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Mediating effect of telomere length in a hypertension population exposed to cadmium: a case–control study

Abstract

Cadmium (Cd) is associated with telomere length and hypertension, respectively, but the mechanism behind its relationship is unclear. Our study aimed to clarify the role of telomere length in the relationship between Cd and hypertension. A 1:1 matched case–control study was conducted with 213 hypertensive patients and 213 normotensive controls in Taiyuan, Shanxi Province, China, from February and June 2016. General demographic characteristics information and lifestyle were collected using a structured questionnaire. Urine samples were collected to test urinary Cd (UCd) levels and corrected by urinary creatinine (UCr) levels. Peripheral leukocyte absolute telomere length (ATL) was measured using quantitative polymerase chain reaction. Logistic regression was used to screen the influencing factors of hypertension. A mediation effect analysis was used to explore the role of telomere length between Cd exposure and the risk of hypertension. We found that the hypertension group had a significantly higher UCd level compared to the control group (0.91 vs 0.80 μg/g Cr, P < 0.01), while ATL showed the opposite relationship (2.36 vs 2.65 kb, P < 0.01). The Regression analysis of hypertension identified these significant predictors: family history of hypertension (OR = 3.129, 95% confidence interval (95% CI): 1.767–5.540), Body mass index (BMI, OR = 1.088, 95% CI: 1.023–1.157), total cholesterol (TC, OR = 1.277, 95% CI: 1.024–1.592), UCd (OR = 2.092, 95% CI: 1.179–3.710), ATL (OR = 0.105, 95% CI: 0.025–0.453) and 8-hydroxy-2-deoxyguanosine (8-OHdG, OR = 7.864, 95% CI: 3.516–17.589). Mediating effect analysis revealed that ATL was a potential partial mediating factor between Cd and hypertension. Cd may induce hypertension by affecting telomere length, but this requires further exploration.

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Fig. 1: Mediating effect model.
Fig. 2: Relationship between UCd, ATL, and blood pressure.
Fig. 3: Scatter plot of correlation between UCd and ATL in the control and hypertension groups.
Fig. 4: ATL as a mediator between cadmium and hypertension.

Data availability

If additional data are available from the corresponding author on reasonable request.

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Acknowledgements

We sincerely thank all study participants for providing information and biological samples. In addition, we particularly appreciate the fund projects that provide funds and experimental research equipment. Finally, we thank all the authors participating in this project for their efforts.

Funding

This work was supported by the National Natural Science Foundation of China [grant number 81273040, 81872701]; Research project of postgraduate education reform in Shanxi province [grant number 2018JG47].

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LJL and LNM conceived the idea, designed, and instructed the study, contributed to interpretation of results. RJL, HK, ZZ, YYG, and ZCH participated in the sample collection and collation. QY, RJL, YYG, YFZ, and YXL, contributed to the experimental technology and substances. QY and RJL conducted a global and careful analysis of the data. QY wrote the article, and all the authors checked and approved the final manuscript.

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Correspondence to Lina Mu or Lijian Lei.

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Yang, Q., Liu, R., Gao, Y. et al. Mediating effect of telomere length in a hypertension population exposed to cadmium: a case–control study. J Hum Hypertens (2022). https://doi.org/10.1038/s41371-022-00685-x

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