Journal Article

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

Chow, Elaine, So, Wing Yee, Hardikar, Anandwardhan A, Wu, Hongjiang, Ng Alex C W, Kong, Alice P, Keech, Anthony C, Carroll, Luke, Lau Eric S H, Lim Cadmon K P, Tam Claudia H T, Jenkins, Alicia J, Jiang Guozhi, Lee, Heung Man, Luk, Andrea O, Ma Ronald C W, Chan Juliana C N, Cheng, Feifei, Fan Baoqi, Yang, Aimin, Joglekar, Mugdha V

2022

Overview

Aims/hypothesisFew 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.MethodsWe 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.ResultsIn 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 ∆∆Ct 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, HbA1c, 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/interpretationrLTL 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.

• Publisher: Springer Nature B.V
• Subject: Biomarkers / Diabetes / Diabetes mellitus (non-insulin dependent) / End-stage renal disease / Epidermal growth factor receptors / Kidney diseases / Lipids / Renal function / Risk factors / Telomeres