Short leukocyte telomere length and increased risk of infection after gastrointestinal surgery: analysis of individuals from the Danish general population

Abstract Purpose Short leukocyte telomere length is associated with increased risk of infections and infection-related death in the general population; however, it is unclear whether this association applies to infections following surgery. This study investigated whether short leukocyte telomere length was associated with increased postoperative infection or mortality risk in a prospective cohort of gastrointestinal surgery patients. Methods This study included a subset of individuals from a Danish prospective general population study (Copenhagen General Population Study [CGPS]) who underwent any type of gastrointestinal surgery between 2004 and 2021 following enrollment. Exposures were baseline measured leukocyte telomere length and three genetic variants ( TERT rs7726159, TERC rs1317082, OBFC1 rs2487999) predicting leukocyte telomere length. Primary outcomes were 90-day infections and 90-day mortality following the first occurrence of surgery after GCPS enrollment. Associations between exposures and outcomes were assessed using multivariable Cox regression models. Results Among 107,536 individuals, 13,161 (median age:68 years; 53.2% female) were included in the study. Of these, 968 (7.4%) had an infection and 882 (6.7%) died within 90 days postoperatively. Multivariable adjusted HRs for shortest (1st ) versus longest (4th ) age-adjusted quartile of telomere length were 1.32 (95%CI:1.07–1.64; p = 0.009) for any 90-day postoperative infection and 1.56 (95%CI:1.03–2.34; p = 0.03) for 90-day pneumonia. No associations were found between measured shorter telomere lengths and 90-day postoperative mortality. Genetically predicted shorter telomere lengths were not associated with the outcomes of interest. Conclusion Short age-adjusted telomere length was associated with higher risk of infections but not mortality within 90 days after gastrointestinal surgery in the Danish general population.