Association between Body Iron Status and Leukocyte Telomere Length, a Biomarker of Biological Aging, in a Nationally Representative Sample of US Adults

Abstract

BackgroundExcess iron levels can induce oxidative stress and could therefore affect telomere attrition. However, little is known about the impact of body iron status on telomere length. ObjectiveOur aim was to examine the association between serum ferritin concentrations, an indicator of body iron status, and leukocyte telomere length in US adults. DesignWe conducted a nationwide, population-based, cross-sectional study. Participants/settingWe used data from the National Health and Nutrition Examination Survey (NHANES) 1999-2002. We included 7,336 adults aged 20 years or older who had available data on serum ferritin levels and telomere length. High ferritin levels were defined as a serum ferritin level >200 ng/mL (449.4 pmol/L) in women and >300 ng/mL (674.1 pmol/L) in men. Low ferritin levels were defined as a serum ferritin level <30 ng/mL (67.4 pmol/L). Main outcome measuresLeukocyte telomere length was assayed using the quantitative polymerase chain reaction method. Statistical analysesLinear regression with survey weights was performed to estimate the association between serum ferritin levels and telomere length. ResultsThe prevalence of adults with high and low serum ferritin levels was 10.9% and 17.6%, respectively. High ferritin levels were inversely associated with telomere length compared to normal ferritin levels. After adjustment for demographic, socioeconomic and lifestyle factors, body mass index, C-reactive protein, and leukocyte cell type composition, the β coefficient for log-transformed telomere length was –0.020 (standard error [SE]=0.009; P=0.047). The association was stronger in adults aged 65 years or older (β coefficient –0.081, SE=0.017; P<0.001) than in adults 20 to 44 years old (β coefficient –0.023, SE=0.019; P=0.24) or adults aged 45 to 64 years old (β coefficient 0.024, SE=0.015; P=0.10) (P for interaction 0.003). Low ferritin levels were not significantly associated with telomere length compared with normal ferritin levels. ConclusionsIn a US nationally representative population, high body iron status was associated with shorter telomeres, especially in adults aged 65 years or older.