Sex-specific associations between telomere length and health indicators: a cross-sectional study using Specific Health Checkups in Matsuura City, Japan

Abstract Health checkups are essential for the early detection and prevention of disease. Japan’s Specific Health Checkups program, launched in 2008, plays an important role in monitoring population health. However, identifying health indicators associated with biological aging remains challenging. This study investigated the associations between leukocyte telomere length, a biomarker of biological aging, and the results of Specific Health Checkups. We analyzed data from 435 residents aged 40–74 years in Matsuura City who underwent Specific Health Checkups between June and July 2021. Leukocyte telomere length was estimated using quantitative real-time PCR. Health checkup variables included body mass index, blood pressure, laboratory test results, and lifestyle factors obtained from questionnaires. Associations were examined using multivariable regression analyses, with statistical significance defined as p < 0.05. Among males, elevated systolic blood pressure (47.1%) and body mass index (30.5%) were the most common abnormal findings, whereas among females, elevated systolic blood pressure (44.4%) and triglycerides (33.3%) were most prevalent. In multivariable analyses, shorter telomere length was significantly associated with higher serum creatinine levels in males ( p = 0.031) and higher HbA1c levels in females ( p = 0.042). In secondary analyses, reduced masticatory function was associated with higher creatinine levels in males ( p = 0.020), while older age ( p = 0.004), smoking ( p = 0.023), and weight change ( p < 0.001) were associated with higher HbA1c levels in females. Although hypertension and obesity were the most prevalent health issues in this population, serum creatinine in males and HbA1c in females showed stronger associations with shorter telomere length than other examined health indicators. These findings suggest that kidney function in males and glucose metabolism in females may represent important correlates of biological aging in this population. Integrating biomarkers of biological aging with routine health checkup data may help identify population-specific health priorities and support the development of tailored public health strategies.