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

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.