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Objective <p>Telomere shortening has been implicated in cellular aging and may play a role in the pathophysiology of polycystic ovary syndrome (PCOS). The main objective is to investigate the relationship between leukocyte telomere length (LTL) and polycystic ovary syndrome (PCOS) in a Pakistani population and to contextualize findings through a meta-analysis of existing literature.</p> Design <p>This case-control study included 280 participants (120 PCOS patients and 160 age-matched healthy controls). Biochemical and hormonal profiles were assessed. Telomere length was measured by qPCR. Correlation and multiple regression analyses were conducted. A meta-analysis (8 studies) with sensitivity and meta-regression analyses was performed.</p> Results <p>PCOS patients had significantly higher BMI, total cholesterol, triglycerides, LDL, and VLDL (<i>p</i> &lt; 0.001), and lower HDL (<i>p</i> &lt; 0.001). LH, FSH, and prolactin levels were significantly elevated (<i>p</i> &lt; 0.05), with no significant difference in testosterone. LTL was significantly shorter in PCOS women (<i>p</i> = 0.007). LTL correlated negatively with BMI (<i>r</i>=–0.157, <i>p</i> = 0.035) and LH (<i>r</i>=–0.192, <i>p</i> = 0.001). Regression analysis showed a significant association between PCOS and LTL (<i>p</i> = 0.006) after adjusting for age and BMI. A PCOS×BMI interaction was significant (β=-0.241, <i>p</i> = 0.001). Meta-analysis revealed a non-significant trend towards a shorter LTL (SMD = 1.21, <i>p</i> = 0.123), high heterogeneity (I²=99.6%), and no publication bias (Egger’s <i>p</i> = 0.975). Removal of one study altered significance (<i>p</i> = 0.002). Meta-regression found no moderating effects of age or BMI.</p> Conclusion <p>Shorter LTL in PCOS may reflect underlying metabolic and hormonal dysregulation, particularly influenced by obesity. The meta-analysis findings remain inconclusive due to extreme heterogeneity and limited power, and should be considered exploratory, underscoring the need for larger, standardized longitudinal studies.</p>

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Association of leukocyte telomere length alteration with polycystic ovary syndrome in Pakistani population: a case-control study with meta-analysis

  • 期刊论文

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  • 发表日期：

    2025年11月19日

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  • Zuha Tariq,
  • Arham Javed,
  • Fouzia Amir,
  • Afrose Liaquat,
  • Minahil Tahir,
  • Wafa Khizar,
  • Muhammad Jawad Khan

摘要

Objective

Telomere shortening has been implicated in cellular aging and may play a role in the pathophysiology of polycystic ovary syndrome (PCOS). The main objective is to investigate the relationship between leukocyte telomere length (LTL) and polycystic ovary syndrome (PCOS) in a Pakistani population and to contextualize findings through a meta-analysis of existing literature.

Design

This case-control study included 280 participants (120 PCOS patients and 160 age-matched healthy controls). Biochemical and hormonal profiles were assessed. Telomere length was measured by qPCR. Correlation and multiple regression analyses were conducted. A meta-analysis (8 studies) with sensitivity and meta-regression analyses was performed.

Results

PCOS patients had significantly higher BMI, total cholesterol, triglycerides, LDL, and VLDL (p < 0.001), and lower HDL (p < 0.001). LH, FSH, and prolactin levels were significantly elevated (p < 0.05), with no significant difference in testosterone. LTL was significantly shorter in PCOS women (p = 0.007). LTL correlated negatively with BMI (r=–0.157, p = 0.035) and LH (r=–0.192, p = 0.001). Regression analysis showed a significant association between PCOS and LTL (p = 0.006) after adjusting for age and BMI. A PCOS×BMI interaction was significant (β=-0.241, p = 0.001). Meta-analysis revealed a non-significant trend towards a shorter LTL (SMD = 1.21, p = 0.123), high heterogeneity (I²=99.6%), and no publication bias (Egger’s p = 0.975). Removal of one study altered significance (p = 0.002). Meta-regression found no moderating effects of age or BMI.

Conclusion

Shorter LTL in PCOS may reflect underlying metabolic and hormonal dysregulation, particularly influenced by obesity. The meta-analysis findings remain inconclusive due to extreme heterogeneity and limited power, and should be considered exploratory, underscoring the need for larger, standardized longitudinal studies.