The Association Between Telomere Length and Diabetes Mellitus: Accumulated Evidence From Observational Studies

Abstract Objective In order to assess the associations between telomere length (TL) and diabetes mellitus (DM), especially type 2 diabetes (T2DM), we performed this systematic review and meta-analysis. Methods PubMed, Embase, and Web of Science were thoroughly searched up to July 11, 2023. The pooled standardized mean difference (SMD) and the 95% confidence interval (CI) were evaluated using the random-effects model. Age, sex, study design, duration of diabetes, region, sample size, and body mass index (BMI) were used to stratify subgroup analyses. Results A total of 37 observational studies involving 18 181 participants from 14 countries were included in the quantitative meta-analysis. In this study, patients with diabetes had shorter TL than the non-diabetic, whether those patients had T1DM (−2.70; 95% CI: −4.47, −0.93; P < .001), T2DM (−3.70; 95% CI: −4.20, −3.20; P < .001), or other types of diabetes (−0.71; 95% CI: −1.10, −0.31; P < .001). Additionally, subgroup analysis of T2DM showed that TL was significantly correlated with age, sex, study design, diabetes duration, sample size, detection method, region, and BMI. Conclusion A negative correlation was observed between TL and DM. To validate this association in the interim, more extensive, superior prospective investigations and clinical trials are required.