Analysis of Attained Height and Diabetes Among 554,122 Adults Across 25 Low- and Middle- Income Countries

Felix Teufel, Pascal Geldsetzer, Jennifer Manne-Goehler, Omar Karlsson, Viola Koncz, Andreas Deckert, Michaela Theilmann, Maja-Emilia Marcus, Cara Ebert, Jacqueline A. Seiglie, Kokou Agoudavi, Glennis Andall-Brereton, Gladwell Gathecha, Mongal Singh Gurung, David Guwatudde, Corine Houehanou, Nahla C Hwalla, Gibson B Kagaruki, Khem B Karki, Demetre LabadariosJoão S Martins, Mohamed Msaidie, Bolormaa Norov, Abla Mehio Sibai, Lela Sturua, Lindiwe Tsabedze, Chea Stanford Wesseh, Justine Davies, Rifat Atun , Sebastian Vollmer, S. V. Subramanian, Till Winfried Bärnighausen, Lindsay Jaacks, Jan-Walter De Neve

Research output: Contribution to journalArticlepeer-review

Abstract

OBJECTIVE
The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income
countries (LMICs), but the factors driving this rapid increase are not well understood.
Adult height, in particular shorter height, has been suggested to contribute to the
pathophysiology and epidemiology of diabetes and may inform how adverse
environmental conditions in early life affect diabetes risk. We therefore systematically
analyzed the association of adult height and diabetes across LMICs, where
such conditions are prominent.
RESEARCH DESIGN AND METHODS
We pooled individual-level data from nationally representative surveys in LMICs
that included anthropometric measurements and diabetes biomarkers. We calculated
odds ratios (ORs) for the relationship between attained adult height and
diabetes using multilevel mixed-effects logistic regression models. We estimated
ORsfor the pooled sample, major world regions, andindividual countries, in addition
to stratifying all analyses by sex. We examined heterogeneity by individual-level
characteristics.
RESULTS
Our sample included 554,122 individuals across 25 population-based surveys.
Average height was 161.7 cm (95% CI 161.2–162.3), and the crude prevalence of
diabetes was 7.5% (95% CI 6.9–8.2).Wefound no relationship between adult height
and diabetes across LMICs globally or in most world regions. When stratifying our
sample by country and sex, we found an inverse association between adult height
and diabetes in 5% of analyses (2 out of 50). Results were robust to alternative model
specifications.
CONCLUSIONS
Adult height is not associated with diabetes across LMICs. Environmental factors in
early life reflected in attained adult height likely differ from those predisposing
individuals for diabetes.
Original languageEnglish
JournalDiabetes Care
Early online date6 Aug 2020
DOIs
Publication statusE-pub ahead of print - 6 Aug 2020

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