Background: Previously, we demonstrated that a water, sanitation, handwashing, and nutritional intervention improved linear growth and was unexpectedly associated with shortened childhood telomere length (TL) (Lin et al., 2017). Here, we assessed the association between TL and growth.
Methods: We measured relative TL in whole blood from 713 children. We reported differences between the 10th percentile and 90th percentile of TL or change in TL distribution using generalized additive models, adjusted for potential confounders.
Results: In cross-sectional analyses, long TL was associated with a higher length-for-age Z score at age 1 year (0.23 SD adjusted difference in length-for-age Z score (95% CI 0.05, 0.42; FDR-corrected p-value = 0.01)). TL was not associated with other outcomes.
Conclusions: Consistent with the metabolic telomere attrition hypothesis, our previous trial findings support an adaptive role for telomere attrition, whereby active TL regulation is employed as a strategy to address 'emergency states' with increased energy requirements such as rapid growth during the first year of life. Although short periods of active telomere attrition may be essential to promote growth, this study suggests that a longer overall initial TL setting in the first two years of life could signal increased resilience against future telomere erosion events and healthy growth trajectories.
Funding: Funded by the Bill and Melinda Gates Foundation.
The WASH Benefits data and code that support the findings of this study are available in Open Science Framework (https://osf.io/9snat/).
WASH Benefits Bangladesh Analysis of Telomere and Growth OutcomesOpen Science Framework.
WASH Benefits Bangladesh Analysis of Telomere OutcomesOpen Science Framework, https://doi.org/10.17605/OSF.IO/EVC98.
- John M Colford Jr.
- Audrie Lin
The funders had no role in study design, data collection and interpretation, or the decision to submit the work for publication.
Human subjects: Clinical trial registration: The trial was registered at ClinicalTrials.gov (NCT01590095).Human subjects: Primary caregivers of all children provided written informed consent. The study protocols were approved by human subjects committees at icddr,b (PR-11063 and PR-14108), the University of California, Berkeley (2011-09-3652 and 2014-07-6561) and Stanford University (25863 and 35583).
- Eduardo Franco, McGill University, Canada
- Received: June 30, 2020
- Accepted: September 4, 2021
- Accepted Manuscript published: September 8, 2021 (version 1)
© 2021, Lin et al.
This article is distributed under the terms of the Creative Commons Attribution License permitting unrestricted use and redistribution provided that the original author and source are credited.