Telomere Length Profile and Associated Clinical Factors among Tuberculosis Patients in Indonesia

Tuberculosis remains a major cause of chronic respiratory morbidity in developing countries, including Indonesia. Persistent lung injury in tuberculosis is driven by chronic inflammation and cellular senescence, biological processes closely linked to telomere shortening. However, data on telomere length (TL) profiles and their association with clinical factors in tuberculosis patients remain limited. To characterize TL profiles and identify associated clinical factors among tuberculosis patients in Indonesia.

This cross-sectional study was conducted at Persahabatan National Respiratory Referral Hospital and Jakarta Islamic Hospital Cempaka Putih between October 2024 and March 2025. Adult patients with tuberculosis who met the inclusion criteria were enrolled. Relative telomere length (RTL) was measured from peripheral blood mononuclear cells using flow cytometry combined with fluorescence in situ hybridization.

A total of 64 tuberculosis patients were included, with a mean age of 41.36 ± 16.23 years, and the majority were male (68.7%). The mean RTL was 6.83 ± 1.36, with a median of 6.54. Shorter RTL was significantly associated with older age, higher body mass index (BMI), diabetes mellitus (DM), and the occurrence of drug-induced liver injury (DILI) ( P < 0.05). Among the evaluated clinical factors, age remained the strongest determinant of telomere shortening.

RTL was shorter with increasing age, higher BMI, DM, and the occurrence of DILI in tuberculosis patients. These findings highlight telomere alteration as a potential clinical health indicator that may assist in identifying risk profiles in diagnostic and treatment contexts.