Effect of adiposity on leukocyte telomere length in US adults by race/ethnicity: The National Health and Nutrition Examination Survey

Objective Obesity is associated with telomere attrition – a marker of cellular and biological aging. The US has the highest proportion of obesity and is comprised of a racially/ethnic diverse population. Little is known about the relationship between obesity and telomere attrition according to race/ethnicity in the US. Our objective is to examine the differential association. Design and setting The effect of body mass index (BMI), % total body fat (TBF) and waist circumference (WC) on leukocyte telomere length (LTL) were examined as adiposity measures according to race/ethnicity and sex specific race/ethnicity using separate adjusted linear regressions on a sample of 4,919 respondents aged 20-84 years from cross-sectional 1999-2002 data using the US National Health and Nutrition Examination Survey. Mediation analyses assessed health behaviors associated with the relationship between adiposity measures and LTL. Main outcome measure LTL Results African Americans (AA) experienced a 28% and 11% decrease in LTL associated with increasing BMI and WC, (p=.02 and .03) respectively. Mexican Americans (MA) experienced a 33% decrease in LTL associated with increasing %TBF (p=.04). Whites experienced a 19%, 23%, and .08% decrease in LTL associated with increasing BMI, %TBF, and WC, (p=.05, .003, .02) respectively. White men experienced a 26% decrease in LTL due to increasing BMI (p=.05). AA women experienced a 41%, 44%, and 16% decrease in LTL due to increasing BMI, %TBF, and WC, respectively (p=.007, .02, .04). White women experienced a 29% decrease in LTL associated with increasing %TBF (p=.006). Selected health behaviors were associated with the relationship between adiposity measures and LTL. Conclusion Overall, AA and Whites have worse cellular and biological aging related to collective adiposity measures. According to sex, AA women experienced more deleterious cellular and biological aging. Findings suggest tailored interventions to improve adverse behaviors that contribute to obesity may improve telomere attrition in US adults.