Leukocyte telomere length and mitochondrial DNA copy number association with colorectal cancer risk in an aging population
In this study, we evaluated the association of blood leukocyte telomere length (LTL) and mitochondrial DNA copy number (mtDNA-CN) with the risk of incident colorectal cancer (CRC). We studied and followed-up a cohort of Russian men and women (aged 45 – 69 years, n = 9360, 54% female) from the HAPIEE study for 15 years. Using the nested case-control design, we selected cases with incident CRC among those free from any baseline cancer (n = 146) and sex- and age-stratified controls among those free from baseline cancer and cardiovascular disease and alive at the end of the follow-up (n = 799). We employed multivariable-adjusted logistic regression to estimate the odds ratios (ORs) of CRC per 1 decile of LTL or mtDNA-CN. We observed an inverse association of LTL and mtDNA-CN baseline values with the 15-year risk of incident CRC. Carriers of shorter telomeres had an increased 15-year risk of incident CRC with adjusted OR 3.2 (95% CI: 2.56 – 3.87, P < 0.001) per 1 decile decrease in LTL, independent of baseline age, sex, smoking, body mass index, blood pressure, lipid levels, and education. Similarly, lower mtDNA-CN was associated with the higher risk of incident CRC with adjusted OR 1.7 (95% CI: 1.12 – 1.89, P < 0.001) per 1 decile decrease in mtDNA-CN, independent of the aforementioned factors. Using the modified values of LTL and mtDNA-CN adjusted for multiple factors and their interactions with a case–control status, the ORs of CRC were 2.53 and 1.52 per 1 decile decrease in adjusted baseline LTL and mtDNA-CN, respectively. In conclusion, LTL and mtDNA-CN were independent inverse predictors of the 15-year risk of CRC in the Russian cohort. These findings highlight the relevance for subsequent research to exploit the mechanisms through which LTL and mtDNA-CN may reflect human health.
United Nations, Department of Economic and Social Affairs, Population Division, 2017, World Population Prospects: The 2017 Revision, Key Findings and Advance Tables. Working Paper No. ESA/P/WP/248. Available from: https://www.population.un.org/wpp/publications/files/wpp2017_keyfindings.pdf [Last accessed on 2022 Sep 01].
World Health Organization. Global Health Estimates: Leading causes of Death 2000-2019. Geneva: World Health Organization. Available from: https://www.who.int/data/gho/data/themes/mortality-and-global-health-estimates/the-leading-causes-of-death [Last accessed on 2022 Sep 01].
GLOBOCAN Estimated Age-Standardized Cancer Incidence and Mortality Worldwide, 2020. Available from: https://www.globocan.iarc.fr/gco.iarc.fr/today/online-analysis-table?v=2020 [Last accessed on 2022 Sep 01].
Nikitenko TM, Shcherbakova LV, Malyutina SK, et al., 2017, The metabolic syndrome as a risk factor for colorectal cancer. Obes Metab, 14: 24–32. https://doi.org/10.14341/OMET2017224-32
Markowitz SD, Bertagnolli MM, 2009, Molecular origins of cancer: Molecular basis of colorectal cancer. N Engl J Med, 361: 2449–2460. https://doi.org/10.1056/NEJMra0804588
Martin-Ruiz CM, Gussekloo J, Vanheemst D, et al., 2005, Telomere length in white blood cells is not associated with morbidity or mortality in the oldest old: A population-based study. Aging Cell, 4: 287–290. https://doi.org/10.1111/j.1474-9726.2005.00171.x
Blackburn EH, 2000, Telomere states and cell fates. Nature, 408: 53–56. https://doi.org/10.1038/35040500
Hunt SC, Chen W, Gardner JP, et al., 2008, Leukocyte telomeres are longer in African Americans than in whites: The national heart, lung, and blood institute family heart study and the Bogalusa heart study. Aging Cell, 7: 451–458. https://doi.org/10.1111/j.1474-9726.2008.00397.x
Marioni RE, Harris SE, Shah S, et al., 2018, The epigenetic clock and telomere length are independently associated with chronological age and mortality. Int J Epidemiol, 47: 356. https://doi.org/10.1093/ije/dyx233
Gardner M, Bann D, Wiley L, et al., 2014, Gender and telomere length: Systematic review and meta-analysis. Exp Gerontol, 51: 15–27. https://doi.org/10.1016/j.exger.2013.12.004
Benetos A, Kark JD, Susser E, et al., 2013, Tracking and fixed ranking of leukocyte telomere length across the adult life course. Aging Cell, 12: 615–621. https://doi.org/10.1111/acel.12086
Nordfjall K, Eliasson M, Stegmayr B, et al., 2008, Increased abdominal obesity, adverse psychosocial factors and shorter telomere length in subjects reporting early ageing; The MONICA Northern Sweden study. Scand J Public Health, 36: 744–752. https://doi.org/10.1177/1403494808090634
Cawthon RM, Smith KR, O’Brien E, et al., 2003, Association between telomere length in blood and mortality in people aged 60 years or older. Lancet, 361: 393–395. https://doi.org/10.1016/S0140-6736(03)12384-7
Rode L, Nordestgaard BG, Bojesen SE, 2015, Peripheral blood leukocyte telomere length and mortality among 64,637 individuals from the general population. J Natl Cancer Inst, 107: djv074. https://doi.org/10.1093/jnci/djv074
Wang Q, Zhan Y, Pedersen NL, et al., 2018, Telomere length and all-cause mortality: A meta-analysis. Ageing Res Rev, 48: 11–20. https://doi.org/10.1016/j.arr.2018.09.002
Sevini F, Giuliani C, Vianello D, et al., 2014, mtDNA mutations in human aging and longevity: Controversies and new perspectives opened by high-throughput technologies. Exp Gerontol, 56: 234–244. https://doi.org/10.1016/j.exger.2014.03.022
Lagouge M, Larsson NG, 2013, The role of mitochondrial DNA mutations and free radicals in disease and ageing. J Intern Med, 273: 529–543. https://doi.org/10.1111/joim.12055
Ashar FN, Moes A, Moore AZ, et al., 2015, Association of mitochondrial DNA levels with frailty and all-cause mortality. J Mol Med (Berl), 93: 177–186. https://doi.org/10.1007/s00109-014-1233-3
Castellani CA, Longchamps RJ, Sumpter JA, et al., 2020, Mitochondrial DNA copy number can influence mortality and cardiovascular disease via methylation of nuclear DNA CpGs. Genome Med, 12: 84. https://doi.org/10.1186/s13073-020-00778-7
Mons U, Muezzinler A, Schottker B, et al., 2017, Leukocyte telomere length and all-cause, cardiovascular disease, and cancer mortality: Results from individual-participant-data meta-analysis of 2 large prospective cohort studies. Am J Epidemiol, 185: 1317–1326. https://doi.org/10.1093/aje/kww210
Zhang X, Zhao Q, Zhu W, et al., 2017, The association of telomere length in peripheral blood cells with cancer risk: A systematic review and meta-analysis of prospective studies. Cancer Epidemiol Biomarkers Prev, 26: 1381–1390. https://doi.org/10.1158/1055-9965
Kuo CL, Pilling LC, Kuchel GA, et al., 2019, Telomere length and aging-related outcomes in humans: A Mendelian randomization study in 261,000 older participants. Aging Cell, 18: e13017. https://doi.org/10.1111/acel.13017
Gao Y, Wei Y, Zhou X, et al., 2020, Assessing the relationship between leukocyte telomere length and cancer risk/mortality in UK biobank and TCGA datasets with the genetic risk score and mendelian randomization approaches. Front Genet, 11: 583106. https://doi.org/10.3389/fgene.2020.583106
Hertweck KL, Dasgupta S, 2017, The landscape of mtDNA modifications in cancer: A tale of two cities. Front Oncol, 7: 262. https://doi.org/10.3389/fonc.2017.00262
Wang L, Lv H, Ji P, et al., 2018, Mitochondrial DNA copy number is associated with risk of head and neck squamous cell carcinoma in Chinese population. Cancer Med, 7: 2776–2782. https://doi.org/10.1002/cam4.1452
Reznik E, Miller ML, Senbabaoglu Y, et al., 2016, Mitochondrial DNA copy number variation across human cancers. Elife, 5: e10769. https://doi.org/10.7554/eLife.10769
Xu J, Chang WS, Tsai CW, et al., 2020, Mitochondrial DNA copy number in peripheral blood leukocytes is associated with biochemical recurrence in prostate cancer patients in African Americans. Carcinogenesis, 41: 267–273. https://doi.org/10.1093/carcin/bgz139
Peasey A, Bobak M, Kubinova R, et al., 2006, Determinants of cardiovascular disease and other non-communicable diseases in Central and Eastern Europe: Rationale and design of the HAPIEE study. BMC Public Health, 6: 255–264. https://doi.org/10.1186/1471-2458-6-255
Smith CL, Kalco SR, Cantor CR, 1988, Pulsed-field gel electrophoresis and the technology of large DNA molecules. In: Davies KE, editor. Genome Analysis: A Practical Approach. Oxford: IRL Press, pp.41–72.
Stefler D, Malyutina S, Maximov V, et al., 2018, Leukocyte telomere length and risk of coronary heart disease and stroke mortality: Prospective evidence from a Russian cohort. Sci Rep, 8: 16627. https://doi.org/10.1038/s41598-018-35122-y
Maximov V, Malyutina S, Orlov P, et al., 2020, Copy number of the mitochondrial DNA of leucocytes as an aging marker and risk factors for the development of age-related diseases in humans. Adv Gerontol, 10: 1–8. https://doi.org/10.1134/S2079057020010129
Cawthon RM, 2002, Telomere measurement by quantitative PCR. Nucleic Acids Res, 30: e47. https://doi.org/10.1093/nar/30.10.e47
Hovatta I, Demello VD, Kananen L, et al., 2012, Leukocyte telomere length in the Finnish diabetes prevention study. PLoS One, 7: e34948. https://doi.org/10.1371/journal.pone.0034948
Ajaz S, Czajka A, Malik A, 2015, Accurate measurement of circulating mitochondrial DNA content from human blood samples using real-time quantitative PCR. Methods Mol Biol, 1264: 117–131. https://doi.org/10.1007/978-1-4939-2257-4_12
Willeit P, Willeit J, Kloss-brandstatter A, et al., 2011, Fifteen-year follow-up of association between telomere length and incident cancer and cancer mortality. JAMA, 306: 42–44. https://doi.org/10.1001/jama.2011.901
Qin Q, Sun J, Yin J, et al., 2014, Telomere length in peripheral blood leukocytes is associated with risk of colorectal cancer in Chinese population. PLoS One, 9: e88135. https://doi.org/10.1371/journal.pone.0088135
Zhang C, Chen X, Li L, et al., 2015, The Association between telomere length and cancer prognosis: Evidence from a meta-analysis. PLoS One, 10: e0133174. https://doi.org/10.1371/journal.pone.0133174
Jia H, Wang Z, 2016, Telomere length as a prognostic factor for overall survival in colorectal cancer patients. Cell Physiol Biochem, 38: 122–128. https://doi.org/10.1159/00043861
Kroupa M, Rachakonda SK, Liska V, et al., 2019, Relationship of telomere length in colorectal cancer patients with cancer phenotype and patient prognosis. Br J Cancer, 121: 344–350. https://doi.org/10.1038/s41416-019-0525-3
Kibriya MG, Raza M, Kamal M, et al., 2022, Relative telomere length change in colorectal carcinoma and its association with tumor characteristics, gene expression and microsatellite instability. Cancers (Basel), 14: 2250. https://doi.org/10.3390/cancers14092250
Wentzensen IM, Mirabello L, Pfeiffer RM, et al., 2011, The association of telomere length and cancer: A meta-analysis. Cancer Epidemiol Biomarkers Prev, 20: 1238–1250. https://doi.org/10.1158/1055-9965.EPI-11-0005
Luu HN, Qi M, Wang R, et al., 2019, Association between leukocyte telomere length and colorectal cancer risk in the Singapore Chinese health study. Clin Transl Gastroenterol, 10: e00043. https://doi.org/10.14309/ctg.0000000000000043
Wang W, Zheng L, Zhou N, et al., 2017, Meta-analysis of associations between telomere length and colorectal cancer survival from observational studies. Oncotarget, 8: 62500– 62507. https://doi.org/10.18632/oncotarget.20055
Huang B, Gao YT, Shu XO, et al., 2014, Association of leukocyte mitochondrial DNA copy number with colorectal cancer risk: Results from the shanghai women’s health study cancer. Epidemiol Biomarkers Prev, 23: 2357–2365. https://doi.org/10.1158/1055-9965.EPI-14-0297
Li Y, Sundquist K, Wang X, et al., 2021, Association of mitochondrial DNA copy number and telomere length with prevalent and incident cancer and cancer mortality in women: A prospective Swedish population-based study. Cancers (Basel), 13: 3842. https://doi.org/10.3390/cancers13153842
Van Osch FH, Voets AM, Schouten LJ, et al., 2015, Mitochondrial DNA copy number in colorectal cancer: Between tissue comparisons, clinic pathological characteristics and survival. Carcinogenesis, 36: 1502–1510. https://doi.org/10.1093/carcin/bgv151
Thyagarajan B, Wang R, Barcelo H, et al., 2012, Mitochondrial copy number is associated with colorectal cancer risk. Cancer Epidemiol Biomarkers Prev, 21: 1574–1581. https://doi.org/10.1158/1055-9965.EPI-12-0138-T
Wang Y, He S, Zhu X, et al., 2016, High copy number of mitochondrial DNA predicts poor prognosis in patients with advanced stage colon cancer. Int J Biol Markers, 31: e382–e388. https://doi.org/10.5301/jbm.5000211
Mi J, Tian G, Liu S, et al., 2015, The relationship between altered mitochondrial DNA copy number and cancer risk: A meta-analysis. Sci Rep, 5: 10039. https://doi.org/10.1038/srep10039
Gruber HJ, Semeraro MD, Renner W, et al., 2021, Telomeres and age-related diseases. Biomedicines, 9: 1335. https://doi.org/10.3390/biomedicines9101335
Nassour J, Schmidt TT, Karlseder J, 2021, Telomeres and cancer: Resolving the paradox. Annu Rev Cancer Biol, 5: 59–77. https://doi.org/10.1146/annurev-cancerbio-050420-023410
Filograna R, Mennuni M, Alsina D, et al., 2021, Mitochondrial DNA copy number in human disease: The more the better? FEBS Lett, 595: 976–1002. https://doi.org/10.1002/1873-3468.14021
Bensard CL, Wisidagama DR, Olson KA, et al., 2020, Regulation of tumor initiation by the mitochondrial pyruvate carrier. Cell Metab, 31: 284–300.e7. https://doi.org/10.1016/j.cmet.2019.11.002
Kopinski PK, Singh LN, Zhang S, et al., 2021, Mitochondrial DNA variation and cancer. Nat Rev Cancer, 21: 431–445. https://doi.org/10.1038/s41568-021-00358-w
Smith AL, Whitehall JC, Bradshaw C, et al., 2020, Age-associated mitochondrial DNA mutations cause metabolic remodeling that contributes to accelerated intestinal tumorigenesis. Nat Cancer, 1: 976–989. https://doi.org/10.1038/s43018-020-00112-5
Ji X, Guo W, Gu X, et al., 2022, Mutational profiling of mtDNA control region reveals tumor-specific evolutionary selection involved in mitochondrial dysfunction. EBioMedicine, 80: 104058. https://doi.org/10.1016/j.ebiom.2022.104058
Tomasova K, Kroupa M, Zinkova A, et al., 2022, Monitoring of telomere dynamics in peripheral blood leukocytes in relation to colorectal cancer patients’ outcomes. Front Oncol, 12: 962929. https://doi.org/10.3389/fonc.2022.962929
Cui H, Huang P, Wang Z, et al., 2013, Association of decreased mitochondrial DNA content with the progression of colorectal cancer. BMC Cancer, 13: 110. https://doi.org/10.1186/1471-2407-13-110