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Controls were frequency\u2010matched to cases by study site, age, sex and race. Age ranged from 53 to 73\u00a0years. Severe chronic periodontitis was defined using the <jats:styled-content style=\"fixed-case\">CDC<\/jats:styled-content>\u2010<jats:styled-content style=\"fixed-case\">AAP<\/jats:styled-content> case classification. <jats:styled-content style=\"fixed-case\">LTL<\/jats:styled-content> was measured from <jats:styled-content style=\"fixed-case\">DNA<\/jats:styled-content> collected at two time points, 6\u00a0years apart, with quantitative polymerase chain reaction relative to a single\u2010copy control gene. Multiple linear regression evaluated associations between <jats:styled-content style=\"fixed-case\">LTL<\/jats:styled-content> measured at baseline, follow\u2010up and change scores with severe chronic periodontitis, adjusting for potential confounders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Cases had shorter <jats:styled-content style=\"fixed-case\">LTL<\/jats:styled-content> than controls at baseline (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.03) and follow\u2010up (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.04) after adjusting for confounding. Overall there was a net reduction in <jats:styled-content style=\"fixed-case\">LTL<\/jats:styled-content> over time (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.02). The rate of <jats:styled-content style=\"fixed-case\">LTL<\/jats:styled-content> did not differ between cases and controls (<jats:italic>p\u00a0<\/jats:italic>=<jats:italic>\u00a0<\/jats:italic>0.80).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Leukocyte telomere length shortening occurred at the same rate among adults with and without severe chronic periodontitis. This suggests that <jats:styled-content style=\"fixed-case\">LTL<\/jats:styled-content> shortening may have occurred earlier in the life course.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jcpe.12337","type":"journal-article","created":{"date-parts":[[2014,11,22]],"date-time":"2014-11-22T07:57:08Z","timestamp":1416643028000},"page":"12-20","source":"Crossref","is-referenced-by-count":22,"title":["Telomere length attrition and chronic periodontitis: an <scp>ARIC<\/scp> Study nested case\u2013control study"],"prefix":"10.1111","volume":"42","author":[{"given":"Anne E.","family":"Sanders","sequence":"first","affiliation":[{"name":"Department of Dental Ecology School of Dentistry University of North Carolina\u2010Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1290-7251","authenticated-orcid":false,"given":"Kimon","family":"Divaris","sequence":"additional","affiliation":[{"name":"Department of Pediatric Dentistry School of Dentistry University of North Carolina\u2010Chapel Hill Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supawadee","family":"Naorungroj","sequence":"additional","affiliation":[{"name":"Division of Operative Dentistry Department of Conservative Dentistry School of Dentistry Prince of Songkla University Hat Yai Thailand"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gerardo","family":"Heiss","sequence":"additional","affiliation":[{"name":"Department of Epidemiology Gillings School of Global Public Health University of North Carolina\u2010Chapel Hill (UNC) Chapel Hill NC USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosa A.","family":"Risques","sequence":"additional","affiliation":[{"name":"Department of Pathology University of Washington Seattle WA USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,12,26]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/gkr634"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2010.00350.x"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2012.00455.x"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/30.10.e47"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034510375830"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro2337"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1474-9726.2006.00224.x"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/hmg\/ddt065"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1111\/jre.12134"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1038\/mp.2011.53"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/dju035"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034512457373"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1902\/jop.2012.110664"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1177\/0022034510377793"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0757.2012.00457.x"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.2004.060749"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.it.2013.09.001"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1113306109"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.freeradbiomed.2007.10.001"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.1170633"},{"key":"e_1_2_6_22_1","article-title":"Reproducibility of telomere length assessment: an international collaborative study","author":"Martin\u2010Ruiz C. 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