Abstract
ObjectiveTo investigate whether height is associated with peripheral arterial disease (PAD) in patients with type 2 diabetes.Research design and methodsThis was an observational study performed in 4,528 Chinese patients with type 2 diabetes. Anthropometric measures and the ankle-brachial index (ABI) were performed on each subject. PAD was defined as those patients with a history of revascularization or amputation due to ischemia, or an ABI <0.9.ResultsA total of 23.3 % of T2DM patients had PAD (men 22.9 % and women 23.7 %). The mean age and height were 57.8 ± 12.5 years and 170.5 cm for men, and 60.0 ± 11.7 years and 158.9 cm for women, respectively. The ABI and frequency of PAD were higher with decreasing height quartiles. An inverse association was observed between height- and gender-adjusted risk of PAD. This relationship remained unchanged following further adjustment for potential confounders. Subjects in the shortest stature group had of 1.174 times higher risk of PAD for men and 1.143 times for women, compared with those in the tallest stature group. The multivariate adjusted hazard ratios (95 % CI) of PAD for a 10-cm height increase were 0.85 (95 % CI 0.78–0.94).ConclusionA short stature seems to be associated with higher risk of PAD in Chinese diabetic patients. However, the cross-sectional nature of the study limits conclusions regarding the direction or causality. Further longitudinal study is warranted in this and other ethnic groups.
Highlights
This study revealed significantly negative associations between height and peripheral arterial disease (PAD) among type 2 diabetic patients
Shorter participants with diabetes were more likely to accumulate their risks of PAD in their adulthood, compared to taller participants
The meta-analysis from 121 prospective cohort studies demonstrated that taller people have a lower risk of death from coronary disease and stroke subtypes, and show that adult short stature poses 1.5 times higher risk for coronary heart disease (CHD) morbidity and mortality than being a tall individual [9]
Summary
Our cross-sectional study included 4,528 T2DM patients with a diagnosis of diabetes according to American Diabetes Association criteria (2005). After resting for 5 min in the supine decubitus position, systolic BP was measured in both arms and the highest value was selected for calculation of the ABI (denominator). The systolic BP of the posterior tibial artery was measured in each leg, and the highest value (whether tibial or pedal) was taken as reference for calculating the individual ABI of each leg (numerator). Three models examining the association of height with PAD and ABI were used under different adjustment schemes. The second model adjusted for duration of diabetes, smoking status, hypertension, dyslipidemia, current medication use (antihypertensives, statins, insulin and oral antidiabetes drugs), systolic blood pressure, diastolic blood pressure, fasting plasma glucose, HbA1c, eGFR, albuminuria, triglyceride, total cholesterol, HDL cholesterol, LDL cholesterol and log-transformed triglyceride.
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