Adult Body Height Is Associated with the Risk of Type 2 but Not Type 1 Diabetes Mellitus: A Retrospective Cohort Study of 783,029 Individuals in Germany

Abstract: Background Background: Diabetes mellitus is a major global health burden associated with high morbidity and mortality. Although a short adult body height has been associated with increased risk of type 2 diabetes (T2D), there are large inconsistencies between the studies. Therefore, we aimed to investigate the association between body height and T2D in a large cohort of adult outpatients in Germany. Methods: A total of 783,029 adult outpatients with available body height data from the Disease Analyzer (IQVIA) database were included in Germany between 2010 and 2020. The incidence of diabetes mellitus (type 1 and type 2) was evaluated as a function of the patients’ body height stratified by age, sex, and body-mass-index (BMI). Results: In both women and men in all age groups, incidence of T2D decreased with the increasing body height (<50, 51–60, 61–70, and >70 years). There was no association between the body height and the individual HbA1c value. In multivariable Cox regression analyses adjusted for patient age and BMI, hazard ratios for the development of T2D were 1.15 (95% CI: 1.13–1.17) for each 10 cm decrease in body height in women and 1.10 (95% CI: 1.09–1.12) in men. No significant association was found between body height and the development of T1D. Conclusions: We present the first data from a large cohort of outpatients in Germany, providing strong evidence for an association between adult body height and T2D. These data add to the current literature and might help in implementing body height into existing diabetes risk stratification tools to further reduce morbidity and mortality worldwide.

[1]  K. Kostev,et al.  Positive association between body height and breast cancer prevalence: a retrospective study with 135,741 women in Germany , 2022, Breast Cancer Research and Treatment.

[2]  T. Luedde,et al.  The association between body height and cancer: a retrospective analysis of 784,192 outpatients in Germany , 2022, Journal of Cancer Research and Clinical Oncology.

[3]  W. Rathmann,et al.  Association of glucose-lowering drugs with incident stroke and transient ischaemic attacks in primary care patients with type 2 diabetes: disease analyzer database , 2022, Acta Diabetologica.

[4]  C. Heidemann,et al.  [Algorithm for the Classification of Type 1 and Type 2 Diabetes Mellitus for the Analysis of Routine Data]. , 2022, Gesundheitswesen (Bundesverband der Arzte des Offentlichen Gesundheitsdienstes (Germany)).

[5]  K. Cusi,et al.  A global view of the interplay between non-alcoholic fatty liver disease and diabetes. , 2022, The lancet. Diabetes & endocrinology.

[6]  D. Khanna,et al.  Body Mass Index (BMI): A Screening Tool Analysis , 2022, Cureus.

[7]  T. Luedde,et al.  Prevalence of diabetes mellitus among 80,193 gastrointestinal cancer patients in five European and three Asian countries , 2021, Journal of Cancer Research and Clinical Oncology.

[8]  B. Duncan,et al.  IDF diabetes Atlas: Global, regional and country-level diabetes prevalence estimates for 2021 and projections for 2045 , 2021, Diabetes Research and Clinical Practice.

[9]  N. Stefan.  Causes, consequences, and treatment of metabolically unhealthy fat distribution. , 2020, The lancet. Diabetes & endocrinology.

[10]  G. Meng,et al.  Height predict incident non-alcoholic fatty liver disease among general adult population in Tianjin, China, independent of body mass index, waist circumference, waist-to-height ratio, and metabolic syndrome , 2020, BMC Public Health.

[11]  J. Shaw,et al.  Global and regional diabetes prevalence estimates for 2019 and projections for 2030 and 2045: results from the International Diabetes Federation Diabetes Atlas, 9th edition. , 2019, Diabetes research and clinical practice.

[12]  M. Schulze,et al.  Associations of short stature and components of height with incidence of type 2 diabetes: mediating effects of cardiometabolic risk factors , 2019, Diabetologia.

[13]  A. Pottegård,et al.  Associations between adult height and type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies , 2019, Journal of Epidemiology & Community Health.

[14]  C. Torp‐Pedersen,et al.  The Importance and Role of Multiple Risk Factor Control in Type 2 Diabetes , 2019, Current Cardiology Reports.

[15]  W. Rathmann,et al.  Basic characteristics and representativeness of the German Disease Analyzer database
. , 2018, International journal of clinical pharmacology and therapeutics.

[16]  J. Shaw,et al.  IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045. , 2018, Diabetes research and clinical practice.

[17]  E. Bonifacio,et al.  Type 1 diabetes mellitus , 2017, Nature Reviews Disease Primers.

[18]  Marcelo P. Segura-Lepe,et al.  Rare and low-frequency coding variants alter human adult height , 2016, Nature.

[19]  M. Laakso,et al.  Short Adult Stature Predicts Impaired &bgr;-Cell Function, Insulin Resistance, Glycemia, and Type 2 Diabetes in Finnish Men , 2016, The Journal of clinical endocrinology and metabolism.

[20]  F. Hu,et al.  Divergent associations of height with cardiometabolic disease and cancer: epidemiology, pathophysiology, and global implications. , 2016, The lancet. Diabetes & endocrinology.

[21]  G. Davey Smith,et al.  Adult height, nutrition, and population health. , 2016, Nutrition reviews.

[22]  Tom R. Gaunt,et al.  Adult height, coronary heart disease and stroke: a multi-locus Mendelian randomization meta-analysis , 2015, International journal of epidemiology.

[23]  M. Schulze,et al.  Characterization of metabolically unhealthy normal-weight individuals: Risk factors and their associations with type 2 diabetes. , 2015, Metabolism: clinical and experimental.

[24]  J. Danesh,et al.  Genetically determined height and coronary artery disease. , 2015, The New England journal of medicine.

[25]  A. Motala,et al.  Global estimates of undiagnosed diabetes in adults. , 2014, Diabetes research and clinical practice.

[26]  Luke W Johnston,et al.  Short Leg Length, a Marker of Early Childhood Deprivation, Is Associated With Metabolic Disorders Underlying Type 2 Diabetes , 2013, Diabetes Care.

[27]  M. Dehghani,et al.  Hip circumference, height and risk of type 2 diabetes: systematic review and meta‐analysis , 2012, Obesity reviews : an official journal of the International Association for the Study of Obesity.

[28]  K. W. Davidson,et al.  Adult height and the risk of cause-specific death and vascular morbidity in 1 million people: individual participant meta-analysis. , 2012, International journal of epidemiology.

[29]  T. Rohrer,et al.  Growth in children and adolescents with type 1 diabetes. , 2012, The Journal of pediatrics.

[30]  X. Shu,et al.  Age at Menarche, the Leg Length to Sitting Height Ratio, and Risk of Diabetes in Middle-Aged and Elderly Chinese Men and Women , 2012, PloS one.

[31]  H. Brenner,et al.  Prognostic value of haemoglobin A1c and fasting plasma glucose for incident diabetes and implications for screening , 2011, European Journal of Epidemiology.

[32]  P. O S I T I O N S T A T E M E N T,et al.  Diagnosis and Classification of Diabetes Mellitus , 2011, Diabetes Care.

[33]  S. Haffner,et al.  Height, ethnicity, and the incidence of diabetes: the San Antonio Heart Study. , 2009, Metabolism: clinical and experimental.

[34]  H. Tan,et al.  Is Femur Length the Key Height Component in Risk Prediction of Type 2 Diabetes Among Adults? , 2009, Diabetes Care.

[35]  M. Amini,et al.  Effects of gender and height on the oral glucose tolerance test: the isfahan diabetes prevention study. , 2008, The review of diabetic studies : RDS.

[36]  K. Chien.  An Accurate Risk Score Based on Anthropometric, Dietary, and Lifestyle Factors to Predict the Development of Type 2 Diabetes , 2007, Diabetes Care.

[37]  Kurt Hoffmann,et al.  An Accurate Risk Score Based on Anthropometric, Dietary, and Lifestyle Factors to Predict the Development of Type 2 Diabetes , 2007, Diabetes Care.

[38]  D. Leroith,et al.  Mechanisms of Disease: metabolic effects of growth hormone and insulin-like growth factor 1 , 2007, Nature Clinical Practice Endocrinology &Metabolism.

[39]  Heiner Boeing,et al.  Comparison of Anthropometric Characteristics in Predicting the Incidence of Type 2 Diabetes in the EPIC-Potsdam Study A table elsewhere in this issue shows conventional and Système International (SI) units and conversion factors for many substances. , 2006, Diabetes Care.

[40]  T. Erlinger,et al.  Short Stature and the Risk of Adiposity, Insulin Resistance, and Type 2 Diabetes in Middle Age , 2006, Diabetes Care.

[41]  T. Reinehr,et al.  The ‘accelerator hypothesis’: relationship between weight, height, body mass index and age at diagnosis in a large cohort of 9,248 German and Austrian children with type 1 diabetes mellitus , 2005, Diabetologia.

[42]  Heejung Bang,et al.  Identifying individuals at high risk for diabetes: The Atherosclerosis Risk in Communities study. , 2005, Diabetes care.

[43]  Meena Kumari,et al.  Prospective study of social and other risk factors for incidence of type 2 diabetes in the Whitehall II study. , 2004, Archives of internal medicine.

[44]  R. DeFronzo,et al.  Pathogenesis of type 2 diabetes mellitus. , 2004, The Medical clinics of North America.

[45]  E. Traisman,et al.  Mauriac's syndrome revisited , 1984, European Journal of Pediatrics.

[46]  Jennifer R. Harris,et al.  Heritability of Adult Body Height: A Comparative Study of Twin Cohorts in Eight Countries , 2003, Twin Research.

[47]  Y. Ben-Shlomo,et al.  An investigation of fetal, postnatal and childhood growth with insulin‐like growth factor I and binding protein 3 in adulthood , 2003, Clinical endocrinology.

[48]  K. Silventoinen.  DETERMINANTS OF VARIATION IN ADULT BODY HEIGHT , 2003, Journal of Biosocial Science.

[49]  D. Lawlor,et al.  The association between components of adult height and Type II diabetes and insulin resistance: British Women's Heart and Health Study , 2002, Diabetologia.

[50]  D. Dunger,et al.  Circulating concentrations of insulin-like growth factor-I and development of glucose intolerance: a prospective observational study , 2002, The Lancet.

[51]  W. Tamborlane,et al.  Recent advances in treatment of youth with Type 1 diabetes: better care through technology , 2001, Diabetic medicine : a journal of the British Diabetic Association.

[52]  E. Arnesen,et al.  Sex differences in risk factors for clinical diabetes mellitus in a general population: a 12-year follow-up of the Finnmark Study. , 1998, American Journal of Epidemiology.

[53]  O. Kordonouri,et al.  Factors Influencing Height and Weight Development in Children With Diabetes: Results of the Berlin Retinopathy Study , 1997, Diabetes Care.

[54]  Raoul Rooman,et al.  Longitudinal Data on Growth and Final Height in Diabetic Children , 1995, Pediatric Research.

[55]  M. Brown,et al.  Growth During Childhood and Final Height in Type 1 Diabetes , 1994, Diabetic medicine : a journal of the British Diabetic Association.

[56]  P. Mauriac.  [Hepatomegaly, dwarfism, obesity and diabetes in children: Mauriac's syndrome]. , 1951, Vida nueva.