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. 2003 Feb;57(2):141–146. doi: 10.1136/jech.57.2.141

Associations of height, leg length, and lung function with cardiovascular risk factors in the Midspan Family Study

D Gunnell 1, E Whitley 1, M Upton 1, A McConnachie 1, S Davey 1, G Watt 1
PMCID: PMC1732388  PMID: 12540691

Abstract

Background: Taller people and those with better lung function are at reduced risk of coronary heart disease (CHD). Biological mechanisms for these associations are not well understood, but both measures may be markers for early life exposures. Some studies have shown that leg length, an indicator of pre-pubertal nutritional status, is the component of height most strongly associated with CHD risk. Other studies show that height-CHD associations are greatly attenuated when lung function is controlled for. This study examines (1) the association of height and the components of height (leg length and trunk length) with CHD risk factors and (2) the relative strength of the association of height and forced expiratory volume in one second (FEV1) with risk factors for CHD.

Subjects and methods: Cross sectional analysis of data collected at detailed cardiovascular screening examinations of 1040 men and 1298 women aged 30–59 whose parents were screened in 1972–76. Subjects come from 1477 families and are members of the Midspan Family Study.

Setting: The towns of Renfrew and Paisley in the West of Scotland.

Results: Taller subjects and those with better lung function had more favourable cardiovascular risk factor profiles, associations were strongest in relation to FEV1. Higher FEV1 was associated with lower blood pressure, cholesterol, glucose, fibrinogen, white blood cell count, and body mass index. Similar, but generally weaker, associations were seen with height. These associations were not attenuated in models controlling for parental height. Longer leg length, but not trunk length, was associated with lower systolic and diastolic blood pressure. Longer leg length was also associated with more favourable levels of cholesterol and body mass index than trunk length.

Conclusions: These findings provide indirect evidence that measures of lung development and pre-pubertal growth act as biomarkers for childhood exposures that may modify an individual's risk of developing CHD. Genetic influences do not seem to underlie height-CHD associations.

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Selected References

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  1. Berenson G. S., Srinivasan S. R., Bao W., Newman W. P., 3rd, Tracy R. E., Wattigney W. A. Association between multiple cardiovascular risk factors and atherosclerosis in children and young adults. The Bogalusa Heart Study. N Engl J Med. 1998 Jun 4;338(23):1650–1656. doi: 10.1056/NEJM199806043382302. [DOI] [PubMed] [Google Scholar]
  2. Billewicz W. Z., Thomson A. M., Fellowes H. M. A longitudinal study of growth in Newcastle upon Tyne adolescents. Ann Hum Biol. 1983 Mar-Apr;10(2):125–133. doi: 10.1080/03014468300006271. [DOI] [PubMed] [Google Scholar]
  3. Davey Smith G., Hart C., Upton M., Hole D., Gillis C., Watt G., Hawthorne V. Height and risk of death among men and women: aetiological implications of associations with cardiorespiratory disease and cancer mortality. J Epidemiol Community Health. 2000 Feb;54(2):97–103. doi: 10.1136/jech.54.2.97. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Frankel S., Elwood P., Sweetnam P., Yarnell J., Smith G. D. Birthweight, body-mass index in middle age, and incident coronary heart disease. Lancet. 1996 Nov 30;348(9040):1478–1480. doi: 10.1016/S0140-6736(96)03482-4. [DOI] [PubMed] [Google Scholar]
  5. Gerver W. J., De Bruin R. Relationship between height, sitting height and subischial leg length in Dutch children: presentation of normal values. Acta Paediatr. 1995 May;84(5):532–535. doi: 10.1111/j.1651-2227.1995.tb13688.x. [DOI] [PubMed] [Google Scholar]
  6. Gunnell D. J., Davey Smith G., Frankel S., Nanchahal K., Braddon F. E., Pemberton J., Peters T. J. Childhood leg length and adult mortality: follow up of the Carnegie (Boyd Orr) Survey of Diet and Health in Pre-war Britain. J Epidemiol Community Health. 1998 Mar;52(3):142–152. doi: 10.1136/jech.52.3.142. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Gunnell D. J., Smith G. D., Frankel S. J., Kemp M., Peters T. J. Socio-economic and dietary influences on leg length and trunk length in childhood: a reanalysis of the Carnegie (Boyd Orr) survey of diet and health in prewar Britain (1937-39). Paediatr Perinat Epidemiol. 1998 Jul;12 (Suppl 1):96–113. doi: 10.1046/j.1365-3016.1998.0120s1096.x. [DOI] [PubMed] [Google Scholar]
  8. Gunnell D., Smith G. D., McConnachie A., Greenwood R., Upton M., Frankel S. Separating in-utero and postnatal influences on later disease. Lancet. 1999 Oct 30;354(9189):1526–1527. doi: 10.1016/S0140-6736(99)02937-2. [DOI] [PubMed] [Google Scholar]
  9. Gunnell David. Can adult anthropometry be used as a 'biomarker' for prenatal and childhood exposures? Int J Epidemiol. 2002 Apr;31(2):390–394. [PubMed] [Google Scholar]
  10. Hawthorne V. M., Watt G. C., Hart C. L., Hole D. J., Smith G. D., Gillis C. R. Cardiorespiratory disease in men and women in urban Scotland: baseline characteristics of the Renfrew/Paisley (midspan) study population. Scott Med J. 1995 Aug;40(4):102–107. doi: 10.1177/003693309504000402. [DOI] [PubMed] [Google Scholar]
  11. Hebert P. R., Rich-Edwards J. W., Manson J. E., Ridker P. M., Cook N. R., O'Connor G. T., Buring J. E., Hennekens C. H. Height and incidence of cardiovascular disease in male physicians. Circulation. 1993 Oct;88(4 Pt 1):1437–1443. doi: 10.1161/01.cir.88.4.1437. [DOI] [PubMed] [Google Scholar]
  12. Hole D. J., Watt G. C., Davey-Smith G., Hart C. L., Gillis C. R., Hawthorne V. M. Impaired lung function and mortality risk in men and women: findings from the Renfrew and Paisley prospective population study. BMJ. 1996 Sep 21;313(7059):711–716. doi: 10.1136/bmj.313.7059.711. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Kannel W. B., Seidman J. M., Fercho W., Castelli W. P. Vital capacity and congestive heart failure. The Framingham study. Circulation. 1974 Jun;49(6):1160–1166. doi: 10.1161/01.cir.49.6.1160. [DOI] [PubMed] [Google Scholar]
  14. Lange P., Nyboe J., Appleyard M., Jensen G., Schnohr P. Spirometric findings and mortality in never-smokers. J Clin Epidemiol. 1990;43(9):867–873. doi: 10.1016/0895-4356(90)90070-6. [DOI] [PubMed] [Google Scholar]
  15. Leon D. A., Lithell H. O., Vâgerö D., Koupilová I., Mohsen R., Berglund L., Lithell U. B., McKeigue P. M. Reduced fetal growth rate and increased risk of death from ischaemic heart disease: cohort study of 15 000 Swedish men and women born 1915-29. BMJ. 1998 Jul 25;317(7153):241–245. doi: 10.1136/bmj.317.7153.241. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Leon D. A., Smith G. D., Shipley M., Strachan D. Adult height and mortality in London: early life, socioeconomic confounding, or shrinkage? J Epidemiol Community Health. 1995 Feb;49(1):5–9. doi: 10.1136/jech.49.1.5. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Lowe G. D., Upton M. N., Rumley A., McConnachie A., O'Reilly D. S., Watt G. C. Different effects of oral and transdermal hormone replacement therapies on factor IX, APC resistance, t-PA, PAI and C-reactive protein--a cross-sectional population survey. Thromb Haemost. 2001 Aug;86(2):550–556. [PubMed] [Google Scholar]
  18. Marmot M. G., Shipley M. J., Rose G. Inequalities in death--specific explanations of a general pattern? Lancet. 1984 May 5;1(8384):1003–1006. doi: 10.1016/s0140-6736(84)92337-7. [DOI] [PubMed] [Google Scholar]
  19. McNamara J. J., Molot M. A., Stremple J. F., Cutting R. T. Coronary artery disease in combat casualties in Vietnam. JAMA. 1971 May 17;216(7):1185–1187. [PubMed] [Google Scholar]
  20. Palmer J. R., Rosenberg L., Shapiro S. Stature and the risk of myocardial infarction in women. Am J Epidemiol. 1990 Jul;132(1):27–32. doi: 10.1093/oxfordjournals.aje.a115639. [DOI] [PubMed] [Google Scholar]
  21. Persson C., Bengtsson C., Lapidus L., Rybo E., Thiringer G., Wedel H. Peak expiratory flow and risk of cardiovascular disease and death. A 12-year follow-up of participants in the population study of women in Gothenburg, Sweden. Am J Epidemiol. 1986 Dec;124(6):942–948. doi: 10.1093/oxfordjournals.aje.a114483. [DOI] [PubMed] [Google Scholar]
  22. Rich-Edwards J. W., Manson J. E., Stampfer M. J., Colditz G. A., Willett W. C., Rosner B., Speizer F. E., Hennekens C. H. Height and the risk of cardiovascular disease in women. Am J Epidemiol. 1995 Nov 1;142(9):909–917. doi: 10.1093/oxfordjournals.aje.a117738. [DOI] [PubMed] [Google Scholar]
  23. Rosén T., Bengtsson B. A. Premature mortality due to cardiovascular disease in hypopituitarism. Lancet. 1990 Aug 4;336(8710):285–288. doi: 10.1016/0140-6736(90)91812-o. [DOI] [PubMed] [Google Scholar]
  24. Saccà L., Cittadini A., Fazio S. Growth hormone and the heart. Endocr Rev. 1994 Oct;15(5):555–573. doi: 10.1210/edrv-15-5-555. [DOI] [PubMed] [Google Scholar]
  25. Smith G. D., Greenwood R., Gunnell D., Sweetnam P., Yarnell J., Elwood P. Leg length, insulin resistance, and coronary heart disease risk: the Caerphilly Study. J Epidemiol Community Health. 2001 Dec;55(12):867–872. doi: 10.1136/jech.55.12.867. [DOI] [PMC free article] [PubMed] [Google Scholar]
  26. Strachan D. P. Ventilatory function, height, and mortality among lifelong non-smokers. J Epidemiol Community Health. 1992 Feb;46(1):66–70. doi: 10.1136/jech.46.1.66. [DOI] [PMC free article] [PubMed] [Google Scholar]
  27. Tanner J. M., Hayashi T., Preece M. A., Cameron N. Increase in length of leg relative to trunk in Japanese children and adults from 1957 to 1977: comparison with British and with Japanese Americans. Ann Hum Biol. 1982 Sep-Oct;9(5):411–423. doi: 10.1080/03014468200005951. [DOI] [PubMed] [Google Scholar]
  28. Upton M. N., Ferrell C., Bidwell C., McConnachie A., Goodfellow J., Davey Smith G., Watt G. C. Improving the quality of spirometry in an epidemiological study: The Renfrew-Paisley (Midspan) family study. Public Health. 2000 Sep;114(5):353–360. [PubMed] [Google Scholar]
  29. Upton M. N., McConnachie A., McSharry C., Hart C. L., Smith G. D., Gillis C. R., Watt G. C. Intergenerational 20 year trends in the prevalence of asthma and hay fever in adults: the Midspan family study surveys of parents and offspring. BMJ. 2000 Jul 8;321(7253):88–92. doi: 10.1136/bmj.321.7253.88. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. Wadsworth M. E. J., Hardy R. J., Paul A. A., Marshall S. F., Cole T. J. Leg and trunk length at 43 years in relation to childhood health, diet and family circumstances; evidence from the 1946 national birth cohort. Int J Epidemiol. 2002 Apr;31(2):383–390. [PubMed] [Google Scholar]
  31. Wannamethee S. G., Shaper A. G., Whincup P. H., Walker M. Adult height, stroke, and coronary heart disease. Am J Epidemiol. 1998 Dec 1;148(11):1069–1076. doi: 10.1093/oxfordjournals.aje.a009584. [DOI] [PubMed] [Google Scholar]
  32. Yarnell J. W., Limb E. S., Layzell J. M., Baker I. A. Height: a risk marker for ischaemic heart disease: prospective results from the Caerphilly and Speedwell Heart Disease Studies. Eur Heart J. 1992 Dec;13(12):1602–1605. doi: 10.1093/oxfordjournals.eurheartj.a060111. [DOI] [PubMed] [Google Scholar]

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