title: Telomere Length and Coronary Atherosclerosis in Rheumatoid Arthritis.
abstract: Telomeres protect against chromosomal end damage and shorten with each cell division; their length may be a marker of cardiovascular and overall biological aging. We examined the hypothesis that reduced telomere length is associated with increased coronary atherosclerosis in rheumatoid arthritis (RA).
  
  
  
  We performed a cross-sectional study in 145 patients with RA and 87 control subjects frequency-matched for age, race, and sex. Coronary artery calcium score was determined by noncontrast cardiac computed tomography. Telomere length was measured from whole blood DNA, using real-time quantitative polymerase chain reaction and expressed as telomeric product to a single-copy gene product ratio (T/S ratio). Associations between telomere length, coronary artery calcium score, and 28-joint Disease Activity Score (DAS28) were assessed with Spearman correlation, proportional odds logistic regression, and linear regression, adjusting for age, race, and sex.
  
  
  
  Telomere length was significantly inversely correlated with age in patients with RA (ρ = -0.37, p < 0.001) and control subjects (ρ = -0.39, p = 0.001). Among patients with RA, for every interquartile range (IQR) decrease in telomere length (T/S ratio), the odds of higher coronary artery calcium score increased by 38% (95% CI: 4-60) after adjusting for age, race, and sex (p adjusted = 0.03). Telomere length was not associated with DAS28 (p adjusted = 0.17). Telomere length was not significantly different in patients with RA [median (IQR): 1.02 units (0.9-1.11)] compared to control subjects [1.05 units (0.95-1.17); p = 0.10].
  
  
  
  Telomere length is inversely associated with coronary artery calcium score, independent of age, race, and sex in patients with RA.
authors.affiliation: From the departments of Medicine and Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; the departments of Medicine and Radiology, Emory University, Atlanta, Georgia, USA; and the departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada.M.J. Ormseth, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center; J.F. Solus, PhD, Department of Medicine, Vanderbilt University Medical Center; A.M. Oeser, BS, MLAS, CCRP, Department of Medicine, Vanderbilt University Medical Center; A. Bian, MPH, Department of Biostatistics, Vanderbilt University Medical Center; T. Gebretsadik, MPH, Department of Biostatistics, Vanderbilt University Medical Center; A. Shintani, PhD, MPH, Department of Biostatistics, Vanderbilt University Medical Center; P. Raggi, MD, departments of Medicine and Radiology, University of Alberta; C.M. Stein, MD, Department of Medicine, Vanderbilt University Medical Center. michelle.ormseth@vanderbilt.edu.
authors.forename: Michelle J
authors.initials: MJ
authors.lastname: Ormseth
authors.affiliation: From the departments of Medicine and Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; the departments of Medicine and Radiology, Emory University, Atlanta, Georgia, USA; and the departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada.M.J. Ormseth, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center; J.F. Solus, PhD, Department of Medicine, Vanderbilt University Medical Center; A.M. Oeser, BS, MLAS, CCRP, Department of Medicine, Vanderbilt University Medical Center; A. Bian, MPH, Department of Biostatistics, Vanderbilt University Medical Center; T. Gebretsadik, MPH, Department of Biostatistics, Vanderbilt University Medical Center; A. Shintani, PhD, MPH, Department of Biostatistics, Vanderbilt University Medical Center; P. Raggi, MD, departments of Medicine and Radiology, University of Alberta; C.M. Stein, MD, Department of Medicine, Vanderbilt University Medical Center.
authors.forename: Joseph F
authors.initials: JF
authors.lastname: Solus
authors.affiliation: From the departments of Medicine and Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; the departments of Medicine and Radiology, Emory University, Atlanta, Georgia, USA; and the departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada.M.J. Ormseth, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center; J.F. Solus, PhD, Department of Medicine, Vanderbilt University Medical Center; A.M. Oeser, BS, MLAS, CCRP, Department of Medicine, Vanderbilt University Medical Center; A. Bian, MPH, Department of Biostatistics, Vanderbilt University Medical Center; T. Gebretsadik, MPH, Department of Biostatistics, Vanderbilt University Medical Center; A. Shintani, PhD, MPH, Department of Biostatistics, Vanderbilt University Medical Center; P. Raggi, MD, departments of Medicine and Radiology, University of Alberta; C.M. Stein, MD, Department of Medicine, Vanderbilt University Medical Center.
authors.forename: Annette M
authors.initials: AM
authors.lastname: Oeser
authors.affiliation: From the departments of Medicine and Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; the departments of Medicine and Radiology, Emory University, Atlanta, Georgia, USA; and the departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada.M.J. Ormseth, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center; J.F. Solus, PhD, Department of Medicine, Vanderbilt University Medical Center; A.M. Oeser, BS, MLAS, CCRP, Department of Medicine, Vanderbilt University Medical Center; A. Bian, MPH, Department of Biostatistics, Vanderbilt University Medical Center; T. Gebretsadik, MPH, Department of Biostatistics, Vanderbilt University Medical Center; A. Shintani, PhD, MPH, Department of Biostatistics, Vanderbilt University Medical Center; P. Raggi, MD, departments of Medicine and Radiology, University of Alberta; C.M. Stein, MD, Department of Medicine, Vanderbilt University Medical Center.
authors.forename: Aihua
authors.initials: A
authors.lastname: Bian
authors.affiliation: From the departments of Medicine and Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; the departments of Medicine and Radiology, Emory University, Atlanta, Georgia, USA; and the departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada.M.J. Ormseth, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center; J.F. Solus, PhD, Department of Medicine, Vanderbilt University Medical Center; A.M. Oeser, BS, MLAS, CCRP, Department of Medicine, Vanderbilt University Medical Center; A. Bian, MPH, Department of Biostatistics, Vanderbilt University Medical Center; T. Gebretsadik, MPH, Department of Biostatistics, Vanderbilt University Medical Center; A. Shintani, PhD, MPH, Department of Biostatistics, Vanderbilt University Medical Center; P. Raggi, MD, departments of Medicine and Radiology, University of Alberta; C.M. Stein, MD, Department of Medicine, Vanderbilt University Medical Center.
authors.forename: Tebeb
authors.initials: T
authors.lastname: Gebretsadik
authors.affiliation: From the departments of Medicine and Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; the departments of Medicine and Radiology, Emory University, Atlanta, Georgia, USA; and the departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada.M.J. Ormseth, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center; J.F. Solus, PhD, Department of Medicine, Vanderbilt University Medical Center; A.M. Oeser, BS, MLAS, CCRP, Department of Medicine, Vanderbilt University Medical Center; A. Bian, MPH, Department of Biostatistics, Vanderbilt University Medical Center; T. Gebretsadik, MPH, Department of Biostatistics, Vanderbilt University Medical Center; A. Shintani, PhD, MPH, Department of Biostatistics, Vanderbilt University Medical Center; P. Raggi, MD, departments of Medicine and Radiology, University of Alberta; C.M. Stein, MD, Department of Medicine, Vanderbilt University Medical Center.
authors.forename: Ayumi
authors.initials: A
authors.lastname: Shintani
authors.affiliation: From the departments of Medicine and Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; the departments of Medicine and Radiology, Emory University, Atlanta, Georgia, USA; and the departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada.M.J. Ormseth, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center; J.F. Solus, PhD, Department of Medicine, Vanderbilt University Medical Center; A.M. Oeser, BS, MLAS, CCRP, Department of Medicine, Vanderbilt University Medical Center; A. Bian, MPH, Department of Biostatistics, Vanderbilt University Medical Center; T. Gebretsadik, MPH, Department of Biostatistics, Vanderbilt University Medical Center; A. Shintani, PhD, MPH, Department of Biostatistics, Vanderbilt University Medical Center; P. Raggi, MD, departments of Medicine and Radiology, University of Alberta; C.M. Stein, MD, Department of Medicine, Vanderbilt University Medical Center.
authors.forename: Paolo
authors.initials: P
authors.lastname: Raggi
authors.affiliation: From the departments of Medicine and Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee; the departments of Medicine and Radiology, Emory University, Atlanta, Georgia, USA; and the departments of Medicine and Radiology, University of Alberta, Edmonton, Alberta, Canada.M.J. Ormseth, MD, MSCI, Department of Medicine, Vanderbilt University Medical Center; J.F. Solus, PhD, Department of Medicine, Vanderbilt University Medical Center; A.M. Oeser, BS, MLAS, CCRP, Department of Medicine, Vanderbilt University Medical Center; A. Bian, MPH, Department of Biostatistics, Vanderbilt University Medical Center; T. Gebretsadik, MPH, Department of Biostatistics, Vanderbilt University Medical Center; A. Shintani, PhD, MPH, Department of Biostatistics, Vanderbilt University Medical Center; P. Raggi, MD, departments of Medicine and Radiology, University of Alberta; C.M. Stein, MD, Department of Medicine, Vanderbilt University Medical Center.
authors.forename: C Michael
authors.initials: CM
authors.lastname: Stein
mesh_terms: D000375:Aging / Q000235:genetics / Q000378:metabolism; D001172:Arthritis, Rheumatoid / Q000150:complications* / Q000235:genetics / Q000378:metabolism; D050197:Atherosclerosis / Q000209:etiology* / Q000235:genetics / Q000378:metabolism; D015415:Biomarkers; D003324:Coronary Artery Disease / Q000209:etiology* / Q000235:genetics / Q000378:metabolism; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016615:Telomere; D059506:Telomere Shortening / Q000502:physiology*
chemical_list: D015415:Biomarkers
keywords: AGING; ATHEROSCLEROSIS; CARDIOVASCULAR; RHEUMATOID ARTHRITIS; TELOMERE