Felix Teufel1, Pascal Geldsetzer1,2, Jennifer Manne-Goehler3,4, Omar Karlsson5,6, Viola Koncz1,7, Andreas Deckert1, Michaela Theilmann1, Maja-Emilia Marcus8, Cara Ebert9, Jacqueline A Seiglie10,11, Kokou Agoudavi12, Glennis Andall-Brereton13, Gladwell Gathecha14, Mongal S Gurung15, David Guwatudde16, Corine Houehanou17, Nahla Hwalla18, Gibson B Kagaruki19, Khem B Karki20, Demetre Labadarios21, Joao S Martins22, Mohamed Msaidie23, Bolormaa Norov24, Abla M Sibai25, Lela Sturua26, Lindiwe Tsabedze27, Chea S Wesseh28, Justine Davies29,30, Rifat Atun31,32, Sebastian Vollmer8, S V Subramanian33,34, Till Bärnighausen1,31,35, Lindsay M Jaacks31,36, Jan-Walter De Neve37. 1. Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany. 2. Division of Primary Care and Population Health, Department of Medicine, Stanford University, Stanford, CA. 3. Division of Infectious Diseases, Brigham and Women's Hospital, Boston, MA. 4. Medical Practice Evaluation Center, Massachusetts General Hospital, Boston, MA. 5. Takemi Program in International Health, Harvard T.H. Chan School of Public Health, Boston, MA. 6. Centre for Economic Demography, Lund University, Lund, Sweden. 7. Institute for Medical Information Processing, Biometry and Epidemiology, Ludwig-Maximilians University of Munich, Munich, Germany. 8. Department of Economics and Centre for Modern Indian Studies, Georg-August-Universität Göttingen, Göttingen, Germany. 9. RWI - Leibniz Institute for Economic Research, Essen (Berlin Office), Germany. 10. Diabetes Unit, Massachusetts General Hospital, Harvard Medical School, Boston, MA. 11. Department of Medicine, Harvard Medical School, Boston, MA. 12. Togo Ministry of Health, Lomé, Togo. 13. Caribbean Public Health Agency, Port of Spain, Trinidad and Tobago. 14. Division of Non-communicable Diseases, Kenya Ministry of Health, Nairobi, Kenya. 15. Health Research and Epidemiology Unit, Ministry of Health, Thimphu, Bhutan. 16. Department of Epidemiology and Biostatistics, School of Public Health, Makerere University, Kampala, Uganda. 17. Laboratory of Epidemiology of Chronic and Neurological Diseases, Faculty of Health Sciences, University of Abomey-Calavi, Cotonou, Benin. 18. Faculty of Agricultural and Food Sciences, American University of Beirut, Beirut, Lebanon. 19. National Institute for Medical Research, Dar es Salaam, Tanzania. 20. Nepal Health Research Council, Kathmandu, Nepal. 21. Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa. 22. Faculty of Medicine and Health Sciences, National University of East Timor, Dili, Timor-Leste. 23. Ministry of Health, Solidarity, Social Cohesion and Gender, Government of the Union of Comoros, Moroni, Union of Comoros. 24. National Center for Public Health, Ulaanbaatar, Mongolia. 25. Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon. 26. Non-Communicable Disease Department, National Center for Disease Control and Public Health, Tbilisi, Georgia. 27. Eswatini Ministry of Health, Mbabane, Eswatini. 28. Liberia Ministry of Health, Monrovia, Liberia. 29. Medical Research Council/Wits Rural Public Health and Health Transition Research Unit, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa. 30. Institute of Applied Health Research, University of Birmingham, Birmingham, U.K. 31. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA. 32. Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA. 33. Harvard Center for Population and Development Studies, Cambridge, MA. 34. Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA. 35. Africa Health Research Institute, Somkhele, South Africa. 36. Public Health Foundation of India, New Delhi, India. 37. Heidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany janwalter.deneve@uni-heidelberg.de.
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 ORs for the pooled sample, major world regions, and individual 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). We found 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.
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 ORs for the pooled sample, major world regions, and individual 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). We found 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.
Authors: Sarita Shrestha; Sara H Rasmussen; Anton Pottegård; Lars H Ängquist; Tine Jess; Kristine H Allin; Lise G Bjerregaard; Jennifer L Baker Journal: J Epidemiol Community Health Date: 2019-04-08 Impact factor: 3.710
Authors: Justine Ina Davies; Andrew John Macnab; Peter Byass; Shane A Norris; Moffat Nyirenda; Atul Singhal; Eugene Sobngwi; Abdallah S Daar Journal: Lancet Glob Health Date: 2018-03 Impact factor: 26.763
Authors: Peter H Whincup; Samantha J Kaye; Christopher G Owen; Rachel Huxley; Derek G Cook; Sonoko Anazawa; Elizabeth Barrett-Connor; Santosh K Bhargava; Bryndís E Birgisdottir; Sofia Carlsson; Susanne R de Rooij; Roland F Dyck; Johan G Eriksson; Bonita Falkner; Caroline Fall; Tom Forsén; Valdemar Grill; Vilmundur Gudnason; Sonia Hulman; Elina Hyppönen; Mona Jeffreys; Debbie A Lawlor; David A Leon; Junichi Minami; Gita Mishra; Clive Osmond; Chris Power; Janet W Rich-Edwards; Tessa J Roseboom; Harshpal Singh Sachdev; Holly Syddall; Inga Thorsdottir; Mauno Vanhala; Michael Wadsworth; Donald E Yarbrough Journal: JAMA Date: 2008-12-24 Impact factor: 56.272
Authors: Viola Koncz; Pascal Geldsetzer; Jennifer Manne-Goehler; Amanda S Wendt; Felix Teufel; S V Subramanian; Till Bärnighausen; Jan-Walter De Neve Journal: Obesity (Silver Spring) Date: 2019-03 Impact factor: 5.002