Effect of Ethnicity on the Relationship Between Telomere Length and Metabolic Markers in Kuwait

The telomere plays a critical role in maintaining genomic stability, and its length serves as a marker of cellular aging. Emerging evidence projects telomere length as a clinical risk factor for metabolic diseases.

Our present study examines the associations between telomere length and demographic factors including metabolic health in a multiethnic cohort to provide insight into the effect of ethnicity on the potential use of telomere length as a biomarker for assessing diabetes risk.

This cross-sectional study cohort comprised 2083 individuals of Arab, South Asian, or Southeast Asian descent living in Kuwait. Telomere lengths were measured from peripheral venous blood DNA using quantitative polymerase chain reaction-based techniques. Associations between telomere length and metabolic indicators (including body mass index [BMI], being diabetic, glycated hemoglobin A1c [HbA1c], fasting blood glucose [FBG], and homeostatic model assessment of insulin resistance [HOMA-IR]) were analyzed using Spearman correlation and quantile regression, adjusting for covariates.

South Asian and Southeast Asian participants had significantly higher median telomere lengths than Arabs. Median telomere lengths varied significantly across sex, age tertiles, ethnicity, being diabetic, BMI, and HOMA-IR scores. Telomere length was negatively associated with being male (β = -.49; 95% CI, [-0.85 to -0.13]), diabetic (β = -.77; 95% CI, [-1.25 to -0.29]), age (β = -.06; 95% CI, [-0.08 to -0.04]), HOMA-IR (β = -1.01; 95% CI, [-1.43 to -0.575]), BMI (β = -.11; 95% CI, [-0.14 to -0.083]), and HbA1c (β = -.213; 95% CI, [-0.33 to -0.096]). Negative correlations between telomere lengths and triglycerides, HbA1c, FBG, insulin, and HOMA-IR levels were more highly significant in South Asians than in Arabs and Southeast Asians.

Our study underlines the significant influence of ethnicity on the interplay between telomere length and metabolic health, and emphasizes the need to incorporate ethnic background when relating telomere biology to metabolic disorders. It further highlights the potential to incorporate telomere length into clinical risk factors for diabetes.