Multidomain Correlates of Telomere Shortening in Adults Receiving Advanced Wellness Programs in Thailand

Main Article Content

Tanupol Virunhagarun
Jira Thawornpradit
Sureerat Sritangrattanakul
Natnaree Bunsiraphatsorn
Pornsawan Prutanopajai

Abstract

OBJECTIVES: To characterize telomere length (TL) and determine biological and clinical factors associated with telomere shortening among individuals leukocyte telomere length (LTL) receiving an advanced wellness program at a clinical wellness institution in Thailand.


MATERIALS AND METHODS: This retrospective study included adults aged ≥18 years who underwent TL assessment as part of advanced wellness programs at two clinical wellness institutions in Thailand. Demographic, hormonal, micronutrient, metabolic, and clinical laboratory data were extracted from electronic medical records and laboratory databases within two weeks before or after TL measurement. Associations between TL and related demographic, hormonal, micronutrient, metabolic, and clinical variables were assessed using Pearson’s correlation coefficient. A two-sided p-value < 0.05 was considered statistically significant.


RESULTS: Among 1,684 records, TL –derived biological aging was significantly associated with multiple biological domains. Higher levels of insulin-like growth factor 1 (IGF-1) and dehydroepiandrosterone sulfate (DHEA-S) were positively correlated with slower aging, while cortisol showed no significant association. Markers of glucose metabolism, including fasting glucose, HbA1c, and insulin, demonstrated consistent inverse correlations with TL, indicating accelerated aging with poorer glycemic control. Lipid parameters showed modest associations: total cholesterol and low-density lipoprotein cholesterol (LDL-C) were positively associated with slower aging, whereas triglycerides were inversely associated with faster aging. Ferritin levels were negatively correlated with telomere-related aging, while C-reactive protein (CRP) showed no consistent relationship. Several micronutrients and antioxidants, particularly magnesium, selenium, folate, vitamin D, and coenzyme Q10, exhibited significant inverse associations with accelerated aging, most prominently in the fast-aging group.


CONCLUSION: Telomere shortening was associated with specific biological domains, particularly metabolic regulation and endocrine function, followed by micronutrient status, whereas associations with acute inflammatory markers were limited. These findings support the role of TL as a contextual biomarker for investigating biological aging within clinical wellness institutions in Thailand settings.

Article Details

How to Cite
1.
Virunhagarun T, Thawornpradit J, Sritangrattanakul S, Bunsiraphatsorn N, Prutanopajai P. Multidomain Correlates of Telomere Shortening in Adults Receiving Advanced Wellness Programs in Thailand. BKK Med J [internet]. 2026 Feb. 27 [cited 2026 Mar. 2];22(1):46. available from: https://he02.tci-thaijo.org/index.php/bkkmedj/article/view/280228
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References

Vaiserman A, Krasnienkov D. Telomere Length as a Marker of Biological Age: State-of-the-Art, Open Issues, and Future Perspectives. Front Genet. 2020;11:630186.

Batsis JA, Mackenzie TA, Vasquez E, Germain CM, Emeny RT, Rippberger P, et al. Association of adiposity, telomere length and mortality: data from the NHANES 1999-2002. Int J Obes (Lond). 2018;42(2):198-204.

Wang J, Dong X, Cao L, Sun Y, Qiu Y, Zhang Y, et al. Association between telomere length and diabetes mellitus: A meta-analysis. J Int Med Res. 2016;44(6):1156-73.

Shen X, Wang C, Zhou X, Zhou W, Hornburg D, Wu S, et al. Nonlinear dynamics of multi-omics profiles during human aging. Nature Aging. 2024;4(11):1619-34.

He X, Cao L, Fu X, Wu Y, Wen H, Gao Y, et al. The Association Between Telomere Length and Diabetes Mellitus: Accumulated Evidence From Observational Studies. J Clin Endocrinol Metab. 2024;110(1):e177-e85.

Aulinas A, Ramírez MJ, Barahona MJ, Mato E, Bell O, Surrallés J, et al. Telomeres and endocrine dysfunction of the adrenal and GH/IGF-1 axes. Clin Endocrinol (Oxf). 2013;79(6):751-9.

Vasunilashorn S, Cohen AA. Stress responsive biochemical anabolic/catabolic ratio and telomere length in older adults. Biodemography Soc Biol. 2014;60(2):174-84.

Winn N, Paul A, Musaró A, Rosenthal N. Insulin-like growth factor isoforms in skeletal muscle aging, regeneration, and disease. Cold Spring Harb Symp Quant Biol. 2002;67:507-18.

Lin S-YJ, Cui H, Yusta B, Belsham DD. IGF-I signaling prevents dehydroepiandrosterone (DHEA)-induced apoptosis in hypothalamic neurons. Molecular and Cellular Endocrinology. 2004;214(1):127-35.

Jiang Y, Da W, Qiao S, Zhang Q, Li X, Ivey G, et al. Basal cortisol, cortisol reactivity, and telomere length: A systematic review and meta-analysis. Psychoneuroendocrinology. 2019;103:163-72.

Monzani F, Del Guerra P, Caraccio N, Del Corso L, Casolaro A, Mariotti S, et al. Age-related modifications in the regulation of the hypothalamic-pituitary-thyroid axis. Horm Res. 1996;46(3):107-12.

Alonso-Pedrero L, Ojeda-Rodríguez A, Zalba G, Razquin C, Martínez-González MÁ, Bes-Rastrollo M, et al. Association between ideal cardiovascular health and telomere length in participants older than 55 years old from the SUN cohort. Revista Española de Cardiología (English Edition). 2022;75(4):286-358.

Agmon E, Stockwell BR. Lipid homeostasis and regulated cell death. Curr Opin Chem Biol. 2017;39:83-9.

Chen Y-F, Zhou K-W, Yang G-z, Chen C. Association between lipoproteins and telomere length in US adults: data from the NHANES 1999–2002. Lipids in Health and Disease. 2019;18(1):80.

Liu S, Fu Z, Liu H, Wang Y, Zhou M, Ding Z, et al. Lipid Profiles, Telomere Length, and the Risk of Malignant Tumors: A Mendelian Randomization and Mediation Analysis. Biomedicines. 2024;13(1).

Liu B, Sun Y, Xu G, Snetselaar LG, Ludewig G, Wallace RB, et al. Association between Body Iron Status and Leukocyte Telomere Length, a Biomarker of Biological Aging, in a Nationally Representative Sample of US Adults. J Acad Nutr Diet. 2019;119(4):617-25.

Solorio S, Murillo-Ortíz B, Hernández-González M, Guillén-Contreras J, Arenas-Aranda D, Solorzano-Zepeda FJ, et al. Association between telomere length and C-reactive protein and the development of coronary collateral circulation in patients with coronary artery disease. Angiology. 2011;62(6):467-72.

Tedaldi AM, Behrouzi P, Grootswagers P. Diet, lifestyle and telomere length: using Copula Graphical Models on NHANES data. Aging (Albany NY). 2025;17(2):329-56.

Ruiz LM, Libedinsky A, Elorza AA. Role of Copper on Mitochondrial Function and Metabolism. Front Mol Biosci. 2021;8:711227.

Lin Z, Gao H, Wang B, Wang Y. Dietary Copper Intake and Its Association With Telomere Length: A Population Based Study. Front Endocrinol (Lausanne). 2018;9:404.

Liang C, Zhao R, Du J, Zhao G, Zhang Y. The association between dietary selenium intake and telomere length in hypertension. J Clin Hypertens (Greenwich). 2024;26(8):990-6.

Zhao G, Guo D, Li L, Yang C, Dong J. The Association between Dietary Magnesium Intake and Telomere Length in Adults with Hypertension. The Journal of nutrition, health and aging. 2022;26(11):1010-5.

Intake. Assessing the relationship between dietary nutrient intake and nutrient biomarker data in population surveys. https://www.intake.org/innovations; 2024.

Mazidi M, Michos ED, Banach M. The association of telomere length and serum 25-hydroxyvitamin D levels in US adults: the National Health and Nutrition Examination Survey. Arch Med Sci. 2017;13(1):61-5.

Zhu H, Manson JE, Cook NR, Bekele BB, Chen L, Kane KJ, et al. Vitamin D(3) and marine ω-3 fatty acids supplementation and leukocyte telomere length: 4-year findings from the VITamin D and OmegA-3 TriaL (VITAL) randomized controlled trial. Am J Clin Nutr. 2025;122(1):39-47.

Pelletier O. Vitamin C Status of Cigarette Smokers an Nonsmokers123. The American Journal of Clinical Nutrition. 1970;23(5):520-4.