Telomere length increase after weight loss induced by bariatric surgery: results from a 10 year prospective study

BACKGROUND/OBJECTIVES: Obesity contributes to telomere attrition. Studies focusing on short-term effects of weight loss have been unable to identify protection of telomere length. This study investigates long-term effects of pronounced weight loss induced by bariatric surgery on telomere length. SUBJECTS/METHODS: One hundred forty-two patients were recruited in a prospective, controlled intervention study, follow-up investigations were done after 10.46 +/- 1.48 years. A control group of normal weight participants was recruited and followed from 1995 to 2005 in the Bruneck Study. A total of 110 participants from each study was matched by age and sex to compare changes in telomere length. Quantitative PCR was used to determine telomere length. RESULTS: Telomere length increased significantly by 0.024 +/- 0.14 (P = 0.047) in 142 bariatric patients within 10 years after surgery. The increase was different from telomere attrition in an age-and sex-matched cohort population of the Bruneck Study (-0.057 +/- 0.18; beta = 0.08; P = 0.003). Significant changes in telomere length disappeared after adjusting for baseline body mass index (BMI) because of general differences in BMI and telomere length between the two study populations (beta = 0.07; P = 0.06). Age was proportional to telomere length in matched bariatric patients (r = 0.188; P = 0.049) but inversely correlated with telomere length in participants of the Bruneck Study (r = -0.197; P = 0.039). There was no association between percent BMI/ excess weight loss and telomere attrition in bariatric patients. Baseline telomere length in bariatric patients was inversely associated with baseline plasma cholesterol and triglyceride concentrations. Telomere shortening was associated with lower high-density lipoprotein cholesterol and higher fasting glucose concentration at baseline in bariatric patients. CONCLUSIONS: Increases in relative telomere length were found after bariatric surgery in the long term, presumably due to amelioration of metabolic traits. This may overrule the influence of age and baseline telomere length and facilitate telomere protection in patients experiencing pronounced weight loss.