Table 1.
Associations of telomere length with characteristics of the Health, Eating, Activity and Lifestyle cohort*
| Patient characteristics | No. at baseline (n = 611) | Mean (SD) telomere length at 6 months after diagnosis (T0) | P† (ANCOVA) | No. at 30 months (n = 478) | Mean (SD) telomere length at 30 months after diagnosis (T30) | P† (ANCOVA) | ΔTelomere | P‡ | |
|---|---|---|---|---|---|---|---|---|---|
| No. <0, shortened | No. >0, lengthened | ||||||||
| All | 611 | 0.82 (0.18) | 478 | 0.76 (0.17) | 324 | 154 | |||
| Age | |||||||||
| ≤50 y | 235 | 0.87 (0.18) | <.001 | 135 | 0.83 (0.18) | <.001 | 106 | 59 | .22 |
| >50 y | 376 | 0.78 (0.17) | 343 | 0.74 (0.17) | 218 | 95 | |||
| Menopausal status | |||||||||
| Pre | 216 | 0.87 (0.17) | .02 | 77 | 0.83 (0.17) | .27 | 214 | 94 | .38 |
| Post | 358 | 0.78 (0.17) | 371 | 0.75 (0.17) | 97 | 55 | |||
| Unknown§ | 37 | 0.87 (0.26) | 30 | 0.85 (0.18) | 13 | 5 | |||
| Physical activity, MET hr/wk|| | |||||||||
| None | 97 | 0.75 (0.15) | .21† | 87 | 0.74 (0.18) | .18† | 57 | 30 60 |
.88 |
| >0 to <9 | 153 | 0.81 (0.16) | 189 | 0.76 (0.17) | 129 | ||||
| ≥9 | 199 | 0.79 (0.17) | 202 | 0.78 (0.18) | 138 | 64 | |||
| Unknown§ | 162 | 0.90 (0.19) | |||||||
| Cigarette use | |||||||||
| Ever | 322 | 0.80 (0.18) | .11 | 253 | 0.75 (0.16) | .06 | 179 | 78 | .34 |
| Never | 289 | 0.83 (0.18) | 225 | 0.78 (0.18) | 145 | 76 | |||
| Stress scale | |||||||||
| Low stress, ≤12 | 275 | 0.83 (0.20) | .05 | 311 | 0.78 (0.18) | .008 | 158 | 83 | .14 |
| High stress, >12 | 216 | 0.79 (0.14) | 115 | 0.73 (0.15) | 134 | 51 | |||
| Unknown§ | 120 | 0.83 (0.17) | 52 | 0.79 (0.42) | 32 | 20 | |||
| BMI at time of blood draw | |||||||||
| <18.5kg/m2 | 11 | 0.77 (0.14) | .18 | 8 | 0.70 (0.17) | .89 | 6 | 3 | .94 |
| ≥18.5 to <25kg/m2 | 210 | 0.79 (0.16) | 189 | 0.77 (0.16) | 121 | 62 | |||
| ≥25 to <40kg/m2 | 375 | 0.83 (0.19) | 262 | 0.76 (0.18) | 190 | 86 | |||
| ≥40kg/m2 | 15 | 0.76 (0.16) | 19 | 0.81 (0.14) | 7 | 3 | |||
| Race/ethnicity | |||||||||
| White | 359 | 0.78 (0.16) | <.001 | 306 | 0.72 (0.15) | <.001 | 217 | 89 | .15 |
| Hispanic-white | 75 | 0.83 (0.16) | 61 | 0.77 (0.18) | 41 | 20 | |||
| Black | 160 | 0.90 (0.20) | 96 | 0.89 (0.17) | 58 | 38 | |||
| Other# | 17 | 0.85 (0.14) | 15 | 0.85 (0.13) | 8 | 7 | |||
| Tumor stage | |||||||||
| Local, stage I | 427 | 0.80 (0.18) | .15 | 343 | 0.75 (0.17) | .54 | 230 | 113 | .59 |
| Regional, stage II–IIIA | 183 | 0.84 (0.18) | 135 | 0.79 (0.17) | 94 | 41 | |||
| Unknown# | 1 | 1.17 (—) | |||||||
| ER status | |||||||||
| ER negative | 134 | 0.85 (0.18) | .39 | 93 | 0.79 (0.18) | .68 | 64 | 29 | .89 |
| ER positive | 411 | 0.81 (0.18) | 342 | 0.76 (0.17) | 233 | 109 | |||
| Unknown# | 66 | 0.82 (0.16) | 43 | 0.77 (0.14) | 27 | 16 | |||
| PR status | |||||||||
| PR negative | 176 | 0.82 (0.17) 0.80 | .46 | 129 | 0.77 (0.18) | 87 | 42 | ||
| PR positive | 332 | (0.18) | 280 | 0.76 (0.17) | 191 | 89 | |||
| Unknown# | 103 | 0.84 (0.18) | 69 | 0.78 (0.15) | .61 | 46 | 23 | .87 | |
| Tamoxifen use at time of blood draw | |||||||||
| No | 246 | 0.79 (0.16) | .68 | 228 | 0.76 (0.17) | .17 | 154 | 74 | .93 |
| Yes | 202 | 0.78 (0.16) | 249 | 0.76 (0.18) | 169 | 80 | |||
| Unknown# | 163 | 0.90 (0.20) | 1 | 0.80 (-) | 1 | — | |||
| Treatment received | |||||||||
| Surgery | 148 | 0.83 (0.19) | .10 | 114 | 0.78 (0.20) | .06 | 74 | 40 | .30 |
| Radiotherapy+ surgery | 220 | 0.78 (0.17) | 185 | 0.73 (0.16) | 121 | 64 | |||
| Chemotherapy +surgery | 242 | 0.84 (0.18) | 179 | 0.79 (0.17) | 129 | 50 | |||
| Unknown# | 1 | 1.17 (—) | — | — | |||||
| Chemotherapy** | |||||||||
| 5-Fluorouracil | 21 | 0.88 (0.16) | .25 | 11 | 0.81 (0.11) | .08 | 9 | 2 | .58 |
| Cyclophosphamide | 93 | 0.87 (16) | (.13)¶ | 74 | 0.80 (0.15) | (.10)¶ | 53 | 21 | (.69)¶ |
| Doxorubicin | 18 | 0.77 (0.13) | 12 | 0.70 (0.12) | 10 | 2 | |||
| Taxanes, any | 2 | 0.68 (0.10) | 1 | 0.44 (1) | 1 | 0 | |||
| Other chemo | 17 | 0.88 (0.27) | 13 | 0.87 (0.21) | 7 | 6 | |||
| Combination therapy | 91 | 0.82 (0.17) | 68 | 0.77 (0.18) | 49 | 19 | |||
* ANCOVA = analysis of covariance; BMI = body mass index; ER = estrogen receptor; MET = metabolic equivalents of energy expenditure; PR = progesterone receptor; SD = standard deviation.
† Differences among categorical groups (ANCOVA) adjusted by age. Associations between baseline telomere length were calculated for baseline age, baseline menopausal status, moderate/vigorous physical activity in the year before diagnosis, baseline cigarette use and baseline tamoxifen use. Similarly, associations between 24-month telomere lengths are calculated for age at 24 months, menopausal status at 24 months, physical activity in the year before 30-month interview, cigarette use at 24 months, and tamoxifen use at 24 months.
‡ Two-sided Pearson χ2 test.
§ P value in parentheses excludes other chemotherapy and combination therapies. Taxanes also excluded for telomere length at 30 months (n = 1).
|| Total moderate/vigorous physical activity in the year before diagnosis and in the year before 30-month blood collection in MET hours per week.
¶ Stress scale based on a four-item scale to measure perceived stress (26).
# Omitted from analysis.
** Subset n = 242 at baseline; n = 179 at 30 months.