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[Preprint]. 2025 Dec 17:2025.12.15.25342309. [Version 1] doi: 10.64898/2025.12.15.25342309

Interactive Effects of Telomere Length and Genetic Variants on Alzheimer Disease Risk Across Multiple Ancestral Populations

Zainab Khurshid, Tong Tong, Oluwatosin Olayinka, John J Farrell, Congcong Zhu; Alzheimer’s Disease Sequencing Project, Eden R Martin, Will Bush, Margaret A Pericak-Vance, Li-San Wang, Gerard C Schellenberg, Jonathan L Haines, Kathryn L Lunetta, Xiaoling Zhang, Lindsay A Farrer
PMCID: PMC12723739  PMID: 41445639

Abstract

Background

Telomere length (TL), a biomarker of biological aging, but its association with Alzheimer’s disease (AD) remains unclear.

Methods

We estimated TL in whole-genome sequencing data from 35,014 Alzheimer’s Disease Sequencing Project participants using TelSeq, which after quality control yielded a dataset including 6,973 persons of European ancestry (EA), 4,188 African Americans (AA), 4,005 Caribbean Hispanics (CH), and 4,170 Native American Hispanics (NAH). TL was log-transformed, adjusted for age and blood cell counts, and z-scaled. Scaled TL was dichotomized into long and short groups according to the median. An AD GWAS for the interaction of TL with variants having a minor allele count >20 was performed in each ancestry group using logistic regression models including SNP and TL main effects and a SNP×TL interaction term.

Results

AD risk was associated with shorter TL (β = -0.18, P < 2×10 -16 ). Longer TL was associated with dosages of APOE ε2 ( P <5.08×10 -8 ) and APOE ε4 ( P =2.10×10 -2 ). In the EA group, genome-wide significant (GWS) TLxSNP interactions were identified for variants in SEMA6A (P =1.42×10 -8 ) and LOC105378654 (P =4.17×10 -8 ), between IL15 and INPP4B (P =1.77×10 -8 ) and upstream of RP11-2N5.2 ( P =4.60×10 -8 ). In the NAH group, GWS interactions were observed with an intronic variant in BSN ( P =3.26×10 -8 ) and missense variant in MST1 ( P =3.26×10 -8 ). In the total sample, interactions with variants between CTD-2160D9.1 and EEF1A1P20 ( P <1.19×10 -8 ), in TBC1D22A ( P =1.06×10 -8 ) and in PLK1 ( P =3.28×10 -8 ) were GWS.

Conclusion

We identified variants that significantly impact AD risk through their interaction with TL, suggesting that TL maintenance pathways may be central to AD pathogenesis.

Full Text Availability

The license terms selected by the author(s) for this preprint version do not permit archiving in PMC. The full text is available from the preprint server.


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