File(s) under permanent embargo

Reason: This item is currently closed access.

Telomere length and health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies

journal contribution
posted on 11.03.2019, 14:11 by Lee Smith, Claudio Luchini, Jacopo Demurtas, Pinar Soysal, Brendon Stubbs, Mark Hamer, Alessia Nottegar, Rita T. Lawlor, Guillermo F. Lopez-Sanchez, Joseph Firth, Ai Koyanagi, Justin D. Roberts, Peter Willeit, Thomas Waldhoer, Michael Loosemore, Adam D. Abbs, James Johnstone, Lin Yang, Nicola Veronese
The aim of the present study was to map and grade evidence for the relationships between telomere length with a diverse range of health outcomes, using an umbrella review of systematic reviews with meta-analyses. We searched for meta-analyses of observational studies reporting on the association of telomere length with any health outcome (clinical disease outcomes and intermediate traits). For each association, random-effects summary effect size, 95% confidence interval (CI), and 95% prediction interval were calculated. To evaluate the credibility of the identified evidence, we assessed also heterogeneity, evidence for small-study effect and evidence for excess significance bias. Twenty-one relevant meta-analyses were identified reporting on 50 different outcomes. The level of evidence was high only for the association of short telomeres with higher risk of gastric cancer in the general population (relative risk, RR = 1.95, 95%CI: 1.68–2.26), and moderate for the association of shorter telomeres with diabetes or with Alzheimer’s disease, even if limited to meta-analyses of case-control studies. There was weak evidence for twenty outcomes and not significant association for 27 health outcomes. The present umbrella review demonstrates that shorter telomere length may have an important role in incidence gastric cancer and, probably, diabetes and Alzheimer’s disease. At the same time, conversely to general assumptions, it does not find strong evidence supporting the notion that shorter telomere length plays an important role in many health outcomes that have been studied thus far.



  • Sport, Exercise and Health Sciences

Published in

Ageing Research Reviews




1 - 10


SMITH, L. ... et al, 2019. Telomere length and health outcomes: An umbrella review of systematic reviews and meta-analyses of observational studies. Ageing Research Reviews, 51, pp.1-10.


© Elsevier


AM (Accepted Manuscript)

Publisher statement

This work is made available according to the conditions of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0) licence. Full details of this licence are available at:

Publication date



This paper is closed access until 15 February 2020.