Acta Diabetologica

, Volume 47, Issue 3, pp 237–242

Are measures of height and leg length related to incident diabetes mellitus? The ARIC (Atherosclerosis Risk in Communities) study

  • Shimon Weitzman
  • Chin-Hua Wang
  • James S. Pankow
  • Maria I. Schmidt
  • Frederic L. Brancati
Original Article

Abstract

This study was designed to estimate the risk of developing diabetes in relation to adult height components, namely leg length and leg length/height ratio. Data on 12,800 individuals without diabetes were obtained at the baseline examination from the ARIC cohort. Cox proportional hazard models were used to estimate hazard rate ratios of diabetes for each 5-cm difference in leg length and 1 SD difference in the leg length/height ratio. During a mean follow-up period of 7.6 years, the age-adjusted incidence per 1,000 person years of follow-up was 25.8, 24.2, 10.4, and 16.2 in African American (AA) women, AA men, white women, and white men, respectively. The hazard ratio for diabetes (95% CI) per 5-cm difference in leg length was 0.85 (0.75–0.95) in white men, 0.79 (0.69–0.90) in white women, 0.90 (0.75–1.07) in AA women, and 0.99 (0.77–1.27) in AA men, after adjusting for age, parental history of diabetes, parental socioeconomic status, and weight at age 25. The hazard ratio for diabetes per 1 SD difference in leg length/height ratio followed the same trend. Leg length is inversely and independently related to an increased risk of diabetes in middle-age white men and women but not in African-Americans. This sex–race heterogeneity suggests that nutritional and environmental factors in childhood may modify this risk through different pathways.

Keywords

Diabetes incidence Leg length Leg length/height ratio 

References

  1. 1.
    Brown DC, Byrne CD, Clark PMS et al (1991) Height and glucose tolerance in adult subjects. Diabetologia 34:531–533CrossRefPubMedGoogle Scholar
  2. 2.
    Jang HC, Min HK, Lee HK, Cho NH, Metzger BE (1998) Short stature in Korean women: a contribution to the multifactorial predisposition to gestational diabetes. Diabetologia 41:778–783CrossRefPubMedGoogle Scholar
  3. 3.
    Branchtein L, Schmidt MI, Matos MCG, Yamashita T, Pousada JMDC, Duncan BB, Brazilian Gestational Diabetes Group (2000) Short stature and gestational diabetes in Brazil. Diabetologia 43:848–851CrossRefPubMedGoogle Scholar
  4. 4.
    Kousta E, Lawrence NJ, Penny A et al (2000) Women with a history of gestational diabetes of European and South Asian origin are shorter than women with normal glucose tolerance in pregnancy. Diabet Med 17:792–797CrossRefPubMedGoogle Scholar
  5. 5.
    Anastasiou E, Alevizaki M, Grigorakis SJ, Philippou G, Kyprianou M, Souvatzoglou A (1998) Decreased stature in gestational diabetes mellitus. Diabetologia 41:997–1001CrossRefPubMedGoogle Scholar
  6. 6.
    Moses RG, Mackay MT (2004) Gestational: is there a relationship between leg length and glucose tolerance? Diabetes Care 27:1033–1035CrossRefPubMedGoogle Scholar
  7. 7.
    Wadsworth MEJ, Hardy RJ, Paul AA, Marshall SF, Cole TJ (2002) Leg and trunk length at 43 years in relation to childhood health, diet and family circumstances; evidence from the 1946 national birth cohort. Int J Epidemiol 31:383–390CrossRefPubMedGoogle Scholar
  8. 8.
    Gunnell DJ, Smith GD, Frankel SJ, Kemp M, Peters TJ (1998) Socioeconomic and dietary influences on leg length and trunk length in childhood: a reanalysis of the Carnegie (Boyd Orr) survey of diet and health in prewar Britain (1937–39). Paediatr Perinat Epidemiol 12(Suppl 1):96–113CrossRefPubMedGoogle Scholar
  9. 9.
    Lawlor DA, Ebrahim S, Davey Smith G (2002) The association between components of adult height and type 2 diabetes and insulin resistance: British Women’s Heart and Health Study. Diabetologia 45:1097–1106CrossRefPubMedGoogle Scholar
  10. 10.
    Asao K, Kao WL, Baptiste-Roberts K, Bandeen-Roche K, Erlinger T, Brancati F (2006) Short stature and the risk of adiposity, insulin resistance, and type 2 diabetes in middle age: the Third National Health and Nutrition Examination Survey (NHANES III), 1988–1994. Diabetes Care 29(7):1632–1637CrossRefPubMedGoogle Scholar
  11. 11.
    Njolstad I, Arnesen E, Lund-Larsen PG (1999) Sex differences in risk factors for clinical diabetes mellitus in a general population: a 12-year follow-up of the Finnmark Study. Am J Epidemiol 147:49–58Google Scholar
  12. 12.
    The ARIC Investigators (1989) The atherosclerosis risk in communities (ARIC) study: design and objectives. Am J Epidemiol 129:687–702Google Scholar
  13. 13.
    Baecke JAH, Burema J, Frijters JER (1982) A short questionnaire for the measurement of habitual physical activity in epidemiological studies. Am J Clin Nutr 36:936–942PubMedGoogle Scholar
  14. 14.
    Willett WC, Sampson L, Stampfer M et al (1985) Reproducibility and validity of a semiquantitative food frequency questionnaire. Am J Epidemiol 122:51–65PubMedGoogle Scholar
  15. 15.
    Human Nutrition Information Service (1975–1989) Composition of foods: agriculture handbook No. 8 series. US Department of Agriculture, Washington, DCGoogle Scholar
  16. 16.
    Davey Smith G, Greenwood R, Gunnell DJ, Sweetnam P, Yarnell J, Elwood P (2001) Leg length, insulin resistance, and coronary heart disease risk: the Caerphilly study. J Epidemiol Community Health 55:867–872CrossRefGoogle Scholar
  17. 17.
    Lawlor DA, Taylor M, Davey Smith G, Gunnel D, Ebrahim S (2000) Associations of components of adult height with coronary heart disease in postmenopausal women: the British women’s heart and health study. Heart 90:745–749CrossRefGoogle Scholar
  18. 18.
    Gunnell DJ, Davey Smith G, Frankel S et al (1998) Childhood leg length and adult mortality: follow-up of the Carnegie (Boyd Orr) Survey of diet and health in pre-war Britain. J Epidemiol Community Health 52:142–152CrossRefPubMedGoogle Scholar
  19. 19.
    Gunnel D, Davey Smith G, Frankel SJ, Kemp M, Peters TJ (1998) Socio-economic and dietary influences on leg length and trunk length in childhood: a reanalysis of the Carnegie (Boyd Orr) survey on diet and health in prewar Britain (1937–39). Pediatr Perinatal Epidemiol 12(Suppl 1):96–113CrossRefGoogle Scholar
  20. 20.
    Tanner JM, Ayashi T, Preece MA, Cameron N (1982) Increase in length of leg relative to trunk in Japanese children and adults from 1957–1977: comparison with British and with Japanese Americans. Ann Hum Biol 9:411–423CrossRefPubMedGoogle Scholar
  21. 21.
    Gerver WJM, Bruin RD, Drayer NM (1994) A persistent secular trend for body measurements in Dutch children. The Oosterwolde II study. Acta Pedriatica 83:812–814CrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2009

Authors and Affiliations

  • Shimon Weitzman
    • 5
  • Chin-Hua Wang
    • 1
  • James S. Pankow
    • 2
  • Maria I. Schmidt
    • 3
  • Frederic L. Brancati
    • 4
  1. 1.Department of Nutrition, School of Public HealthUniversity of North Carolina at Chapel HillChapel HillUSA
  2. 2.Division of Epidemiology and Community Health, School of Public HealthUniversity of MinnesotaMinneapolisUSA
  3. 3.Graduate Studies Program in Epidemiology, School of MedicineFederal University of Rio Grande do SulPorto AlegreBrazil
  4. 4.Johns Hopkins UniversityBaltimoreUSA
  5. 5.Department of Epidemiology and Health Services Evaluation, Faculty of Health SciencesBen-Gurion University of the NegevBeershebaIsrael

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