Associations of short stature and components of height with incidence of type 2 diabetes: mediating effects of cardiometabolic risk factors

Diabetologia. 2019 Dec;62(12):2211-2221. doi: 10.1007/s00125-019-04978-8. Epub 2019 Sep 9.

Abstract

Aims/hypothesis: This study aimed to evaluate associations of height as well as components of height (sitting height and leg length) with risk of type 2 diabetes and to explore to what extent associations are explainable by liver fat and cardiometabolic risk markers.

Methods: A case-cohort study within the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study comprising 26,437 participants who provided blood samples was designed. We randomly selected a subcohort of 2500 individuals (2029 diabetes-free at baseline and with anamnestic, anthropometrical and metabolic data for analysis). Of the 820 incident diabetes cases identified in the full cohort during 7 years of follow-up, 698 remained for analyses after similar exclusions.

Results: After adjustment for age, potential lifestyle confounders, education and waist circumference, greater height was related to lower diabetes risk (HR per 10 cm, men 0.59 [95% CI 0.47, 0.75] and women 0.67 [0.51, 0.88], respectively). Leg length was related to lower risk among men and women, but only among men if adjusted for total height. Adjustment for liver fat and triacylglycerols, adiponectin and C-reactive protein substantially attenuated associations between height and diabetes risk, particularly among women.

Conclusions/interpretation: We observed inverse associations between height and risk of type 2 diabetes, which was largely related to leg length among men. The inverse associations may be partly driven by lower liver fat content and a more favourable cardiometabolic profile.

Keywords: Adult height; Blood pressure; Diabetes incidence; Leg length; Liver fat; Short stature; Trunk length.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Body Height / physiology*
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / etiology
  • Diabetes Mellitus, Type 2 / epidemiology*
  • Diabetes Mellitus, Type 2 / etiology
  • Educational Status
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Life Style*
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Waist Circumference*