Association between female-specific reproductive factors and leukocyte telomere length

Abstract STUDY QUESTION What are the associations between female-specific reproductive factors and leukocyte telomere length (LTL)? SUMMARY ANSWER Early menarche, early menopause, short reproductive lifespan, early age at first birth, multiparity, and use of oral contraceptives (OCs) and hormone replacement therapy (HRT) were associated with shorter LTL. WHAT IS KNOWN ALREADY Reproductive factors have been associated with age-related diseases, but their associations with cellular aging, as indicated by LTL, are unclear. STUDY DESIGN, SIZE, DURATION This population-based study included 224 965 women aged 40–69 years from the UK Biobank between 2006 and 2010. PARTICIPANTS/MATERIALS, SETTING, METHODS Women aged 40–69 were included. Female-specific reproductive factors, including age at menarche, age at natural menopause, reproductive lifespan, number of live births, age at first live birth, history of stillbirth, history of miscarriage, and use of OCs and HRT were self-reported. LTL was measured using a validated polymerase chain reaction method. Multiple linear regression and restricted cubic spline models were applied to explore the association between each reproductive factor and LTL. MAIN RESULTS AND THE ROLE OF CHANCE After adjustment for potential confounders, early menarche (<12 years; percent change, per unit change in LTL Z score: −1.29%, 95% CI: −2.32%, −0.26%), early menopause (<45 years; percent change: −7.18%, 95% CI: −8.87%, −5.45%), short reproductive lifespan (<30 years; percent change: −6.10%, 95% CI: −8.14%, −4.01%), multiparity (percent change: −3.38%, 95% CI: −4.38%, −2.37%), early age at first live birth (<20 years; percent change: −4.46%, 95% CI: −6.00%, −2.90%), and use of OCs (percent change: −1.10%, 95% CI: −2.18%, −0.02%) and HRT (percent change: −3.72%, 95% CI: −4.63%, −2.80%) were all significantly associated with shorter LTL. However, no significant association was found for history of miscarriage and stillbirth. We observed nonlinear relationships of age at menarche, age at natural menopause, reproductive lifespan, and age at first live birth with LTL (Pnonlinear < 0.05). LIMITATIONS, REASONS FOR CAUTION Considering that the participants were predominantly of European ethnicity, the findings may not be generalizable to women of other ethnic backgrounds. WIDER IMPLICATIONS OF THE FINDINGS Our findings suggest that early menarche, early menopause, short reproductive lifespan, early age at first birth, multiparity, and use of OCs and HRT were associated with shorter LTL, which has been linked to various chronic diseases. The accelerated shortening of telomeres may potentially contribute to the development of chronic diseases related to reproductive factors. STUDY FUNDING/COMPETING INTEREST(S) This study was funded by the National Natural Science Foundation of China (82003479, 82073660), Hubei Provincial Natural Science Foundation of China (2023AFB663), and the China Postdoctoral Science Foundation (2019M662646, 2020T130220). The authors have no competing interests to disclose. TRIAL REGISTRATION NUMBER N/A.