Association of SGLT2 Inhibitor Use with Leukocyte Telomere Length in Patients with Type 2 Diabetes Mellitus with and Without Chronic Kidney Disease

Objective: This study aimed to investigate telomere length characteristics in patients with type 2 diabetes mellitus (T2DM) according to the presence of chronic kidney disease (CKD) and the use of sodium–glucose cotransporter 2 (SGLT2) inhibitors. Materials and Methods: The study included 100 patients with T2DM, who were divided into groups according to the presence of CKD (50 patients in each group). Renal function parameters, urinary albumin-to-creatinine ratio, the presence of cardiovascular disease, and leukocyte telomere length were assessed. Telomere length was measured by monochrome multiplex quantitative polymerase chain reaction, with determination of the T/S ratio and residual telomere length (ΔT/S). The association between SGLT2 inhibitor therapy and telomere length parameters was additionally analyzed. Results: After adjustment for age, patients with CKD had significantly lower residual telomere length (ΔT/S; p = 0.035), while pathologically short telomeres were observed more frequently (20.8% vs. 2.1%; p = 0.0076). SGLT2 inhibitor use was associated with greater telomere length irrespective of CKD status. In multivariable regression analysis restricted to patients with CKD, SGLT2 inhibitor use was independently associated with greater leukocyte telomere length (B = 0.434; 95% CI: 0.227–0.642; p < 0.001). Conclusions: Patients with T2DM and CKD demonstrate more pronounced age-adjusted telomere shortening, suggesting accelerated biological aging. SGLT2 inhibitor use is associated with preservation of telomere length irrespective of CKD status, which may indicate a potential effect of this drug class on cellular senescence.