Abstract / Description of output
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.
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 language | English |
|---|---|
| Journal | Diabetes Care |
| Early online date | 6 Aug 2020 |
| DOIs | |
| Publication status | E-pub ahead of print - 6 Aug 2020 |