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Original article
DOI: 10.1016/j.rec.2021.04.002
Available online 15 May 2021
Association between ideal cardiovascular health and telomere length in participants older than 55 years old from the SUN cohort
Asociación entre salud cardiovascular ideal y longitud telomérica en una población de edad avanzada de la cohorte SUN
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Lucia Alonso-Pedreroa,b, Ana Ojeda-Rodrígueza,b, Guillermo Zalbab,c, Cristina Razquind, Miguel Á. Martínez-Gonzálezb,d,e,f, Maira Bes-Rastrollob,d,e, Amelia Martia,b,e,
Corresponding author
amarti@unav.es

Corresponding author: Irunlarrea 1, 31008 Pamplona, Navarra, Spain.
a Departamento de Ciencias de la Alimentación y Fisiología, Universidad de Navarra, Pamplona, Navarra, Spain
b Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Navarra, Spain
c Departamento de Bioquímica y Genética, Universidad de Navarra, Pamplona, Navarra, Spain
d Departamento de Medicina Preventiva y Salud Pública, Universidad de Navarra, Pamplona, Navarra, Spain
e Centro de Investigación Biomédica en Red-Fisiopatología de la Obesidad y Nutrición (CIBEROBN), Instituto de Carlos III, Madrid, Spain
f Department of Nutrition, Harvard TH Chan School of Public Health, Boston, United States
Received 18 January 2021. Accepted 05 April 2021
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Tables (4)
Table 1. Definition of cardiovascular health score
Table 2. Baseline characteristics of participants from the SUN project according to tertiles of cardiovascular health score
Table 3. Multivariable adjusted ORs (95%CIs) for short telomeres (≤ 20th percentile) in adults older than 55 years from the SUN project
Table 4. Sensitivity analyses for the association (OR, 95%CI) between ideal cardiovascular health risk and having short telomeres (≤ 20th percentile) (ideal vs. poor tertiles of cardiovascular health score score) in adults older than 55 years from the SUN project
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Abstract
Introduction and objectives

Telomeres are noncoding regions located at the end of chromosomes and their shortening has been associated with risk factors and cardiovascular disease. The aim of this study was to evaluate the association between ideal cardiovascular health (Life's simple 7) and the odds of having short telomeres in a subsample of participants older than 55 years from the Seguimiento Universidad de Navarra (SUN) study.

Methods

We included 886 participants older than 55 years (645 men and 241 women). Telomere length was measured using a real-time quantitative polymerase chain reaction. Cardiovascular health score was defined by the American Heart Association as a composite score of 7 key risk factors (smoking status, physical activity, diet, body mass index, blood pressure, total cholesterol, and fasting blood glucose) with 0 to 2 points for each factor. We categorized this score in tertiles as poor (0-9 points), intermediate (10-11 points) and ideal (12-14 points). The odds of having short telomeres was defined as telomere length below the 20th percentile.

Results

Individuals with higher ideal cardiovascular health had a lower prevalence of having short telomeres (adjusted OR, 0.60; 95%CI, 0.34-1.05; P trend=.052). This association was statistically significant in men (adjusted OR, 0.37; 95%CI, 0.17-0.83; P trend=.025) but not in women.

Conclusions

An inverse association between cardiovascular health score and short telomeres was found especially for men older than 55 years in the SUN population.

The SUN project was registered at ClinicalTrials.gov (Identifier: NCT02669602).

Keywords:
SUN study
Cardiovascular health score
Cardiovascular risk
Telomere length
Cross-sectional study
Abbreviations:
AHA
CVD
CVH
SUN
TL
Resumen
Introducción y objetivos

Los telómeros son regiones no codificantes localizadas al final de los cromosomas de células eucariotas, y su acortamiento se ha visto relacionado con la enfermedad cardiovascular y sus factores de riesgo. El objetivo de este estudio es evaluar la asociación entre el índice de salud cardiovascular ideal y el riesgo de telómero corto en una población de sujetos de edad avanzada de la cohorte Seguimiento Universidad de Navarra (SUN).

Métodos

Se valoró a 886 adultos mayores de 55 años (645 varones y 241 mujeres). La longitud telomérica se midió utilizando qPCR (quantitative protein chain reaction) en tiempo real y reacción única. El índice de salud cardiovascular «Life's simple 7» se definió según la American Heart Association mediante la puntuación de 7 ítems con valores de 0 a 2 para cada uno: tabaquismo, actividad física, dieta, índice de masa corporal, presión arterial, colesterol total y glucosa en sangre. La máxima puntuación del índice corresponde a 14 puntos. Se categorizó en terciles: pobre (0-9 puntos), intermedio (10-11 puntos) e ideal (12-14 puntos). El riesgo de telómero corto se definió como una longitud telomérica por debajo del percentil 20.

Resultados

Sujetos con altos valores en el índice de salud cardiovascular ideal tenían menos riesgo de telómero corto (OR ajustada=0,60; IC95%, 0,34-1,05; p de tendencia lineal=0,052). Esta asociación fue significativa en varones (OR ajustada=0,37; IC95%, 0,17-0,83; p de tendencia lineal=0,025), pero no en mujeres.

Conclusiones

En varones mayores de 55 años, existe una asociación inversa entre el índice de salud cardiovascular y el riesgo de tener telómeros cortos.

El proyecto SUN fue registrado en ClinicalTrials.gov (Identificador: NCT02669602).

Palabras clave:
Cohorte SUN
Índice de Salud Cardiovascular
Riesgo cardiovascular
Longitud telomérica
Estudio transversal

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