Taller people at lower risk for type 2 diabetes

By Dr. Ananya Mandal, MDSep 11 2019

A new German study has found that taller people are at a lower risk of developing type 2 diabetes. The study titled, “Associations of short stature and components of height with incidence of type 2 diabetes: mediating effects of cardiometabolic risk factors,” was published in the latest issue of the journal Diabetologia.

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For this large study the team included participants who were part of the European Prospective Investigation into Cancer and Nutrition (EPIC)-Potsdam study that recruited 27,548 participants with 16,644 women and 10,904 men between 1994 and 1998. The women were between ages 35 and 65 years and the men were aged between 40 and 65 years. A sub population was derived from the study population comprising of 2,500 individuals. Of these 2,029 were free of diabetes at the start of the study.

Over a seven years of follow up they found that there were 820 new cases of diabetes among the individuals. The researchers took into account not only the height of the patients but also their age, body weight, waist circumference, lifestyle habits and factors that may affect risk of type 2 diabetes. They looked at total body height as well as components of height such as sitting height and leg length as well in association with incidence of type 2 diabetes. The participants were provided with questionnaires every two to three years for assessment.

For the assessment the blood samples of the participants were assessed for “total cholesterol, HDL-cholesterol, triacylglycerols and CRP; erythrocyte levels of HbA1c; and activity of γ-glutamyl transferase (GGT)”. Fatty liver index (FLI) was measured using “BMI, waist circumference, GGT and triacylglycerols”, the team wrote.

The researchers have found that for each 10 cm increase in height of an individual, there was a 41 percent and 33 percent reduction in the risk of type 2 diabetes among men and women respectively. They also noted that leg length was associated with a lowered risk of type 2 diabetes among both men and women. When adjusted for total height however, the benefit of longer legs was only seen among men and was nullified among women.

Among overweight individuals, every additional 10 cm in height meant 36 percent and 30 percent reduction in risk of type 2 diabetes among men and women respectively, the researchers found. The team wrote, “This may indicate that a higher diabetes risk with larger waist circumference counteracts beneficial effects related to height, irrespective of whether larger waist circumference is due to growth or due to consuming too many calories.”

According to the authors this is the first study that connects height of an individual with the risk of long term health conditions. A similar study few months back showed raised risk of cancers among tall persons. The experts have said that since the number of cells in tall persons is greater, they may be at a greater risk of cancers. What is baffling is the raised risk of type 2 diabetes among shorter individuals.

According to the researchers, raised liver fat content among persons who are shorter could be one of the reasons behind the raised diabetes risk. On the other hand those who are taller have a better “cardiometabolic profile” the team wrote. They added, “Our findings suggest that short people might present with higher cardiometabolic risk factor levels and have higher diabetes risk compared with tall people. Our study also suggests that early interventions to reduce height-related metabolic risk throughout life likely need to focus on determinants of growth in sensitive periods during pregnancy, early childhood, puberty and early adulthood, and should take potential sex-differences into account.”

They had taken into consideration the liver fat of the participants as well as “triacylglycerols, adiponectin and C-reactive protein”. When these features of liver fat and other parameters were considered, the benefit of height and risk of type 2 diabetes was found to be nullified said the researchers. This was especially true among women, the researchers wrote.

According to the researchers as a person achieves his or her full adult height, this parameters is unmodifiable. This means that in order to reduce the risk of heart disease and diabetes among shorter individuals, there should be appropriate monitoring and screening for diabetes. In addition liver fat seems to play an important role in raising the risk of diabetes among shorter individuals. Therapeutic measures as well as lifestyle factors that reduce the liver fat could be adopted for shorter individuals to lower their risk of type 2 diabetes, the authors wrote.

The authors concluded, “We observed inverse associations between height and risk of type 2 diabetes, which was largely related to leg length among men. The inverse associations may be partly driven by lower liver fat content and a more favourable cardiometabolic profile.”