Leukocyte telomere length and chronic disease burden in an adult community sample: a cross-sectional study

Abstract Introduction Telomere length is a biomarker of cellular aging and chronic disease risk, but its population-level correlates and disease-specific patterns remain unclear. This study examined telomere length associations and its contribution to disease prediction. Methods Leukocyte telomere length measured using quantitative polymerase chain reaction was analyzed in 615 Filipino adults. Associations with sociodemographic, lifestyle, and physiologic factors were evaluated among healthy participants using variance-robust methods and Welch tests. Linear support vector classifiers with SHapley Additive exPlanations interpretation predicted cancer, cardiovascular disease (CVD), mental health disorders, allergy, and diabetes using 5-fold cross-validation. Results Postgraduate participants had shorter telomere lengths than did high school graduates (mean difference, 2.740; P = .02) and college graduates (mean difference, 2.884; P = .01). Telomere length did not differ between individuals without CVD and CVD alone; however, CVD-only cases had shorter telomere lengths than did those with additional comorbidities (mean difference, −3.253; P = .009). Single allergy cases had shorter telomere lengths (P = .03), whereas cancer-only cases had longer telomere lengths (P = .003). Model accuracies ranged from 85.37% to 93.47%, with telomere length contributing mainly to cancer prediction. Discussion Telomere length showed disease-specific associations and improved cancer prediction but had limited links with measured exposures. Longitudinal studies are needed to clarify causality and refine telomere length–based risk stratification.