title: Leukocyte telomere length and mortality in the National Health and Nutrition Examination Survey, 1999-2002.
abstract: BACKGROUND
  This study examined the association between leukocyte telomere length--a marker of cell aging--and mortality in a nationally representative sample of US adults ages 50-84 years. We also examined moderating effects of age, sex, race/ethnicity, and education.
  
  
  METHODS
  Data were from the National Health and Nutrition Examination Survey, 1999-2002 (n = 3,091). Cox proportional hazards regression was used to estimate the risk of all-cause and cause- specific mortality adjusting for sociodemographic characteristics, smoking, body mass index, and chronic conditions.
  
  
  RESULTS
  Eight hundred and seventy deaths occurred over an average of 9.5 years of follow-up. In the full sample, a decrease of 1 kilobase pair in telomere length at baseline was marginally associated with a 10% increased hazard of all-cause mortality (hazard ratio [HR]: 1.1, 95% confidence interval [CI]: 0.9, 1.4) and a 30% increased hazard of death due to diseases other than cardiovascular disease or cancer (HR: 1.3, 95% CI: 0.9, 1.9). Among African-American but not white or Mexican-American respondents, a decrease of 1 kilobase pair in telomere length at baseline was associated with a two-fold increased hazard of cardiovascular mortality (HR: 2.0, 95% CI: 1.3, 3.1). There was no association between telomere length and cancer mortality.
  
  
  CONCLUSIONS
  The association between leukocyte telomere length and mortality differs by race/ethnicity and cause of death.
authors.affiliation: From the aDepartment of Epidemiology and Center for Social Epidemiology and Population Health, University of Michigan, Ann Arbor, MI; bDivision of General Medical Disciplines, Stanford University, Stanford, CA; cDepartment of Psychiatry, dDivision of General Internal Medicine, and eDepartment of Biochemistry and Biophysics, University of California, San Francisco, CA.
authors.forename: Belinda L
authors.initials: BL
authors.lastname: Needham
authors.forename: David
authors.initials: D
authors.lastname: Rehkopf
authors.forename: Nancy
authors.initials: N
authors.lastname: Adler
authors.forename: Steven
authors.initials: S
authors.lastname: Gregorich
authors.forename: Jue
authors.initials: J
authors.lastname: Lin
authors.forename: Elizabeth H
authors.initials: EH
authors.lastname: Blackburn
authors.forename: Elissa S
authors.initials: ES
authors.lastname: Epel
mesh_terms: D001741:Black or African American; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000401:mortality*; D005260:Female; D006801:Humans; D007962:Leukocytes / Q000378:metabolism*; D008297:Male; D017058:Mexican Americans; D008875:Middle Aged; D009026:Mortality / Q000208:ethnology*; D009369:Neoplasms / Q000401:mortality*; D009749:Nutrition Surveys; D016016:Proportional Hazards Models; D012307:Risk Factors; D016615:Telomere / Q000378:metabolism*; D014481:United States / Q000453:epidemiology; D044465:White People