Short Leg Length, a Marker of Early Childhood Deprivation, Is Associated With Metabolic Disorders Underlying Type 2 Diabetes

Author:

Johnston Luke W.1,Harris Stewart B.2,Retnakaran Ravi3,Gerstein Hertzel C.4,Zinman Bernard35,Hamilton Jill167,Hanley Anthony J.138

Affiliation:

1. Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada

2. Centre for Studies in Family Medicine, University of Western Ontario, London, Ontario, Canada

3. Leadership Sinai Centre for Diabetes, Division of Endocrinology, University of Toronto, Toronto, Ontario, Canada

4. Division of Endocrinology and Metabolism, McMaster University and Hamilton Health Sciences, Hamilton, Ontario, Canada

5. Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada

6. Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada

7. Hospital for Sick Children, Toronto, Ontario, Canada

8. Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada

Abstract

OBJECTIVE Short leg length, a marker of early childhood deprivation, has been used in studies of the association of early life conditions with adult chronic disease risk. The objective of this study was to determine the cross-sectional associations of leg length with measures of insulin sensitivity and β-cell function. RESEARCH DESIGN AND METHODS Subjects (n = 462) at risk for type 2 diabetes were recruited into the PROspective Metabolism and ISlet cell Evaluation (PROMISE) longitudinal cohort. Leg length was calculated from sitting and standing height at the 3-year clinical examination. Glucose tolerance status was determined using an oral glucose tolerance test. Insulin sensitivity was assessed using homeostasis model assessment of insulin resistance (HOMA-IR) and the Matsuda insulin sensitivity index (ISI), while the insulinogenic index over HOMA-IR (IGI/IR) and the insulin secretion sensitivity index 2 (ISSI-2) determined β-cell function. Multiple linear regression analysis was conducted, adjusting for covariates including age, sex, ethnicity, family history of diabetes, waist, and weight. RESULTS Leg length and leg-to-height ratio were significantly associated with HOMA-IR (β = −0.037, β = −10.49, respectively; P < 0.0001), ISI (β = 0.035, β = 8.83, respectively; P < 0.0001), IGI/IR (β = 0.021, P < 0.05; β = 7.60, P < 0.01, respectively), and ISSI-2 (β = 0.01, P < 0.03; β = 3.34, P < 0.01, respectively) after adjustment for covariates. The association of shorter leg length with lower insulin sensitivity was most evident for those with high waist circumferences. CONCLUSIONS Shorter legs were independently associated with lower insulin sensitivity and β-cell function, suggesting that early childhood deprivation may increase the risk of developing diabetes.

Publisher

American Diabetes Association

Subject

Advanced and Specialized Nursing,Endocrinology, Diabetes and Metabolism,Internal Medicine

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