Relationship between the short stature and the prevalence of metabolic syndrome and insulin resistance markers in workers of a private educational institution in Peru

Highlights

• Metabolic syndrome (MetS) is a condition closely linked with obesity and insulin resistance (IR).

• This cross-sectional study found that short stature was associated with MetS and IR markers (TyG index and TG/HDL-c ratio).

• Cohort studies evaluating novel anthropometric markers as risk factors for metabolic disorders are needed.

Abstract

Background and aims

Short stature has been linked with the development of metabolic syndrome (MetS). However, only one study has been conducted in Latin American adults. We aimed to assess the association between short stature and MetS in workers of a private educational institution in Peru. In addition, we evaluated the association between height and surrogate markers of insulin resistance (IR).

Methods

We performed an analytical cross-sectional study. We categorized the height in tertiles and evaluated MetS according to the Latin American Diabetes Association statement. We used the triglycerides and glucose (TyG) index and the triglycerides to HDL-cholesterol (TG/HDL-c) ratio as IR markers. We elaborated crude and adjusted Poisson generalized linear models to evaluate the association between height tertiles and MetS. For the IR markers, we carried out crude and adjusted linear regressions.

Results

We analyzed 1080 participants and the overall prevalence of MetS was 16.2%. In the adjusted Poisson generalized linear model, using the high tertile as a reference, we found statistically significant differences in the prevalence of MetS with the low and intermediate tertile (aPR = 2.03; 95%CI: 1.48–2.77 and aPR = 1.41; 95%CI: 1.01–1.99; respectively). In the gender-stratified analysis, we found statistical significance between height and MetS when comparing high and low tertile for both genders. For IR markers, we found an inverse association between the height and TyG index (aβ = −0.14; 95%CI: 0.19 to −0.10) and TG/HDL-c ratio (aβ = −0.62; 95%CI: 0.84 to −0.39). When we stratified by gender, the association for both secondary outcomes and height remained statistically significant in both groups.

Conclusions

We found an association between short stature and the prevalence of MetS and IR markers. We need studies with national representative samples to define the threshold of short stature with better sensitivity and specificity for the screening of MetS.

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.