Ethnic disparities in relationships of obesity indices with telomere length in Asians with type 2 diabetes

Abstract Background Obesity and shorter telomeres increase the risk for diabetes complications and mortality. However, the relationship between obesity and telomere length in diverse Asian populations with type 2 diabetes (T2D) is not well understood. This study examined the association of baseline and changes in obesity indices with telomere length in multiethnic Asian populations with T2D. Methods Leukocyte telomere length (LTL) was measured by quantitative polymerase chain reaction in the SMART2D cohort (n = 1431 at baseline, n = 1039 after 3.2 years median follow‐up). Associations between obesity indices and LTL were assessed by linear regression. Results Compared with Chinese, LTL was longer in Malays ( P < 0.0001) and similar in Indians. Cross‐sectionally, body mass index (BMI)‐adjusted (residual) visceral fat area (VFA; β = −0.004, P = 0.006), and waist‐to‐hip ratio (β = −1.95, P = 0.030) were significantly associated with LTL in Chinese but not in Malays and Indians. Changes in BMI ( r = −0.080; P = 0.053) and VFA ( r = −0.126; P = 0.002) were inversely correlated with changes in LTL only in Chinese. Furthermore, in Chinese, 1‐SD incremental changes in BMI (β = −0.070; P = 0.040) and VFA (β = −0.088, P = 0.028) were significantly associated with larger telomere attrition, independent of age, sex, diabetes condition, baseline LTL, obesity, and inflammation markers. Conclusions Three‐year changes in BMI and VFA were associated with telomere dynamics in Chinese but not in Malays and Indians with T2D. Reducing obesity may reduce the risk of diabetes complications associated with shorter LTL in the Chinese population.