title: Telomeric g-tail length and hospitalization for cardiovascular events in hemodialysis patients.
abstract: OBJECTIVE
  Telomeric G-tails play a pivotal role in maintaining the intramolecular loop structure of telomeres. Previous in vitro studies have suggested that the erosion of telomeric G-tails triggers cellular senescence, leading to organ dysfunction and atherosclerosis. The authors recently established a method to measure telomeric G-tail length using a hybridization protection assay. Using this method, this study investigated whether telomeric G-tail length could be used as a novel predictor for future cardiovascular events in hemodialysis patients.
  
  
  METHODS
  A prospective observational study was performed involving a cohort of 203 Japanese hemodialysis patients to examine the lengths of telomeric G-tails and total telomeres and subsequent cardiovascular events during a median follow-up period of 48 months. The lengths of telomeric G-tails and total telomeres were also measured in 203 participants who did not have CKD and who were age- and sex-matched to hemodialysis patients.
  
  
  RESULTS
  The lengths of telomeric G-tails and total telomeres were significantly shorter in hemodialysis patients than in control subjects. Telomeric G-tails, but not total telomeres, were independently and negatively associated with clinical history of cardiovascular disease. During follow-up, 80 cardiovascular events occurred. Total telomere length did not predict cardiovascular events. However, the length of telomeric G-tails was associated with new-onset cardiovascular events (hazard ratio per log luminescence signals, 0.12; 95% confidence interval, 0.12 to 0.50) that persisted after adjustment for age, sex, diabetes mellitus, clinical history of cardiovascular disease, inflammation, use of vitamin D, and serum levels of phosphate and intact parathyroid hormone.
  
  
  CONCLUSIONS
  Longer telomeric G-tail length is associated with a lower risk of future cardiovascular events in hemodialysis patients.
authors.affiliation: Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan;
authors.forename: Shuma
authors.initials: S
authors.lastname: Hirashio
authors.affiliation: Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan;
authors.forename: Ayumu
authors.initials: A
authors.lastname: Nakashima
authors.affiliation: Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan;
authors.forename: Shigehiro
authors.initials: S
authors.lastname: Doi
authors.affiliation: Departments of Cellular and Molecular Biology and.
authors.forename: Kumiko
authors.initials: K
authors.lastname: Anno
authors.affiliation: Departments of Cellular and Molecular Biology and.
authors.forename: Eriko
authors.initials: E
authors.lastname: Aoki
authors.affiliation: Departments of Cellular and Molecular Biology and.
authors.forename: Akira
authors.initials: A
authors.lastname: Shimamoto
authors.affiliation: General Incorporated Association Hiroshima Kidney Organization, Hiroshima, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Yorioka
authors.affiliation: Molecular and Internal Medicine, Graduate School of Biomedical & Health Science, Hiroshima University, Hiroshima, Japan; and.
authors.forename: Nobuoki
authors.initials: N
authors.lastname: Kohno
authors.affiliation: Department of Nephrology, Hiroshima University Hospital, Hiroshima, Japan;
authors.forename: Takao
authors.initials: T
authors.lastname: Masaki
authors.affiliation: Departments of Cellular and Molecular Biology and toshi@hiroshima-u.ac.jp.
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Tahara
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000235:genetics*; D016022:Case-Control Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D006435:Renal Dialysis; D051436:Renal Insufficiency, Chronic / Q000150:complications / Q000235:genetics* / Q000628:therapy*; D012307:Risk Factors; D059506:Telomere Shortening
keywords: CKD; cardiovascular disease; hemodialysis; telomere; telomeric G-tail