Diabetes & Metabolic Syndrome: Clinical Research & Reviews
Relationship between the short stature and the prevalence of metabolic syndrome and insulin resistance markers in workers of a private educational institution in Peru
Introduction
Metabolic syndrome (MetS) is a complex condition closely linked with obesity and insulin resistance (IR) [1]. This conditions are determinants of endothelial dysfunction [2] and are related to cardiovascular and metabolic abnormalities such as type 2 diabetes mellitus (T2DM), stroke, and acute myocardial infarction [3].
Adult height and its components (e.g. leg length and leg length-to-height ratio) are a reflection of childhood growth patterns [4], and the short stature during childhood has been associated with a higher probability of obesity during adulthood [5]. Similarly, some studies conducted in the U.S [4]. and European adults [6,7] have found that short stature is associated with a major risk of adiposity, IR, and T2DM. However, whereas some prospective studies have shown an association between height-related indexes and T2DM only in men [6,8], a systematic review found an inverse relationship between height and risk of T2DM only significant in women [9]. In Latin America, previous research in Colombia [10] and Brazil [[11], [12], [13]] have linked the short stature with overweight and obesity. However, even though Peru is one of the countries worldwide with the shortest average height [14,15], no studies have been published in this population, except one that assessed the relationship between a height-related anthropometric index (waist-to-height ratio) with IR biomarkers [16].
Lipid profile and its components have been described as predictors of IR, cardiovascular and metabolic disorders [17]. Then, based on this components, surrogated IR markers were developed, being the most used the triglycerides and glucose (TyG) index and triglycerides to HDL-cholesterol (TG/HDL-c) ratio [18]. Therefore, previous studies have described the association of these markers with IR and T2DM, being useful in cardiometabolic evaluation [16,17,19,20].
The purpose of this study was to assess the association between short stature and MetS in an adult population working in an educational institution in Lima-Peru. In addition, we evaluated the association between height and surrogate markers of IR.
Section snippets
Study design, population and statistical power calculation
We carried out an analytical cross-sectional study using data from adults working in a private educational institution located in Lima-Peru, previously collected for surveillance purposes and an interventional study. We did not find previous research that evaluated our association of interest. Then, we estimated the statistical power based on the study conducted by Lawlor et al. [21], which evaluated the association between short stature and the prevalence of T2DM. We found a statistical power
Results
In total, we enrolled 1099 participants during the study period; we excluded 15 people who had fasting glucose levels ≥126 mg/dL and four people because they did not have the variables of interest. Finally, we analyzed 1080 participants.
Main findings
To our knowledge, only one study in Latin America has assessed the relationship between short stature and MetS [5] and this is the first one conducted in Peru. We found that the lowest tertile of height was associated with MetS, independently of gender. Similarly, we reported an inverse relationship between height and both IR biomarkers (TyG index and TG/HDL-c ratio).
Comparison with other studies
Different studies worldwide have reported an association between short stature and some metabolic abnormalities, such as T2DM,
Conclusion
We found an association between the lowest tertile of height and MetS. Similarly, we evidenced an inverse relationship between height and two IR biomarkers: TyG index and TG/HDL-c ratio. We recommend carrying out future cohort studies in the Peruvian population, where stature and other novel anthropometric markers (i.e., leg length, leg length–to–height ratio and leg-to-trunk length ratio) could be evaluated as risk factors for the development of MetS, T2DM and other cardiovascular outcomes.
Authors’ contributions
All authors conceived the idea and conceptualized the study and design, performed and reviewed the statistical analyses, drafted the manuscript and approved the final version.
Funding
This study was self-funded.
Declaration of competing interest
The authors have no potential competing interests.
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