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a Department
of Social Medicine, University of Bristol, Canynge Hall, Whiteladies
Road, Bristol BS8 2PR, UK, b Cyncoed, Cardiff, c Department of Epidemiology and Public Health
Medicine, The Queen's University of Belfast, Belfast
Correspondence to: Professor Davey Smith (George.Davey-Smith{at}bristol.ac.uk)
Accepted for publication 6 June 2001
BACKGROUND
Adult
height has been inversely associated with coronary heart disease risk
in several studies. The mechanism for this association is not well
understood, however, and this was investigated by examining components
of stature, cardiovascular disease risk factors and subsequent coronary
heart disease in a prospective study.
METHODSAll men aged
45-59 years living in the town of Caerphilly, South Wales were
approached, and 2512 (89%) responded and underwent a detailed
examination, which included measurement of height and sitting height
(from which an estimate of leg length was derived). Participants were
followed up through repeat examinations and the cumulative incidence of
coronary heart diseaseboth fatal and non-fatalover a 15 year follow
up period is the end point in this report.
RESULTSCross
sectional associations between cardiovascular risk factors and
components of stature (total height, leg length and trunk length)
demonstrated that factors related to the insulin resistance syndromethe homeostasis model assessment of insulin resistance, fasting triglyceride levels and total to HDL cholesterol ratiowere less favourable in men with shorter legs, while showing reverse or no
associations with trunk length. Fibrinogen levels were inversely associated with leg length and showed a weaker association with trunk
length. Forced expiratory volume in one second was unrelated to leg
length but strongly positively associated to trunk length. Other risk
factors showed little association with components of stature. The risk
of coronary heart disease was inversely related to leg length but
showed little association with trunk length.
CONCLUSIONLeg length
is the component of stature related to insulin resistance and coronary
heart disease risk. As leg length is unrelated to lung function
measures it is unlikely that these can explain the association in this
cohort. Factors that influence leg length in adulthoodincluding
nutrition, other influences on growth in early life, genetic and
epigenetic influencesmerit further investigation in this regard. The
reported associations suggest that pre-adult influences are important
in the aetiology of coronary heart disease and insulin resistance.
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