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

Journal article

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 S. Gurung, David Guwatudde, Corine Houehanou, Nahla Hwalla, Gibson B. Kagaruki, Khem B. Karki, Demetre Labadarios, Joao S. Martins, Mohamed Msaidie, Bolormaa Norov, Abla M. Sibai, Lela Sturua, Lindiwe Tsabedze, Chea S. Wesseh, Justine Davies, Rifat Atun, Sebastian Vollmer, S.V. Subramanian, Till Bärnighausen, Lindsay M. Jaacks, Jan-Walter De Neve
Diabetes Care, vol. 43, 2020 Oct, pp. 2403--2410

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APA Click to copy
Teufel, F., Geldsetzer, P., Manne-Goehler, J., Karlsson, O., Koncz, V., Deckert, A., … De Neve, J.-W. (2020). Analysis of Attained Height and Diabetes Among 554,122 Adults Across 25 Low- and Middle-Income Countries. Diabetes Care, 43, 2403–2410.

Chicago/Turabian Click to copy
Teufel, Felix, Pascal Geldsetzer, Jennifer Manne-Goehler, Omar Karlsson, Viola Koncz, Andreas Deckert, Michaela Theilmann, et al. “Analysis of Attained Height and Diabetes Among 554,122 Adults Across 25 Low- and Middle-Income Countries.” Diabetes Care 43 (October 2020): 2403–2410.

MLA Click to copy
Teufel, Felix, et al. “Analysis of Attained Height and Diabetes Among 554,122 Adults Across 25 Low- and Middle-Income Countries.” Diabetes Care, vol. 43, Oct. 2020, pp. 2403–10.

BibTeX Click to copy

@article{teufel2020a,
  title = {Analysis of Attained Height and Diabetes Among 554,122 Adults Across 25 Low- and Middle-Income Countries},
  year = {2020},
  month = oct,
  journal = {Diabetes Care},
  pages = {2403--2410},
  volume = {43},
  author = {Teufel, Felix and Geldsetzer, Pascal and Manne-Goehler, Jennifer and Karlsson, Omar and Koncz, Viola and Deckert, Andreas and Theilmann, Michaela and Marcus, Maja-Emilia and Ebert, Cara and Seiglie, Jacqueline A. and Agoudavi, Kokou and Andall-Brereton, Glennis and Gathecha, Gladwell and Gurung, Mongal S. and Guwatudde, David and Houehanou, Corine and Hwalla, Nahla and Kagaruki, Gibson B. and Karki, Khem B. and Labadarios, Demetre and Martins, Joao S. and Msaidie, Mohamed and Norov, Bolormaa and Sibai, Abla M. and Sturua, Lela and Tsabedze, Lindiwe and Wesseh, Chea S. and Davies, Justine and Atun, Rifat and Vollmer, Sebastian and Subramanian, S.V. and Bärnighausen, Till and Jaacks, Lindsay M. and De Neve, Jan-Walter},
  month_numeric = {10}
}

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.

Conclusion
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.