Body height is associated with decreased long-term stroke but not coronary heart disease mortality?

Association of Adult Height with Cardiovascular Mortality: A Systematic Review and Meta-Analysis of Cohort Studies

BACKGROUND

Epidemiological studies on the association between adult height and cardiovascular disease (CVD) mortality have provided conflicting findings. We examined the association between adult height and the risk of CVD mortality.

METHODS

We searched PubMed, Scopus, ISI Web of Knowledge, and Google Scholar for relevant studies published up to September 2021. Prospective cohort studies that reported the risk estimates for death from CVD, coronary heart disease (CHD), and stroke were included. The random-effects model was used to calculate summary relative risks (RRs) and 95% confidence intervals (CIs) for the highest vs. lowest categories of adult height.

RESULTS

In total, 20 prospective cohort publications were included in this systematic review and 17 in the meta-analysis. During 5 to 41 years of follow-up, the total number of deaths from CVD was 95,197 (51,608 from CHD and 20,319 from a stroke) among 2,676,070 participants. The summary RR comparing the highest and lowest categories of height was 0.80 (95% CI: 0.74-0.87, I ² = 59.4%, n = 15 studies) for CVD mortality, 0.82 (95% CI: 0.74-0.90, I ² = 70.6%, n = 12) for CHD mortality, 0.73 (95% CI: 0.67-0.80, I ² = 0%, n = 10) for stroke mortality, 0.70 (95% CI: 0.61-0.81, I ² = 0%, n = 4) for hemorrhagic stroke mortality, and 0.88 (95% CI: 0.72-1.08, I ² = 0%, n = 4) for ischemic stroke mortality.

CONCLUSION

The present comprehensive meta-analysis provides evidence for an inverse association between adult height and the risk of CVD, CHD, and stroke mortality.

Greater Height Is Associated with a Larger Carotid Lumen Diameter

Background: Previous studies link tall stature with a reduced ischemic stroke risk. One theory posits that tall people have larger cerebral artery lumens and therefore have a lower plaque occlusion risk than those who are short. Previous studies have not critically evaluated the associations between height and cerebral artery structure independent of confounding factors. Methods: The hypothesis linking stature with cerebral artery lumen size was tested in 231 adults by measuring the associations between height and common carotid artery diameter (CCAD) and intima-media thickness (IMT) after controlling for recognized vascular influencing factors (e.g., adiposity, blood pressure, plasma lipids, etc.). Results: Height remained a significant CCAD predictor across all developed multiple regression models. These models predict a ~0.03 mm increase in CCAD for each 1-cm increase in height in this sample. This magnitude of CCAD increase with height represents over a 60% enlargement of the artery's lumen area across adults varying in stature from short (150 cm) to tall (200 cm). By contrast, IMT was non-significantly correlated with height across all developed regression models. Conclusions: People who are tall have a larger absolute CCAD than people who are short, while IMT is independent of stature. These observations potentially add to the growing cardiovascular literature aimed at explaining the lower risk of ischemic strokes in tall people.

Association between Height and Actinic Keratosis: A Nationwide Population-based Study in South Korea

The association between actinic keratosis (AK) and anthropometric measures has not been investigated. This study aims to evaluate the associations between anthropometric measures and the incidence of AK in South Korea. We analyzed clinical data from individuals aged over 20 years who received a health examination arranged by the national insurance program between 2005 and 2008. Newly diagnosed AK was identified using claims data from baseline to the date of diagnosis or until December 31, 2015. The incidence of AK was highest among the elderly (aged over 60 years) and showed a male bias. The risk of AK increased with greater height. The quintile with the greatest height had an increased risk of AK compared with the quintile with the lowest height (hazard ratio = 1.28, 95% confidence interval: 1.24-1.33) after adjustment for age, sex, income, smoking status, alcohol consumption, hypertension, dyslipidemia, myocardial infarction, congestive heart failure, and chronic obstructive pulmonary disease. This study showed a positive association between the incidence of AK and human height. However, it is unclear whether these findings can be generalized to Koreans who have not received an examination or to populations in other countries.

Maternal height and risk of hypertensive disorders in pregnancy

PURPOSE

The relationship between maternal height and gestational hypertensive disorders was examined in a cohort of Chinese gravidae managed in 1997-2013 to clarify the association between short stature with preeclampsia (PE) and gestational hypertension (GH).

MATERIALS AND METHODS

Retrospective study of 87 290 gravidae categorized by their height into four quartile groups. The impact of short stature, defined as height in the lowest quartile, on incidence of PE and GH was studied in relation to the presence of risk factors. The independent role of short stature was determined by regression analysis.

RESULTS

The 25th, 50th, and 75th percentile values of height were 154 cm, 158 cm, and 161 cm respectively. The incidence of PE, but not GH, was inversely correlated with height (p = .025). Short stature altered the impact of parity status, advanced age, high body mass index, infant gender, and medical history, on incidence of PE but not GH. On regression analysis, short stature increased risk of PE (adjusted RR 1.134, 95%CI 1.005-1.279) but reduced GH (adjusted RR 0.836, 95%CI 0.718-0.974).

CONCLUSIONS

Maternal short stature should be defined according to distribution in a specific ethnic group, and it exerts a significant but opposite effect on the incidence of PE versus GH.

Height associated variants demonstrate assortative mating in human populations

Understanding human mating patterns, which can affect population genetic structure, is important for correctly modeling populations and performing genetic association studies. Prior studies of assortative mating in humans focused on trait similarity among spouses and relatives via phenotypic correlations. Limited research has quantified the genetic consequences of assortative mating. The degree to which the non-random mating influences genetic architecture remains unclear. Here, we studied genetic variants associated with human height to assess the degree of height-related assortative mating in European-American and African-American populations. We compared the inbreeding coefficient estimated using known height associated variants with that calculated from frequency matched sets of random variants. We observed significantly higher inbreeding coefficients for the height associated variants than from frequency matched random variants (P < 0.05), demonstrating height-related assortative mating in both populations.

Tall stature in coronary heart disease patients is associated with decreased risk of frailty in late life

AIM

We investigated the possible inverse association between tall stature and subsequent late-life frailty.

METHODS

A subset of surviving men with coronary heart disease (n = 1232; mean age at baseline 57.0 ± 6.0 years), who previously participated in the Bezafibrate Infarction Prevention clinical trial (1990-1997) were reassessed during 2004-2008 (T1; n = 558) and 2011-2013 (T2; n = 351) at the mean ages of 72.6 ± 6.4 years and 77.2 ± 6.4 years, respectively. Frailty status was measured at T2 according to the physical phenotype developed by Fried, and was categorized into non-frail, prefrail and frail. We estimated the odds ratios of increasing frailty by tertiles of height at baseline.

RESULTS

Among 351 patients, 117 (33.3%) were classified as non-frail, 134 (38.2%) as prefrail and 100 (28.5%) as frail. Frailty was found among 21% of participants at the highest tertile, 33% at the middle tertile and 46% at the lowest tertile for height (P for trend = 0.002). Adjusting for age, weight, place of birth, education, blood pressure, New York Heart Association classification functional class and comorbidity score, the estimated OR for increasing frailty for participants in the highest tertile was 0.32 (95% CI 0.17-0.59) and for those at the middle tertile 0.46 (95% CI 0.27-0.79), as compared with the lowest tertile. An increment of 1 SD of height was associated with a 38% (95% CI 18-53%) decrease in frailty odds.

CONCLUSION

Among men with coronary heart disease, tall stature was associated with lower adjusted odds of late-life frailty. Geriatr Gerontol Int 2017; 17: 1270-1277.

IGF-1 deficiency in a critical period early in life influences the vascular aging phenotype in mice by altering miRNA-mediated post-transcriptional gene regulation: implications for the developmental origins of health and disease hypothesis

Epidemiological findings support the concept of Developmental Origins of Health and Disease, suggesting that early-life hormonal influences during a sensitive period of development have a fundamental impact on vascular health later in life. The endocrine changes that occur during development are highly conserved across mammalian species and include dramatic increases in circulating IGF-1 levels during adolescence. The present study was designed to characterize the effect of developmental IGF-1 deficiency on the vascular aging phenotype. To achieve that goal, early-onset endocrine IGF-1 deficiency was induced in mice by knockdown of IGF-1 in the liver using Cre-lox technology (Igf1 ^f/f mice crossed with mice expressing albumin-driven Cre recombinase). This model exhibits low-circulating IGF-1 levels during the peripubertal phase of development, which is critical for the biology of aging. Due to the emergence of miRNAs as important regulators of the vascular aging phenotype, the effect of early-life IGF-1 deficiency on miRNA expression profile in the aorta was examined in animals at 27 months of age. We found that developmental IGF-1 deficiency elicits persisting late-life changes in miRNA expression in the vasculature, which significantly differed from those in mice with adult-onset IGF-1 deficiency (TBG-Cre-AAV8-mediated knockdown of IGF-1 at 5 month of age in Igf1 ^f/f mice). Using a novel computational approach, we identified miRNA target genes that are co-expressed with IGF-1 and associate with aging and vascular pathophysiology. We found that among the predicted targets, the expression of multiple extracellular matrix-related genes, including collagen-encoding genes, were downregulated in mice with developmental IGF-1 deficiency. Collectively, IGF-1 deficiency during a critical period during early in life results in persistent changes in post-transcriptional miRNA-mediated control of genes critical targets for vascular health, which likely contribute to the deleterious late-life cardiovascular effects known to occur with developmental IGF-1 deficiency.

Shorter adult height is associated with poorer cognitive performance in elderly men with type II diabetes

We studied the relationship of adult body height with five cognitive outcomes (executive functioning, semantic categorization, attention/working memory, episodic memory, and an overall cognition measure) in 897 cognitively normal elderly with type 2 diabetes. Regression analyses controlling for sociodemographic, cardiovascular, and diabetes-related risk factors and depression demonstrated that in males, shorter stature was associated with poorer executive functioning (p = 0.001), attention/working memory (p = 0.007), and overall cognition (p = 0.016), but not with episodic memory (p = 0.715) or semantic categorization (p = 0.948). No relationship between height and cognition was found for females. In cognitively normal type 2 diabetes male subjects, shorter stature, a surrogate for early-life stress and poor nutrition, was associated with cognitive functions.

IGF-1 deficiency impairs cerebral myogenic autoregulation in hypertensive mice

Aging impairs autoregulatory protection in the brain, exacerbating hypertension-induced cerebromicrovascular injury, neuroinflammation, and development of vascular cognitive impairment. Despite the importance of the age-related decline in circulating insulin-like growth factor-1 (IGF-1) levels in cerebrovascular aging, the effects of IGF-1 deficiency on functional adaptation of cerebral arteries to high blood pressure remain elusive. To determine whether IGF-1 deficiency impairs autoregulatory protection, hypertension was induced in control and IGF-1-deficient mice (Igf1(f/f)+TBG-iCre-AAV8) by chronic infusion of angiotensin-II. In hypertensive control mice, cerebral blood flow (CBF) autoregulation was extended to higher pressure values and the pressure-induced tone of middle cerebral arteries (MCAs) was increased. In hypertensive IGF-1-deficient mice, autoregulation was markedly disrupted, and MCAs did not show adaptive increases in myogenic tone. In control mice, the mechanism of adaptation to hypertension involved upregulation of TRPC channels in MCAs and this mechanism was impaired in hypertensive IGF-1-deficient mice. Likely downstream consequences of cerebrovascular autoregulatory dysfunction in hypertensive IGF-1-deficient mice included exacerbated disruption of the blood-brain barrier and neuroinflammation (microglia activation and upregulation of proinflammatory cytokines and chemokines), which were associated with impaired hippocampal cognitive function. Collectively, IGF-1 deficiency impairs autoregulatory protection in the brain of hypertensive mice, potentially exacerbating cerebromicrovascular injury and neuroinflammation mimicking the aging phenotype.

Endothelin-1-induced focal cerebral ischemia in the growth hormone/IGF-1 deficient Lewis Dwarf rat

Aging is a major risk factor for cerebrovascular disease. Growth hormone (GH) and its anabolic mediator, insulin-like growth factor (IGF)-1, decrease with advancing age and this decline has been shown to promote vascular dysfunction. In addition, lower GH/IGF-1 levels are associated with higher stroke mortality in humans. These results suggest that decreased GH/IGF-1 level is an important factor in increased risk of cerebrovascular diseases. This study was designed to assess whether GH/IGF-1-deficiency influences the outcome of cerebral ischemia. We found that endothelin-1-induced middle cerebral artery occlusion resulted in a modest but nonsignificant decrease in cerebral infarct size in GH/IGF-1 deficient dw/dw rats compared with control heterozygous littermates and dw/dw rats with early-life GH treatment. Expression of endothelin receptors and endothelin-1-induced constriction of the middle cerebral arteries were similar in the three experimental groups. Interestingly, dw/dw rats exhibited reduced brain edema and less astrocytic infiltration compared with their heterozygous littermates and this effect was reversed by GH-treatment. Because reactive astrocytes are critical for the regulation of poststroke inflammatory processes, maintenance of the blood-brain barrier and neural repair, further studies are warranted to determine the long-term functional consequences of decreased astrocytic activation in GH/IGF-1 deficient animals after cerebral ischemia.

Trade-offs in relative limb length among Peruvian children: extending the thrifty phenotype hypothesis to limb proportions

Background and Methods

Both the concept of ‘brain-sparing’ growth and associations between relative lower limb length, childhood environment and adult disease risk are well established. Furthermore, tibia length is suggested to be particularly plastic under conditions of environmental stress. The mechanisms responsible are uncertain, but three hypotheses may be relevant. The ‘thrifty phenotype’ assumes that some components of growth are selectively sacrificed to preserve more critical outcomes, like the brain. The ‘distal blood flow’ hypothesis assumes that blood nutrients decline with distance from the heart, and hence may affect limbs in relation to basic body geometry. Temperature adaptation predicts a gradient of decreased size along the limbs reflecting decreasing tissue temperature/blood flow. We examined these questions by comparing the size of body segments among Peruvian children born and raised in differentially stressful environments. In a cross-sectional sample of children aged 6 months to 14 years (n = 447) we measured head circumference, head-trunk height, total upper and lower limb lengths, and zeugopod (ulna and tibia) and autopod (hand and foot) lengths.

Results

Highland children (exposed to greater stress) had significantly shorter limbs and zeugopod and autopod elements than lowland children, while differences in head-trunk height were smaller. Zeugopod elements appeared most sensitive to environmental conditions, as they were relatively shorter among highland children than their respective autopod elements.

Discussion

The results suggest that functional traits (hand, foot, and head) may be partially protected at the expense of the tibia and ulna. The results do not fit the predictions of the distal blood flow and temperature adaptation models as explanations for relative limb segment growth under stress conditions. Rather, our data support the extension of the thrifty phenotype hypothesis to limb growth, and suggest that certain elements of limb growth may be sacrificed under tough conditions to buffer more functional traits.

Adult height and risk of coronary heart disease: Tehran Lipid and Glucose Study

BACKGROUND

We assessed the relationship between height and coronary heart disease (CHD) in an urban population of Tehran.

METHODS

4110 participants of the Tehran Lipid and Glucose Study who were 40 years of age or older (1880 men and 2230 women; mean age, 55.1 and 53.0 years, respectively) and free of CHD at baseline were followed for a mean of 9.1 years. We used Cox proportional hazards regression to evaluate the risk of a first CHD event across height tertiles.

RESULTS

First CHD events occurred in 239 men and 172 women. The estimated crude HR (95% CI) for CHD events associated with an increment of 1 SD in height was 0.96 (0.28-3.33) in men and 0.84 (0.72-0.97) in women. After adjustment for age, the associations were no longer present. Further adjustment for other confounders had little impact on the results: the HR (95% CI) associated with an increase of 1 SD in height was 1.02 (0.87-1.20) in men and 0.82 (0.66-1.02) in women.

CONCLUSIONS

After adjustment for age, height was not associated with CHD incidence in men or women.

Associations of adult height and its components with mortality: a report from cohort studies of 135,000 Chinese women and men

BACKGROUND

Although several studies have evaluated the relationship between adult height and mortality, their results have not been entirely consistent. Little is known about components of adult height in relation to mortality, particularly in developing countries.

METHODS

We examined the association of adult height and its components (leg and trunk length) with mortality using data from 74 869 Chinese women and 61,333 men in the Shanghai Women's (1996-2008) and Men's (2002-2008) Health Studies. Anthropometric measurements, including standing and sitting height and weight, were taken at baseline by trained interviewers according to a standard protocol. Deaths were ascertained by biennial home visits and linkage with the vital statistics registry. Cox regression models were used to evaluate the associations.

RESULTS

Neither height nor its components were associated with all-cause mortality. Height and, less consistently, its components were positively associated with cancer mortality, but inversely associated with cardiovascular disease (CVD) mortality. Hazard ratios (HRs) [95% confidence intervals (CIs)] for cancer mortality per 1-SD increment in height, trunk and leg length were 1.06 (1.01-1.12), 1.07 (1.01-1.12) and 1.03 (0.98-1.08), respectively, in women, and 1.13 (1.05-1.22), 1.09 (1.00-1.19) and 1.10 (1.03-1.16), respectively, in men. The corresponding HRs for CVD mortality were 0.89 (0.84-0.95), 0.93 (0.87-0.99) and 0.91 (0.86-0.98) in women, and 0.93 (0.86-1.02), 0.89 (0.81-0.98) and 0.99 (0.92-1.06) in men.

CONCLUSIONS

Our results suggest that different mechanisms may be involved in linking height and its components with cancer and CVD mortality.

Epidemiology and risk factors of cerebral ischemia and ischemic heart diseases: similarities and differences

Cerebral ischemia and ischemic heart diseases, common entities nowadays, are the main manifestation of circulatory diseases. Cardiovascular diseases, followed by stroke, represent the leading cause of mortality worldwide. Both entities share risk factors, pathophisiology and etiologic aspects by means of a main common mechanism, atherosclerosis. However, each entity has its own particularities. Ischemic stroke shows a variety of pathogenic mechanisms not present in ischemic heart disease. An ischemic stroke increases the risk of suffering a coronary heart disease, and viceversa. The aim of this chapter is to review data on epidemiology, pathophisiology and risk factors for both entities, considering the differences and similarities that could be found in between them. We discuss traditional risk factors, obtained from epidemiological data, and also some novel ones, such as hyperhomocisteinemia or sleep apnea. We separate risk factors, as clasically, in two groups: nonmodifiables, which includes age, sex, or ethnicity, and modifiables, including hypertension, dyslipidemia or diabetis, in order to discuss the role of each factor in both ischemic events, ischemic stroke and coronary heart disease.

Patterns and correlates of adult height in Sri Lanka

The present study examines patterns and socioeconomic and demographic correlates of adult height among Sri Lankan adults. Data were available for height and socio-demographic factors from a nationally representative cross-sectional sample of 4477 subjects above 18 years. Recruitment was between 2005 and 2006. Mean age of all subjects was 46.1±15.1 years. Mean height of males and females were 163.6±6.9cm and 151.4±6.4cm respectively. Mean height showed a significant negative correlation with age (p<0.001, r=-0.207). Highest mean height in females 154.0±5.9cm and males 165.6±6.9cm were observed in those born after 1977. Rural females (151.4±6.2cm) were significantly taller than the urban (151.3±7.2cm). However, this was not observed in males. In multivariate analysis, year of birth, level of education and household income were significantly associated with height. Height demonstrated a significant negative correlation with systolic blood pressure (r=-0.032), presence of diabetes (r=-0.069), total cholesterol (r=-0.106), HDL cholesterol (r=-0.142) and LDL cholesterol (r=-0.104). Height was associated with household income and level of education in Sri Lanka and demonstrated a distinct increasing trend over successive generations.

Short stature is associated with coronary heart disease: a systematic review of the literature and a meta-analysis

AIMS

The aim of this study was to assess the relationship between short stature and coronary heart disease (CHD) morbidity and mortality.

METHODS AND RESULTS

We performed a systematic search from MEDLINE, PREMEDLINE, and All EBM Reviews as well as from a reference list of relevant articles. We used SPICO (Study design, Patient, Intervention, Control-intervention, Outcome) criteria. The methodological quality of studies was analysed by modified Borghoust criteria. From a total of 1907 articles, we selected 52 studies comprising population-based follow-up studies and patient cohorts followed after a CHD event, as well as case-control studies with height either as a continuous or categorical variable, totalling 3 012 747 individuals. The short ones were below 160.5 cm and tall ones over 173.9 cm on average. Among the shortest height category, the relative risks were 1.35 (95% CI 1.25-1.44) for all-cause mortality, 1.55 (1.37-1.74) for all cardiovascular disease (CVD) mortality, 1.49 (1.33-1.67) for CHD, and 1.52 (1.28-1.81) for myocardial infarction when compared with those within the highest height category. The mean relative risk was 1.46 (1.37-1.55). Short stature was associated with increased cardiovascular morbidity and mortality in both genders.

CONCLUSION

The relationship between short stature and CVD appears to be a real one. On the basis of comparison, adults within the shortest category had an approximately 50% higher risk of CHD morbidity and mortality than tall individuals.

Secular trend in height in Al Ain-United Arab Emirates

Correlation between cycles in human stature and those in economic variables is well established. A recent review of international trends in this area provided information from most parts of the world but none on Arabs in the Middle East or more specifically the gulf region. The United Arab Emirates experienced a transformation in economic and social life followed the discovery of oil in the late 1960s and the wealth that it generated. No data is available on human growth at this period of time because its population never had health services prior to the 1970s. A study on conventional cardiovascular risk factors in 2004-2005 included 817 randomly selected national adults (> or =18 years) from both genders. The relationship between height and age in this study showed both men and women have increased in height with time demonstrating the secular change in height most likely a result of changing socioeconomic factors.

Height, wealth, and health: an overview with new data from three longitudinal studies

This overview, based on a literature review and new data from the three cohorts (Whitehall Studies I and II, and the Vietnam Experience Study), has four objectives: (a) to outline the major determinants of height, so providing an indication as to what exposures this characteristic may capture; (b) to summarise, by reviewing reports from large scale studies, the relation between adult height and a range of disease outcomes--both somatic and psychiatric--with particular emphasis on coronary heart disease (CHD) and stroke; (c) to discuss why these relationships may exist, in particular, the role, if any, of socioeconomic position in explaining the apparent associations; and, finally (d) to outline future research directions in this field. The large majority of evidence for predictors of height, and its health consequences, comes from observational studies. While genetic predisposition is a major determinant of height, secular rises in childhood and adult stature across successive birth cohorts suggest that early life environment also has an important impact. Plausible non-genetic determinants of height include nutrition, illness, socioeconomic status, and psychosocial stress. Evidence for an association between height and a series of health endpoints is accumulating. Thus, shorter people appear to experience increased risk of CHD, and these associations appear to be independent of socioeconomic position and other potentially confounding variables. For stroke, and its sub-types, findings are less clear. In contrast to CHD, some cancers, such as carcinoma of the colorectum, prostate, breast (in women), central nervous system, skin, endometrium, thyroid and blood (haematopoietic) are more common in taller people. While height may be negatively related to the risk of completed suicide, conclusions about the links between stature and other health endpoints is problematic given the paucity of evidence, which should be addressed. Ultimately, for want of better data, investigators in this area have used height as a proxy for a range of pre-adult exposures. In future, research should aim to explore the predictive capacity of direct measures of diet, psychosocial stress, childhood chronic illness and so on, rather than focus on height or its components. The problem is that extended follow-up of child cohorts with such data are required, and studies which hold these data are not currently available, although several are either maturing to the point where they offer sufficient clinical outcomes to facilitate analyses or are in the advanced planning stage.

Height differences and the associations between food insecurity, percentage body fat and BMI among men and women

OBJECTIVE

The present study examined the associations between adult food insecurity (FI) and percentage body fat (%BF) and BMI, stratified by height (HT).

DESIGN, SETTING AND SUBJECTS

%BF, HT and BMI of 2117 men and 1909 women in the National Health and Nutrition Examination Survey 1999-2002 were analysed in relation to adult food security status using multiple regression procedures.

RESULTS

Compared with the fully food-secure, men's %BF, BMI and HT were lower as FI intensified. Marginal food security among women was associated with 1.3 cm shorter HT, P = 0.016. Marginal food security among women who were below median HT was associated with about 2.0 kg/m2 higher BMI, P = 0.042. %BF was not associated with FI among women.

CONCLUSIONS

FI is associated with shorter HT and lower %BF and BMI in men. Women's HT should be considered in the reported associations between FI and higher BMI.

Adult height and the risk of mortality in South Korean women

To evaluate the association between adult height as a surrogate marker of childhood circumstances and the risk of mortality, 344,519 South Korean women aged 40-64 years categorized into six height groups were prospectively followed for mortality between 1994 and 2004. In Cox proportional hazards regression with adjustment for behavioral and biologic risk factors, there was an inverse association between height and total mortality; mortality risk decreased 7% for each 5-cm increment in height. The association did not materially change after adjustment for behavioral factors and adulthood socioeconomic factors or after full adjustment for all available covariates. When height-associated risks of death from specific causes were evaluated in a fully adjusted analysis, a 5-cm increment in height was associated with lower risks of death from respiratory diseases, stroke, diabetes mellitus, and external causes (hazard ratios were 0.84 (95% confidence interval (CI): 0.74, 0.96), 0.84 (95% CI: 0.80, 0.88), 0.87 (95% CI: 0.80, 0.96), and 0.88 (95% CI: 0.83, 0.94), respectively) and with a higher risk of death from cancer (hazard ratio = 1.05, 95% CI: 1.02, 1.09). Given that adult height reflects early-life conditions, the independent associations between height and mortality from all causes and specific causes support the view that early-life circumstances significantly influence health outcomes in adulthood.

Anthropometric characteristics as predictors of coronary heart disease in women

OBJECTIVES

Obesity and other anthropometric measures are clearly related to risk of coronary heart disease (CHD), although debate remains as to which measures are most important and how the impact of obesity varies over the life course.

AIM

We aimed to investigate these issues in a large cohort of Swedish women. The Women's Lifestyle and Health Cohort Study includes 49 259 women, aged 30-50 years at baseline (1991-1992) when an extensive questionnaire was completed.

METHODS

Women were given standard instructions for self-measurement of anthropometric characteristics. Women were followed through linkages to national registries until December 2003, during which time 256 cases of incident fatal CHD or nonfatal myocardial infarction occurred.

RESULTS

Waist circumference was associated with increased CHD risk after multivariate adjustment for confounders (HR = 1.9; 95% CI:1.1-3.3; highest versus lowest quartile), whereas height, weight and hip circumference were not. Measures of obesity were strongly related to CHD, and after mutual adjustment, waist-hip ratio (HR = 1.9, 95% CI: 1.2-3.2) was more closely related to CHD risk than BMI (HR = 1.5, 95% CI: 1.0-2.4). Risk of CHD was increased in women who remained heavy, those who were heavy at age 18, and those with low birth weight.

CONCLUSIONS

In conclusion, there is strong evidence for supporting control of obesity, in particular avoidance of abdominal obesity, as a strategy to prevent CHD.

Gender, socio-economic status and metabolic syndrome in middle-aged and old adults

Background

Studies that addressed social and economic determinants of cardiovascular diseases, consistently showed an increase prevalence of the individual features of metabolic syndrome in the lower socio-economic strata. Thus, this study aimed to evaluate the association between social class and metabolic syndrome in a sample of urban middle-aged and old Portuguese adults.

Methods

We evaluated 1962 subjects (1207 women and 755 men) aged 40 or more years. Marital status, education, occupation, menarche age and height distribution were used as socioeconomic indicators. Metabolic syndrome was defined according to the ATP III, by the presence of at least three of the following characteristics: waist circumference >102 cm in men and >88 cm in women; triglycerides ≥ 150 mg/dl; HDL cholesterol <40 mg/dl in men and <50 mg/dl in women; blood pressure ≥ 130/85 mm Hg; and fasting glucose ≥ 110 mg/dl. Proportions were compared using the chi square test or Fisher's exact test. Odds ratios (OR) and 95% confidence intervals (95% CI) were computed using unconditional logistic regression to estimate the magnitude of the associations.

Results

Metabolic syndrome was significantly more frequent in females (24.9 vs. 17.4, p < 0.001). In females, the odds favoring metabolic syndrome significantly increased with age and in unfavorable social class as described by occupation, and decreased with education level. In males, metabolic syndrome was significantly more frequent in the 60–69 years age class (OR = 1.82; 95%CI: 1.02–3.26) when compared to those in the 40–49 years age class. Concerning other socioeconomic indicators no significant associations were found.

Conclusion

This study showed that gender influenced the association of socio-economic status indicators with metabolic syndrome. Females in lower social classes, as defined by education and occupational classification, more frequently presented metabolic syndrome, no such association was found in males.

Height, its components, and cardiovascular risk among older Chinese: a cross-sectional analysis of the Guangzhou Biobank Cohort Study

OBJECTIVES

Better childhood conditions, inferred from height and specifically leg length, are usually protective against ischemic heart disease and its risk factors in Western countries. In other geoethnic populations, height is less clearly protective, casting doubt on there being a biological etiology. To clarify the role of childhood conditions, we examined the associations of height and its components with cardiovascular risk among older Chinese people.

METHODS

We used multivariable regression to examine the associations of height and its components with blood pressure, lipid profile, and diabetes in 10413 older Chinese adults (mean age=64.6 years).

RESULTS

After we adjusted for age, gender, socioeconomic status, and lifestyle habits, greater sitting height was associated with diabetes and dyslipidemia. Longer legs were associated with lower pulse pressure and lower low-density lipoprotein cholesterol.

CONCLUSIONS

We provide indirect anthropometric evidence for the role of pre-pubertal and pubertal exposures on cardiovascular risk. Pubertal exposures are stronger than are prepubertal exposures but may be influenced by osteoporotic decline in old age. Further research should establish whether the observed relations are ethnically specific or relate to the stage or trajectory of socioeconomic development.

Birth weight, components of height and coronary heart disease: evidence from the Whitehall II study

BACKGROUND

Previous studies have suggested that shorter leg length, not trunk length, may explain the inverse association between height and coronary heart disease (CHD) risk. However, investigation of the importance of birth weight for these associations has been limited. This study examines associations of measures of stature and birth weight with CHD risk factors (measures of blood pressure and lipids, 2 h glucose, waist-hip ratio and fibrinogen) and incident non-fatal coronary events in middle age.

METHODS

Data were derived mostly from the Phase 5 (1997-99) clinical screening of the Whitehall II study of British civil servants. The main cross-sectional analyses included 1084 women and 2290 men with complete data.

RESULTS

In women total height and leg length were the measures that tended to be most strongly associated with CHD risk factors, while in men leg length demonstrated the closest associations. Although associations between trunk length and CHD risk factors were weaker, trunk length was the component of height that appeared to be most closely associated with coronary events. Associations between birth weight and CHD risk factors and coronary events were generally weaker than for any measure of stature. Adjustment for birth weight had little effect on associations between components of stature and CHD risk factors or events.

CONCLUSION

Findings from this relatively privileged cohort confirmed that shorter leg length underlies the inverse association between height and CHD risk factors in middle-aged women and men. Furthermore, in this study population shorter trunk length was more closely associated with incident, non-fatal coronary events.

Association between height and coronary heart disease mortality: a prospective study of 35,000 twin pairs

An inverse association between height and risk of coronary heart disease (CHD) is well demonstrated, but it is not known whether this association is because of genetic factors, socioeconomic background, or other environmental factors. Four population-based twin cohorts with register-based follow-up data on CHD mortality from Denmark (1966-1996), Finland (1975-2001), and Sweden (1963-2001 and 1972-2001) were used to investigate this question; response rates varied between 65% and 86%. Together, the cohorts included 74,704 twin individuals (35,042 complete twin pairs) with 5,943 CHD deaths during 1.99 million person-years of follow-up. Cox and conditional logistic regression models were used. Per 1-standard deviation decrease in height, height was inversely associated with CHD mortality in men (hazard ratio = 1.08, 95% confidence interval (CI): 1.04, 1.12) and in women (hazard ratio = 1.06, 95% CI: 1.01, 1.10). A twin who had died from CHD was on average shorter than the co-twin within monozygotic pairs (odds ratio = 1.27, 95% CI: 1.12, 1.44, with no sex difference), whereas a weaker association was found within dizygotic pairs in men (odds ratio = 1.01, 95% CI: 0.91, 1.13) and in women (odds ratio = 1.14, 95% CI: 1.01, 1.28). The inverse association between height and CHD mortality found within monozygotic discordant twin pairs suggests that this association is because of environmental factors that directly affect height and CHD risk.

Relationship between body height and dementia

OBJECTIVE

Structural and functional brain reserves, thought to develop in childhood and adolescence, may be critical in determining the age at onset of cognitive impairment. Body height is affected by childhood conditions that promote growth. The authors examine the relationship of height in midlife and subsequent dementia, Alzheimer disease (AD), and vascular dementia.

METHODS

Dementia was evaluated from 1999 to 2001 in 1,892 men age 76 to 95. Height had been measured when these men participated in the Israeli Ischemic Heart Disease project in 1963. Age, socioeconomic status (SES), and area of birth were also assessed in 1963.

RESULTS

Older men and those with lower SES tended to be shorter. Relative to the shortest quartile, controlling for age, SES, and area of birth, the other quartiles had lesser respective odds ratios for dementia as a whole, AD, and vascular dementia.

CONCLUSION

Height was inversely associated with dementia, AD, and vascular dementia in a male sample. Since height is associated with childhood nutrition and may be associated with other risk factors for dementia, efforts to improve early life conditions that maximize body growth may diminish or delay the onset of dementia in later life.

Relationship between sitting-height-to-stature ratio and adiposity in Brazilian women

Inadequate anthropometric dimensions, such as short leg length or high sitting-height-to-stature ratio (SHSR) in adults, can be considered indices of adverse environmental conditions in early life. Our objective was to describe the association between SHSR, a variable of prepubertal environment, and levels of adiposity in a group of Brazilian women. Six hundred and sixty-nine women aged 20-55 years were studied through a cross-sectional design. Detailed anthropometric measurements were obtained according to standardized procedures. Body mass index (BMI) > or = 30 kg/m2, percent body fat (% BF) measured through bioelectrical impedance >30, and the third tertile of six skinfold sums (SKF sum) were treated as dependent variables. High SHSR was defined as values > or = mean + 1 SD. Data analysis was performed using nonconditional hierarchical multivariate logistic regression, estimating adjusted odds ratios (OR) and 95% confidence intervals (95% CI) for the three dependent variables. Thirty-two percent of women who had high SHSR had low stature, compared with 13.8% in the group with normal SHSR (P < 0.000). After adjustment for age, schooling, total family income, parity, and age of menarche, high SHSR was still associated with BMI > or = 30 kg/m2 (OR, 2.46; 95% CI, 1.31-4.60), % BF >30 (OR, 2.07; 95% CI, 1.11-3.61), and SKF sum (OR, 2.11; 95% CI, 1.33-3.35). These results support the hypothesis that high SHSR, a variable of prepubertal adverse environmental conditions, is independently associated with adiposity in this group of Brazilian women. Responsible factors for high SHSR, other than genetics, should be investigated.

Relationship of physical fitness to chewing in an 80-year-old population

OBJECTIVE

Although tooth loss causes a decrease in masticatory ability, which may influence nutritional status, and impair an individual's general health including physical activity, little is known whether a decrease in chewing ability could result in deterioration in physical fitness in a very elderly population. Thus, the present study evaluated the relationship of chewing ability or teeth number with measures of physical fitness in a sample of 80-years-old in Japan.

DESIGN

Cross-sectional survey.

SUBJECTS AND METHODS

A total of 1282 people who were 80-years old and resided in the Fukuoka Prefecture were approached. A total of 697 individuals (277 male, 420 female) agreed to participate.

RESULTS

Chewing food number and teeth number were related positively with physical fitness measurements of hand grip strength, leg extensor strength, leg extensor power, stepping rate, and one-leg standing time. However, the significant relationship between the number of teeth and physical ability disappeared after adjustment for various confounders, using multiple regression analysis or logistic regression analysis. On the other hand, the relationship of chewing ability with physical fitness measurements of leg extensor strength, one-leg standing time, or isokinetic leg extensor power remained significant even after adjustment for these confounders.

CONCLUSION

There is a relationship between perceived chewing ability (number of foods considered chewable) and physical fitness in this 80-year-old population. Chewing ability may be an independent predictor of physical fitness, thus preventative dental care aimed at preserving chewing ability may be able to enhance activities of daily life and quality of life in very elderly individuals.

Is height related to longevity?

Over the last 100 years, studies have provided mixed results on the mortality and health of tall and short people. However, during the last 30 years, several researchers have found a negative correlation between greater height and longevity based on relatively homogeneous deceased population samples. Findings based on millions of deaths suggest that shorter, smaller bodies have lower death rates and fewer diet-related chronic diseases, especially past middle age. Shorter people also appear to have longer average lifespans. The authors suggest that the differences in longevity between the sexes is due to their height differences because men average about 8.0% taller than women and have a 7.9% lower life expectancy at birth. Animal experiments also show that smaller animals within the same species generally live longer. The relation between height and health has become more important in recent years because rapid developments in genetic engineering will offer parents the opportunity to increase the heights of their children in the near future. The authors contend that we should not be swept along into a new world of increasingly taller generations without careful consideration of the impact of a worldwide population of taller and heavier people.

Influence of height, leg and trunk length on pulse pressure, systolic and diastolic blood pressure

OBJECTIVE

To compare the effects of height, leg and trunk length on pulse pressure (PP), systolic (SBP) and diastolic blood pressure (DBP) in men and women.

DESIGN

Prospective, population-based, birth cohort study.

SETTING

England, Scotland and Wales.

PARTICIPANTS

A total of 1472 men and 1563 women aged 53 years and followed since their birth in 1946.

MAIN OUTCOME MEASURES

PP, SBP and DBP at age 53 years.

RESULTS

PP increased linearly with decreasing height and leg length in men and women [shortest compared with the tallest height (leg length) group, men 54.6 versus 51.0 mmHg (55.8 versus 50.7 mmHg), women 52.9 versus 48.4 mmHg (53.3 versus 48.6 mmHg); P for trend < or = 0.001 in each case]. Adjustment for adult confounding factors and childhood social class or birth weight only slightly weakened these results (P for trend < or = 0.01 in each case). SBP, but not DBP, showed similar but weaker trends in men and women, except for the association with height in men, which lost statistical significance after adjustment. Trunk length was not associated with any outcome measure in men or women.

CONCLUSIONS

Short height and leg length are associated with increased PP and SBP, but not DBP, in middle-aged men and women. PP is a potential mediator between short height and leg length and increased risk of coronary heart disease. Future studies of the association between shortness and coronary heart disease should consider the role of arterial hemodynamics.