Telomeres are repetitive DNA hexamers (TTAGGG) at the ends of chromosomes. The length of telomeric DNA shortens with each cell division, and if they become too short, chromosomes can undergo end-to-end fusions, chromosomal abnormalities, aneuploidy and degradation. Therefore, telomere length ensures chromosome stability and cell protection (Maser and DePinho 2004). Furthermore, the studies show that telomeres shorten with increasing age; thus, telomere length provides information about cell ageing and early mortality (Serrano and Andrés 2004, Cawthon 2003). For this reason, the telomere length can be used as a biomarker for ageing. Firstly this study reported and focused on a relationship between war stress and telomere length. Also, in this study, a group of 40 refugees (Syrian Arabs) who were exposed to war and had to migrate to Turkey, and a control group of 40 people who were not exposed to war (Turkish Arabs live in Syria border of Turkey) were examined according to their anxiety, depression and telomere length.
Wars have had a different effect on the human body in many ways, and one of these ways is stress-related health disorders, anxiety and depression. There are many studies about the effect of war on anxiety and depression in the last decades due to the Arab spring in the Middle East. According to these studies' results, the anxiety ratio ranges between 32 − 26%, and the depression ratio ranges between 48 − 25% (Ünver et al. 2021, Kaya et al. 2019, Steel et al. 2009). Similarly, in this study, the anxiety and depression status of 40 war-exposed refugees, who were exposed to war and had to migrate to Turkey, was found as 60% and 62.5%, respectively. On the other hand, the anxiety and depression status of the control group was found as 27.5% and 37.5%, respectively. A significant difference was found between the group exposed to war and the control group regarding anxiety status (p < 0.001). Also, the average duration of exposure to war for participants in the group exposed to war was calculated as 4.35 ± 1.81 years. A significant correlation was found between the duration of exposure to war and the HADS anxiety score. Also, it was observed that the anxiety status increased significantly with the increase in the duration of exposure to war (r = 0.265, p = 0.018). Many studies reported an association between anxiety and depression disorders and shorter telomeres (Darrow et al. 2016, Needham et al. 2015, Malouff and Schutte 2017). The findings of this study showed that the mean telomere length was 8.44 ± 0.66 kb in participants with anxiety status, while the mean telomere length was 8.76 ± 0.65 kb in participants without anxiety status. A statistically significant difference was found between the presence of anxiety and telomere length among the participants (p = 0.04). These data are similar to other studies in the literature. Also, a significant difference was found between the war-exposed group and the control group regarding depression status (p = 0.025). Hence, a significant correlation was found between the duration of exposure to war and the HADS depression score. It was observed that the depression state increased significantly with the increase in the duration of exposure to war, the same as anxiety status (r = 0,455, p < 0.001). Although telomere length was shorter in the group with depression, no statistically significant difference was found in this study between participants with and without depression in terms of telomere length (p = 0.393).
On the other hand, many studies show a difference between the telomere lengths of the war veterans, who served in Iraq, Afghanistan or the Croatian war and the controls (Bersani et al. 2016, Jergović et al. 2014). Also, people in war zones who try to migrate from these zones suffer from diseases and lose their friends and relatives during the war. Therefore, all of these sufferings cause much stress on their body, and as a consequence, this situation causes telomere shortening in their cells. According to this study, a significant difference was found between the war-exposed group and the control group in terms of telomere length (p < 0.001). Also, it was observed that the telomere length decreased with the time of war exposure among the war-exposed group participants (p < 0.001).
Overall, as a result, this study determined that exposure to war and migrating due to war created stress in the human body and shortened telomeres. Therefore, according to this study, observing the participants exposed to wars and possible health problems such as psychiatric problems, chronic diseases, and early cell ageing will be helpful.