(OR21-03-26) Changing in Telomere Length After Pharmacologic, Surgical, and Dietary Weight Loss in Patients With Type 2 Diabetes Mellitus and Hypertension: A Randomized Clinical Trail

Monday, July 27, 2026

2:54 PM - 3:06 PM ET

Location: Maryland Ballroom C

Presenting Author(s)

Kuat Oshakbayev, MD, PhD, DMSc, full-Professor (he/him/his)

Deputy director for R&D&C in CAD of Internal Medicine
Corporate Fund ''University Medical Center''
Astana, Astana, Kazakhstan

Disclosure(s): No relevant financial relationship(s) with ineligible companies to disclose.

Co-Author(s)

GK

Gani Kuttymuratov

University Medical Center
Astana, Kazakhstan
AD

Aigul Durmanova

University Medical Center
Astana, Kazakhstan
NB

Nurzhan Bikhanov

University Medical Center
Astana, Kazakhstan
AN

Altay Nabiyev

University Medical Center
Astana, Kazakhstan
TS

Timur Suleimenov

University Medical Center
Astana, Kazakhstan
AI

Alisher Idrissov

Astana Medical University
Astana, Kazakhstan
GB

Guldana Bazheneyeva

University Medical Center
Astana, Kazakhstan
AA

Ainur Akilzhanova

National Laboratory Astana, Nazarbayev University, Kazakhstan

Disclosure(s):

Kuat Oshakbayev, 3202: No relevant financial relationship(s) with ineligible companies to disclose.

Objectives: Does slowing Telomere length (TL) shortening only occur due to intentional weight loss? We studied the impact of pharmacologic, surgical, dietary weight loss on TL in patients with type 2 diabetes mellitus (DM) and hypertension (HT).

Methods: A 26-week prospective, multicenter, comparative randomized clinical trial including 60 patients (aged 30-60 years), randomly allocated (based on “day-of-visit”) into three groups: Drug (Semaglutide 1 mg/7 day with oral Empagliflozin 25 mg/day); Surgery (laparoscopic minigastric bypass); and very-low-calorie diet (VLCD, program named ‘Analimentary-detoxication’). Endpoints (baseline/endline): TL, weight loss; HOMA-IR; glycosylated hemoglobin (HbA1c); systolic/diastolic blood pressure (SBP/DBP); lipids. The protocol of Joglekar et al. (2020) was used using primers TelF/TelR (TRs), 36B4F/36B4R and β-globin F/R (SCGs, single-copy genes) to determine relative TL (2^−ΔΔCt, differences between TRs and SCGs in ΔCt value). Linear regression analysis between weight loss and TL was performed (pooled data).

Results: At 26 weeks, weight lost from baseline in Drug (-6.7%, P=0.053), Surgery (-23.4%, P <0.0001) and VLCD (-21.8%, P <0.0001). TL was shortened in Drug (-2.91±0.24 DCt-value, P=0.043), Surgery (-2.37±0.26 DCt-value, P=0.037), and VLCD (-1.88±0.16 DCt-value, P=0.068). HbA1c decreased in Drug (-31.2%, P < 0.0001), Surgery (-27.1%, P <0.0001), and VLCD (-15.5%, P=0.03). HOMA-IR in Drug, Surgery and VLCD decreased by -38.4% (P=0.047), -89.7% (P < 0.0001), and -89.4% (P < 0.0001), respectively. SBP/DBP decreased in Drug (-9.8%, P=0.0002 and -4.2%, P=0.04, respectively); Surgery (-18.4%, P <0.0001 and -12.7%, P=0.0012, respectively); VLCD (-23.9%, P < 0.0001 and 22.1%, P < 0.0001, respectively). Liner regression revealed an inverse correlation between weight loss and TL shortening (r= –0.571; F=30.9, P < 0.0001): TL shortens by 73% if weight lost by 10%; if weight lost by 25%, TL shortens by 22%.

Conclusions: Significant weight loss slows the rate of TL shortening in patients with DM&HT: the greater the weight loss, the less the TL shortens.

Funding Sources: Ministry of Science and Higher Education of the Republic of Kazakhstan (AP23488544)