Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries

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 Singh Gurung; David Guwatudde; Corine Houehanou; Nahla C.  Hwalla; Gibson B Kagaruki; Khem B Karki; Demetre Labadarios; Joao S Martins; Mohamed Msaidie; Bolormaa Norov; Abla M.  Sibai; Lela Sturua; Lindiwe Tsabedze; Chea Stanford Wesseh; Justine Davies; Rifat Atun; Sebastian Vollmer; SV  Subramanian; Till Bärnighausen; Lindsay M Jaacks; Jan-Walter  De Neve

Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries

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 Singh Gurung, David Guwatudde, Corine Houehanou, Nahla C. Hwalla , Gibson B Kagaruki, Khem B Karki, Demetre LabadariosJoao S Martins, Mohamed Msaidie, Bolormaa Norov, Abla M. Sibai , Lela Sturua, Lindiwe Tsabedze, Chea Stanford Wesseh, Justine Davies, Rifat Atun, Sebastian Vollmer, SV Subramanian , Till Bärnighausen, Lindsay M Jaacks, Jan-Walter De Neve

Applied Health Research

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middleincome 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 (2/50). 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
Publication status	Accepted/In press - 11 Jun 2020

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Teufel , F., Geldsetzer, P., Manne-Goehler, J., Karlsson, O., Koncz , V., Deckert , A., Theilmann, M., Marcus , M.-E., Ebert, C., Seiglie , J. A., Agoudavi, K., Andall-Brereton, G., Gathecha, G., Singh Gurung, M., Guwatudde, D., Houehanou, C., Hwalla , N. C., Kagaruki, G. B., Karki, K. B., ... De Neve , J.-W. (Accepted/In press). Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries. Diabetes Care.

@article{97f67622761247a98044fdd1dce9e799,

title = "Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries",

abstract = "Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middleincome 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 (2/50). 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. ",

author = "Felix Teufel and Pascal Geldsetzer and Jennifer Manne-Goehler and Omar Karlsson and Viola Koncz and Andreas Deckert and Michaela Theilmann and Maja-Emilia Marcus and Cara Ebert and Seiglie, {Jacqueline A.} and Kokou Agoudavi and Glennis Andall-Brereton and Gladwell Gathecha and {Singh Gurung}, Mongal and David Guwatudde and Corine Houehanou and Hwalla, {Nahla C.} and Kagaruki, {Gibson B} and Karki, {Khem B} and Demetre Labadarios and Martins, {Joao S} and Mohamed Msaidie and Bolormaa Norov and Sibai, {Abla M.} and Lela Sturua and Lindiwe Tsabedze and Wesseh, {Chea Stanford} and Justine Davies and Rifat Atun and Sebastian Vollmer and SV Subramanian and Till B{\"a}rnighausen and Jaacks, {Lindsay M} and {De Neve}, Jan-Walter",

year = "2020",

month = jun,

day = "11",

language = "English",

journal = "Diabetes Care",

issn = "0149-5992",

publisher = "American Diabetes Association",

}

Teufel , F, Geldsetzer, P, Manne-Goehler, J, Karlsson, O, Koncz , V, Deckert , A, Theilmann, M, Marcus , M-E, Ebert, C, Seiglie , JA, Agoudavi, K, Andall-Brereton, G, Gathecha, G, Singh Gurung, M, Guwatudde, D, Houehanou, C, Hwalla , NC, Kagaruki, GB, Karki, KB, Labadarios, D, Martins, JS, Msaidie, M, Norov, B, Sibai , AM, Sturua, L, Tsabedze, L, Wesseh, CS, Davies, J, Atun, R, Vollmer, S, Subramanian , SV, Bärnighausen, T, Jaacks, LM & De Neve , J-W 2020, 'Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries', Diabetes Care.

TY - JOUR

T1 - Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries

AU - Teufel , Felix

AU - Geldsetzer, Pascal

AU - Manne-Goehler, Jennifer

AU - Karlsson, Omar

AU - Koncz , Viola

AU - Deckert , Andreas

AU - Theilmann, Michaela

AU - Marcus , Maja-Emilia

AU - Ebert, Cara

AU - Seiglie , Jacqueline A.

AU - Agoudavi, Kokou

AU - Andall-Brereton, Glennis

AU - Gathecha, Gladwell

AU - Singh Gurung, Mongal

AU - Guwatudde, David

AU - Houehanou, Corine

AU - Hwalla , Nahla C.

AU - Kagaruki, Gibson B

AU - Karki, Khem B

AU - Labadarios, Demetre

AU - Martins, Joao S

AU - Msaidie, Mohamed

AU - Norov, Bolormaa

AU - Sibai , Abla M.

AU - Sturua, Lela

AU - Tsabedze, Lindiwe

AU - Wesseh, Chea Stanford

AU - Davies, Justine

AU - Atun, Rifat

AU - Vollmer, Sebastian

AU - Subramanian , SV

AU - Bärnighausen, Till

AU - Jaacks, Lindsay M

AU - De Neve , Jan-Walter

PY - 2020/6/11

Y1 - 2020/6/11

N2 - Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middleincome 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 (2/50). 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.

AB - Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middleincome 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 (2/50). 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.

M3 - Article

SN - 0149-5992

JO - Diabetes Care

JF - Diabetes Care

ER -

Analysis of attained height and diabetes among 554,122 adults across 25 low- and middle-income countries

Abstract

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