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  • Associations between adult height and type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies

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Review
Associations between adult height and type 2 diabetes mellitus: a systematic review and meta-analysis of observational studies
  1. Sarita Shrestha1,
  2. Sara H Rasmussen1,
  3. Anton Pottegård2,
  4. Lars H Ängquist1,
  5. Tine Jess1,
  6. Kristine H Allin1,3,
  7. Lise G Bjerregaard1,
  8. Jennifer L Baker1,3
  1. 1 Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, The Capital Region, Copenhagen, Denmark
  2. 2 Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Copenhagen, Denmark
  3. 3 Novo Nordisk Foundation Center for Basic Metabolic Research, Human Genomics and Metagenomics in Metabolism, University of Copenhagen, Copenhagen, Denmark
  1. Correspondence to Dr Jennifer L Baker, Bispebjerg and Frederiksberg Hospital, The Capital Region, Center for Clinical Research and Prevention, Copenhagen, Denmark; jennifer.lyn.baker{at}regionh.dk

Abstract

Background Although short adult height is generally associated with increased risks of type 2 diabetes mellitus (T2DM), there are large inconsistencies across studies. The aims of this study were to describe and quantify currently available evidence on the association between adult height and T2DM, to examine whether the reported associations differ by sex, and to examine the shapes of the height and T2DM associations.

Methods Relevant literature was identified using PubMed (1966–May 2018), EMBASE (1947–May 2018) and Google Scholar (May 2018). We identified cross-sectional and cohort studies with original publications on human subjects, which were included in a random-effects meta-analysis.

Results From 15 971 identified sources, 25 studies met the inclusion criteria for the systematic review (N=401 562 individuals). From these 25 studies, 16 (9 cross-sectional studies and 7 cohort studies) were included in the meta-analysis (n=261 496 individuals). The overall random-effects meta-analysis indicated an inverse association between adult height and T2DM (effect estimate=0.88, 95% CI 0.81 to 0.95). No sex differences in the associations between adult height and T2DM were found (effect estimate for men: 0.86, 95% CI 0.75 to 0.99; effect estimate for women: 0.90; 95% CI 0.80 to 1.01; p value for sex interaction=0.80). Due to lack of data, results on the shape of the association between height and T2DM were inconclusive.

Conclusions Shorter height is associated with an increased risk of T2DM and the association does not significantly differ by sex. The currently available data are insufficient to support conclusions regarding the shape of the association between height and T2DM.

Trial registration number CRD42017062446.

  • adult
  • body height
  • diabetes mellitus, type 2
  • humans
  • risk factors

https://doi.org/10.1136/jech-2018-211567

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    Footnotes

    • Contributors LGB and JLB conceived the study. SS and SHR conducted the literature search and quality assessment independently. Data from all included studies were extracted by SS and researcher SHR extracted data on a random sample of the primary studies. LHA assisted in the meta-analysis. All authors were involved in the data interpretation. SS drafted the manuscript. All authors critically revised the manuscript for important intellectual content and gave final approval of the version to be submitted.

    • Funding This work was supported by funding from the European Union’s Horizon 2020 research and innovation programme under grant agreement no 633595, DynaHEALTH. The funder had no influence on the design and conduct of the study; collection, management, analysis and interpretation of the data; and preparation, review or approval of the protocol.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The meta-analysis was conducted on anonymous data. The project was approved by the Danish Data Protection Agency. The project does not involve personal examinations that require permission from the Regional Ethics Committee.

    • Provenance and peer review Not commissioned; externally peer reviewed.