Examining the relationship between cardiometabolic risk factors and telomere length in women: a systematic review

Abstract Background and Objectives Cardiometabolic syndrome (CMS) poses a significant public health challenge due to its rising prevalence in aging and significant healthcare costs. Recent studies have suggested telomere length (TL), a marker of cellular aging, may be impacted by CMS among women, but comprehensive evidence remains limited. This study aimed to examine the association between CMS risk factors (increased waist circumference [WC], elevated blood pressure, impaired fasting blood glucose, elevated triglycerides, decreased high-density lipoproteins) and TL in women, with consideration of age and race or ethnicity. Research Design and Methods A systematic review was conducted following PRISMA guidelines, with searches across five databases. Thirteen relevant studies published between 2007 and 2022 were included. A narrative synthesis was performed to evaluate associations between CMS risk factors and TL. Results Findings revealed individual CMS risk factors did not demonstrate relationships with TL; however, a link was identified between collective CMS risk factors and decreased TL. The influence of CMS on TL varied by mean sample age, where increased WC was associated with decreased TL for middle adulthood women. Findings based on race or ethnicity were inconclusive due to limited analyses, but examination by continent revealed a relationship between increased WC and decreased TL in Asia and North America. Discussion and Implications There was high heterogeneity among diagnostic criteria for CMS risk factors across studies, potentially limiting findings. This review highlights the need for further research to clarify the complex associations between CMS and TL in women throughout the lifespan. Future large cohort studies using standardized CMS diagnostic criteria should examine variations by age and race or ethnicity to enhance understanding of these relationships.