The Association of Ramadan Fasting on Relative Leukocyte Telomere Length in Type 2 Diabetes Mellitusc
DOI:
https://doi.org/10.15605/jafes.041.01.5071Keywords:
Ramadan fasting, relative leukocyte telomere length, type 2 diabetes mellitusAbstract
Background. Leukocyte telomere length (LTL) is considered a biomarker of cellular senescence. Previous studies have reported the associations between shortened telomere length and type 2 diabetes mellitus (T2DM). However, the role of underlying factors remained unclear. While Ramadan fasting has consistently been shown to improve anthropometric and metabolic parameters in T2DM, its effect on cellular senescence has scarcely been reported.
Objective. We sought to determine whether Ramadan Fasting affect leukocyte telomere length in persons with T2DM.
Methodology. An interventional before-and-after study was conducted on 40 to 60-year-old subjects with T2DM consecutively recruited before Ramadan fasting (May 2018 and May 2019) from the Internal Medicine Outpatient Clinic at Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia. Relative LTL was compared between 48 subjects before Ramadan fasting and after at least 14 days of fasting and then adjusted with key clinical and biochemical parameters.
Results. The relative rLTL in subjects with T2DM was comparable between before and after at least 14 days of Ramadan fasting. (0.391 [0.021–1.515] vs 1.117 [0.528–1.741], p = 0.112).
Conclusion. No significant difference was found in relative leukocyte telomere length among subjects with type 2 diabetes who have undergone Ramadan fasting for at least 14 days. However, this study showed a tendency to have an increase in relative LTL.
Downloads
References
International Diabetes Federation. IDF Diabetes Atlas. 2021. https://idf.org/about-diabetes/resources/idf-diabetes-atlas-2021/
Tian R, Zhang LN, Zhang TT, Pang HY, Chen LF, Shen ZJ, et al. Association between oxidative stress and peripheral leukocyte telomere length in patients with premature coronary artery disease. Med Sci Monit. 2017;23:4382–90. https://pubmed.ncbi.nlm.nih.gov/28892468 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5604488 https://doi.org/10.12659/msm.902106
Gavia-García G, Rosado-Pérez J, Arista-Ugalde TL, Aguiñiga-Sánchez I, Santiago-Osorio E, Mendoza-Núñez VM. Telomere length and oxidative stress and its relation with metabolic syndrome components in the aging. Biology (Basel). 2021;10(4):253. https://pubmed.ncbi.nlm.nih.gov/33804844 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8063797 https://doi.org/10.3390/biology10040253
Palmer AK, Gustafson B, Kirkland JL, Smith U. Cellular senescence: at the nexus between ageing and diabetes. Diabetologia. 2019;62(10):1835–41. https://pubmed.ncbi.nlm.nih.gov/31451866 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6731336 https://doi.org/10.1007/s00125-019-4934-x
Palmer AK, Tchkonia T, LeBrasseur NK, Chini EN, Xu M, Kirkland JL. Cellular senescence in type 2 diabetes: A therapeutic opportunity. Diabetes. 2015;64(7):2289–98. https://pubmed.ncbi.nlm.nih.gov/26106186 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4477358 https://doi.org/10.2337/db14-1820
Jeanclos E, Krolewski A, Skurnick J, Kimura M, Aviv H, Warram JH, et al. Shortened telomere length in white blood cells of patients with IDDM. Diabetes. 1998;47(3):482–6. https://pubmed.ncbi.nlm.nih.gov/9519758 https://doi.org/10.2337/diabetes.47.3.482
Zhao J, Miao K, Wang H, Ding H, Wang DW. Association between telomere length and type 2 diabetes mellitus: A meta-analysis. PLoS One. 2013;8(11):e79993. https://pubmed.ncbi.nlm.nih.gov/24278229 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3836967 https://doi.org/10.1371/journal.pone.0079993
Cheng F, Luk AO, Tam CHT, et al. Shortened relative leukocyte telomere length is associated with prevalent and incident cardiovascular complications in type 2 diabetes: Analysis from the Hong Kong Diabetes Register. Diabetes Care. 2020;43(9):2257–65. https://pubmed.ncbi.nlm.nih.gov/32661111 https://doi.org/10.2337/dc20-0028
Burton DGA, Faragher RGA. Obesity and type-2 diabetes as inducers of premature cellular senescence and ageing. Biogerontology. 2018;19(6):447–59. https://pubmed.ncbi.nlm.nih.gov/30054761 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6223730 https://doi.org/10.1007/s10522-018-9763-7
Sanders JL, Newman AB. Telomere length in epidemiology: a biomarker of aging, age-related disease, both, or neither? Epidemiol Rev. 2013;35(1):112–31. https://pubmed.ncbi.nlm.nih.gov/23302541 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4707879 https://doi.org/10.1093/epirev/mxs008
Wang J, Dong X, Cao L, et al. Association between telomere length and diabetes mellitus: A meta-analysis. J Int Med Res. 2016;44(6):1156–73. https://pubmed.ncbi.nlm.nih.gov/28322101 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5536737 https://doi.org/10.1177/0300060516667132
Shen Q, Zhao X, Yu L, et al. Association of leukocyte telomere length with type 2 diabetes in mainland Chinese populations. J Clin Endocrinol Metab. 2012;97(4):1371–4. https://pubmed.ncbi.nlm.nih.gov/22319045 https://doi.org/10.1210/jc.2011-1562
Mather KA, Jorm AF, Parslow RA, Christensen H. Is telomere length a biomarker of aging? A review. J Gerontol A Biol Sci Med Sci. 2011;66(2):202–13. https://pubmed.ncbi.nlm.nih.gov/21030466 https://doi.org/10.1093/gerona/glq180
Liu Z, Zhang J, Yan J, Wang Y, Li Y. Leucocyte telomere shortening in relation to newly diagnosed type 2 diabetic patients with depression. Oxid Med Cell Longev. 2014;2014:673959. https://pubmed.ncbi.nlm.nih.gov/24868316 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4020220 https://doi.org/10.1155/2014/673959
Asghar M, Yman V, Homann MV, et al. Cellular aging dynamics after acute malaria infection: A 12-month longitudinal study. Aging Cell. 2018;17(1):e12702. https://pubmed.ncbi.nlm.nih.gov/29143441 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5771395 https://doi.org/10.1111/acel.12702
Shammas MA. Telomeres, lifestyle, cancer, and aging. Curr Opin Clin Nutr Metab Care. 2011;14(1):28–34. https://pubmed.ncbi.nlm.nih.gov/21102320 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3370421 https://doi.org/10.1097/MCO.0b013e32834121b1
Elks CE, Scott RA. The long and short of telomere length and diabetes. Diabetes. 2014;63(1):65–7. https://pubmed.ncbi.nlm.nih.gov/24357701 https://doi.org/10.2337/db13-1469
Mah LJ, El-Osta A, Karagiannis TC. GammaH2AX as a molecular marker of aging and disease. Epigenetics. 2010;5(2):129–36. https://pubmed.ncbi.nlm.nih.gov/20150765 https://doi.org/10.4161/epi.5.2.11080
Zhou Y, Ning Z, Lee Y, Hambly BD, McLachlan CS. Shortened leukocyte telomere length in type 2 diabetes mellitus: Genetic polymorphisms in mitochondrial uncoupling proteins and telomeric pathways. Clin Transl Med. 2016;5(1):8. https://pubmed.ncbi.nlm.nih.gov/26951191 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4781821 https://doi.org/10.1186/s40169-016-0089-2
Prattichizzo F, De Nigris V, La Sala L, Procopio AD, Olivieri F, Ceriello A. “Inflammaging” as a druggable target: A senescence-associated secretory phenotype-centered view of type 2 diabetes. Oxid Med Cell Longev. 2016;2016:1810327. https://pubmed.ncbi.nlm.nih.gov/27340505 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4908264 https://doi.org/10.1155/2016/1810327
de Cabo R, Mattson MP. Effects of intermittent fasting on health, aging, and disease. N Engl J Med. 2019;381(26):2541–51. https://pubmed.ncbi.nlm.nih.gov/31881139 https://doi.org/10.1056/NEJMra1905136
Anton SD, Moehl K, Donahoo WT, et al. Flipping the metabolic switch: Understanding and applying the health benefits of fasting. Obesity (Silver Spring). 2018;26(2):254–68. https://pubmed.ncbi.nlm.nih.gov/29086496 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5783752 https://doi.org/10.1002/oby.22065
Harbuwono DS, Kurniawan F, Sudarsono NC, Tahapary DL. The impact of Ramadan fasting on glucose variability in type 2 diabetes mellitus patients on oral anti diabetic agents. PLoS One. 2020;15(6):e0234443. https://pubmed.ncbi.nlm.nih.gov/32598395 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7323947 https://doi.org/10.1371/journal.pone.0234443
Published
How to Cite
Issue
Section
License
Copyright (c) 2026 Mona Hardika, Farid Kurniawan, Purwita Wijaya Laksmi, Syahidatul Wafa, Rheza Meida Marliau, Agian Jeffilano Barinda, Dante Harbuwono, Dicky Tahapary
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The full license text is available at: http://creativecommons.org/licenses/by-nc/3.0/legalcode.
To request permission to translate, reproduce, download, or use articles or images for commercial reuse or business purposes from the Journal of the ASEAN Federation of Endocrine Societies (JAFES), kindly complete the Permission Request for Use of Copyrighted Material Form and email jafes@asia.com or jafes.editor@gmail.com.
A written agreement will be issued to the requester once permission has been granted.
