Telomere Shortening and Accelerated Aging in US Military Veterans

doi:10.3390/ijerph18041743

. 2021 Feb 11;18(4):1743.

doi: 10.3390/ijerph18041743.

Telomere Shortening and Accelerated Aging in US Military Veterans

Jeffrey T Howard^{1

2}, Jud C Janak³, Alexis R Santos-Lozada⁴, Sarah McEvilla¹, Stephanie D Ansley^{1

2}, Lauren E Walker⁵, Avron Spiro^{6

7}, Ian J Stewart⁸

Affiliations

¹ Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
² Consequences of Trauma Working Group, the Center for Community-Based and Applied Health Research, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
³ Bexar Data LLC, San Antonio, TX 78210, USA.
⁴ Department of Human Development and Family Studies, Pennsylvania State University, 119 Health and Human Development Building, University Park, PA 16802, USA.
⁵ David Grant USAF Medical Center, Travis Air Force Base, Fairfield, CA 94535, USA.
⁶ Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA 02130, USA.
⁷ Departments of Epidemiology and Psychiatry, Boston University Schools of Public Health and Medicine, Boston, MA 02118, USA.
⁸ Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA.

PMID: 33670145
PMCID: PMC7916830
DOI: 10.3390/ijerph18041743

Telomere Shortening and Accelerated Aging in US Military Veterans

Jeffrey T Howard et al. Int J Environ Res Public Health. 2021.

. 2021 Feb 11;18(4):1743.

doi: 10.3390/ijerph18041743.

Authors

Jeffrey T Howard^{1

2}, Jud C Janak³, Alexis R Santos-Lozada⁴, Sarah McEvilla¹, Stephanie D Ansley^{1

2}, Lauren E Walker⁵, Avron Spiro^{6

7}, Ian J Stewart⁸

Affiliations

¹ Department of Public Health, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
² Consequences of Trauma Working Group, the Center for Community-Based and Applied Health Research, University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA.
³ Bexar Data LLC, San Antonio, TX 78210, USA.
⁴ Department of Human Development and Family Studies, Pennsylvania State University, 119 Health and Human Development Building, University Park, PA 16802, USA.
⁵ David Grant USAF Medical Center, Travis Air Force Base, Fairfield, CA 94535, USA.
⁶ Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, MA 02130, USA.
⁷ Departments of Epidemiology and Psychiatry, Boston University Schools of Public Health and Medicine, Boston, MA 02118, USA.
⁸ Uniformed Services University of Health Sciences, Bethesda, MD 20814, USA.

PMID: 33670145
PMCID: PMC7916830
DOI: 10.3390/ijerph18041743

Abstract

A growing body of literature on military personnel and veterans' health suggests that prior military service may be associated with exposures that increase the risk of cardiovascular disease (CVD), which may differ by race/ethnicity. This study examined the hypothesis that differential telomere shortening, a measure of cellular aging, by race/ethnicity may explain prior findings of differential CVD risk in racial/ethnic groups with military service. Data from the first two continuous waves of the National Health and Nutrition Examination Survey (NHANES), administered from 1999-2002 were analyzed. Mean telomere length in base pairs was analyzed with multivariable adjusted linear regression with complex sample design, stratified by sex. The unadjusted mean telomere length was 225.8 base shorter for individuals with prior military service. The mean telomere length for men was 47.2 (95% CI: -92.9, -1.5; p < 0.05) base pairs shorter for men with military service after adjustment for demographic, socioeconomic, and behavioral variables, but did not differ significantly in women with and without prior military service. The interaction between military service and race/ethnicity was not significant for men or women. The results suggest that military service may contribute to accelerated aging as a result of health damaging exposures, such as combat, injury, and environmental contaminants, though other unmeasured confounders could also potentially explain the results.

Keywords: accelerated aging; telomeres; veteran’s health.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Multivariable regression-based mean telomere length in base pairs for males and females at mean sample age of 46 years, and mean values of covariates (black bars), with year equivalents of telomere difference between individuals with no military service (gray section of bar) compared to individuals with military service.

See this image and copyright information in PMC

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References

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1. Boos C.J., De Villiers N., Dyball D., McConnell A., Bennett A.N. The Relationship between Military Combat and Cardiovascular Risk: A Systematic Review and Meta-Analysis. Int. J. Vasc. Med. 2019;2019:1–14. doi: 10.1155/2019/9849465. - DOI - PMC - PubMed
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1. Howard J.T., Sosnov J.A., Janak J.C., Gundlapalli A.V., Pettey W.B., Walker L.E., Stewart I.J. Associations of Initial Injury Severity and Posttraumatic Stress Disorder Diagnoses with Long-Term Hypertension Risk After Combat Injury. Hypertension. 2018;71:824–832. doi: 10.1161/HYPERTENSIONAHA.117.10496. - DOI - PubMed

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[1] Heron M. Deaths: Leading Causes for 2017. Natl. Vital Stat. Rep. 2019;68:1–77. - PubMed

[2] Heron M. Deaths: Leading Causes for 2017. Natl. Vital Stat. Rep. 2019;68:1–77. - PubMed

[3] Boos C.J., De Villiers N., Dyball D., McConnell A., Bennett A.N. The Relationship between Military Combat and Cardiovascular Risk: A Systematic Review and Meta-Analysis. Int. J. Vasc. Med. 2019;2019:1–14. doi: 10.1155/2019/9849465. - DOI - PMC - PubMed

[4] Boos C.J., De Villiers N., Dyball D., McConnell A., Bennett A.N. The Relationship between Military Combat and Cardiovascular Risk: A Systematic Review and Meta-Analysis. Int. J. Vasc. Med. 2019;2019:1–14. doi: 10.1155/2019/9849465. - DOI - PMC - PubMed

[5] Crum-Cianflone N.F., Bagnell M.E., Schaller E., Boyko E.J., Smith B., Maynard C., Ulmer C.S., Vernalis M., Smith T.C. Impact of Combat Deployment and Posttraumatic Stress Disorder on Newly Reported Coronary Heart Disease Among US Active Duty and Reserve Forces. Circulation. 2014;129:1813–1820. doi: 10.1161/CIRCULATIONAHA.113.005407. - DOI - PubMed

[6] Crum-Cianflone N.F., Bagnell M.E., Schaller E., Boyko E.J., Smith B., Maynard C., Ulmer C.S., Vernalis M., Smith T.C. Impact of Combat Deployment and Posttraumatic Stress Disorder on Newly Reported Coronary Heart Disease Among US Active Duty and Reserve Forces. Circulation. 2014;129:1813–1820. doi: 10.1161/CIRCULATIONAHA.113.005407. - DOI - PubMed

[7] Howard J.T., Stewart I.J., Kolaja C.A., Sosnov J.A., Rull R.P., Torres I., Janak J.C., Walker L.E., Trone D.W., Armenta R.F. Hypertension in military veterans is associated with combat exposure and combat injury. J. Hypertens. 2020;38:1293–1301. doi: 10.1097/HJH.0000000000002364. - DOI - PubMed

[8] Howard J.T., Stewart I.J., Kolaja C.A., Sosnov J.A., Rull R.P., Torres I., Janak J.C., Walker L.E., Trone D.W., Armenta R.F. Hypertension in military veterans is associated with combat exposure and combat injury. J. Hypertens. 2020;38:1293–1301. doi: 10.1097/HJH.0000000000002364. - DOI - PubMed

[9] Howard J.T., Sosnov J.A., Janak J.C., Gundlapalli A.V., Pettey W.B., Walker L.E., Stewart I.J. Associations of Initial Injury Severity and Posttraumatic Stress Disorder Diagnoses with Long-Term Hypertension Risk After Combat Injury. Hypertension. 2018;71:824–832. doi: 10.1161/HYPERTENSIONAHA.117.10496. - DOI - PubMed

[10] Howard J.T., Sosnov J.A., Janak J.C., Gundlapalli A.V., Pettey W.B., Walker L.E., Stewart I.J. Associations of Initial Injury Severity and Posttraumatic Stress Disorder Diagnoses with Long-Term Hypertension Risk After Combat Injury. Hypertension. 2018;71:824–832. doi: 10.1161/HYPERTENSIONAHA.117.10496. - DOI - PubMed

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Telomere Shortening and Accelerated Aging in US Military Veterans

Affiliations

Telomere Shortening and Accelerated Aging in US Military Veterans

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