34(-0.49,-0.21)for FN BMD category.However,similar findings did not show in neither all subjects nor men.Conclusions: The effect of LTL on BMD and osteoporosis prevalence risk is modified by age in elderly women but not in men,suggesting that the predictive role of LTL in bone loss and osteoporosis differ by sex.Further prospective cohort study and research concerning the biological mechanisms of how age interacts with LTL in the development of osteoporosis must be conducted.