Browsing by Author "Theilmann, Michaela"

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    Analysis of Attained Height and Diabetes Among 554,122 Adults Across 25 Low- and Middle Income Countries
    (2020-10) Teufel, Felix; Geldsetzer, Pascal; Manne-Goehler, Jennifer; Karlsson, Omar; Koncz, Viola; Deckert, Andreas; Theilmann, Michaela; Marcus, Maja-Emilia; Ebert, Cara; A. Seiglie, Jacqueline; Agoudavi, Kokou; Andall-Brereton, Glennis; Gathecha, Gladwell; Gurung, Mongal S; Guwatudde, David; Houehanou, Corine; Hwalla, Nahla; Kagaruki, Gibson B.; Karki, Khem B.; Labadarios, Demetre; Martins, Joao S; Msaidie, Mohamed; Norov, Bolormaa; Sibai, Abla M.; Sturua, Lela; Tsabedze, Lindiwe; Wesseh, Chea S.; Davies, Justine; Atun, Rifat; Vollmer, Sebastian; Subramanian, S.V.; Barnighausen, Till; Jaacks, Lindsay M.; Barnighausen, JTill; Jaacks, Lindsay M.; De Neve, Jan-Walter
    Objective: The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income countries (LMICs), but the factors driving this rapid increase are not well understood. Adult height, in particular shorter height, has been suggested to contribute to the pathophysiology and epidemiology of diabetes and may inform how adverse environmental conditions in early life affect diabetes risk. We therefore systematically analyzed the association of adult height and diabetes across LMICs, where such conditions are prominent. Research design and methods: We pooled individual-level data from nationally representative surveys in LMICs that included anthropometric measurements and diabetes biomarkers. We calculated odds ratios (ORs) for the relationship between attained adult height and diabetes using multilevel mixed-effects logistic regression models. We estimated ORs for the pooled sample, major world regions, and individual countries, in addition to stratifying all analyses by sex. We examined heterogeneity by individual-level characteristics. Results: Our sample included 554,122 individuals across 25 population-based surveys. Average height was 161.7 cm (95% CI 161.2-162.3), and the crude prevalence of diabetes was 7.5% (95% CI 6.9-8.2). We found no relationship between adult height and diabetes across LMICs globally or in most world regions. When stratifying our sample by country and sex, we found an inverse association between adult height and diabetes in 5% of analyses (2 out of 50). Results were robust to alternative model specifications. Conclusions: Adult height is not associated with diabetes across LMICs. Environmental factors in early life reflected in attained adult height likely differ from those predisposing individuals for diabetes.
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    Analysis of Attained Height and Diabetes Among 554,122 Adults Across 25 Low- and Middle Income Countries
    (Diabetes Care, 2020) Teufel, Felix; Geldsetzer, Pascal; Manne-Goehler, Jennifer; Karlsson, Omar; Koncz, Viola; Deckert, Andreas; Theilmann, Michaela; Marcus, Maja-Emilia; Ebert, Cara; Seiglie, Jacqueline A.; Agoudavi, Kokou; Andall-Brereton, Glennis; Gathecha, Gladwell; Gurung, Mongal S.; Guwatudde, David; Houehanou, Corine; Hwalla, Nahla; Kagaruki, Gibson B.; Karki, Khem B.; Labadarios, Demetre; Martins, Joao S.; Msaidie, Mohamed; Norov, Bolormaa; Sibai, Abla M.; Sturua, Lela; Tsabedze, Lindiwe; Wesseh, Chea S.; Davies, Justine; Atun, Rifat; Vollmer, Sebastian; Subramanian, S.V.; Barnighausen, Till; Jaacks, Lindsay M.; Neve, Jan-Walter De
    The prevalence of type 2 diabetes is rising rapidly in low-income and middle-income countries (LMICs), but the factors driving this rapid increase are notwell understood. Adult height, in particular shorter height, has been suggested to contribute to the pathophysiology and epidemiology of diabetes and may inform how adverse environmental conditions in early life affect diabetes risk. We therefore systematically analyzed the association of adult height and diabetes across LMICs, where such conditions are prominent. RESEARCH DESIGN AND METHODS We pooled individual-level data from nationally representative surveys in LMICs that included anthropometric measurements and diabetes biomarkers. We calculated odds ratios (ORs) for the relationship between attained adult height and diabetes using multilevel mixed-effects logistic regression models. We estimated ORs for the pooled sample,major world regions, and individual countries, in addition to stratifying all analyses by sex. We examined heterogeneity by individual-level characteristics. RESULTS Our sample included 554,122 individuals across 25 population-based surveys. Average height was 161.7 cm (95% CI 161.2–162.3), and the crude prevalence of diabetes was 7.5% (95% CI 6.9–8.2). We found no relationship between adult height and diabetes across LMICs globally or in most world regions. When stratifying our sample by country and sex, we found an inverse association between adult height and diabetes in 5% of analyses (2 out of 50). Results were robust to alternative model specifications. CONCLUSIONS Adult height is not associated with diabetes across LMICs. Environmental factors in early life reflected in attained adult height likely differ from those predisposing individuals for diabetes.
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    Diabetes Prevalence and Its Relationship With Education, Wealth, and BMI in 29 Low- and Middle-Income Countries
    (Diabetes Care, 2020) Seiglie, Jacqueline A.; Marcus, Maja-Emilia; Ebert, Cara; Prodromidis, Nikolaos; Geldsetzer, Pascal; Theilmann, Michaela; Agoudavi, Kokou; Andall-Brereton, Glennis; Aryal, Krishna K.; Bicaba, Brice Wilfried; Bovet, Pascal; Brian, Garry; Dorobantu, Maria; Gathecha, Gladwell; Singh Gurung, Mongal; Guwatudde, David; Msaidie, Mohamed; Houehanou, Corine; Houinato, Dismand; Jorgensen, Jutta Mari Adelin; Kagaruki, Gibson B.; Karki, Khem B.; Labadarios, Demetre; Martins, Joao S.; Mayige, Mary T.; Wong-McClure, Roy; Kibachio Mwangi, Joseph; Mwalim, Omar; Norov, Bolormaa; Quesnel-Crooks, Sarah; Silver, Bahendeka K.; Sturua, Lela; Tsabedze, Lindiwe; Stanford Wesseh, Chea; Stokes, Andrew; Atun, Rifat; Davies, Justine I.; Vollmer, Sebastian; Barnighausen, Till W.; Jaacks, Lindsay M.; Meigs, James B.; Wexler, Deborah J.; Manne-Goehler, Jennifer
    Diabetes is a rapidly growing health problem in low- and middle-income countries (LMICs), but empirical data on its prevalence and relationship to socioeconomic status are scarce. We estimated diabetes prevalence and the subset with undiagnosed diabetes in 29 LMICs and evaluated the relationship of education, household wealth, and BMI with diabetes risk. RESEARCH DESIGN AND METHODS We pooled individual-level data from 29 nationally representative surveys conducted between 2008 and 2016, totaling 588,574 participants aged ‡25 years. Diabetes prevalence and the subset with undiagnosed diabetes was calculated overall and by country, World Bank income group (WBIG), and geographic region. Multivariable Poisson regression models were used to estimate relative risk (RR). RESULTS Overall, prevalence of diabetes in 29 LMICs was 7.5% (95% CI 7.1–8.0) and of undiagnosed diabetes 4.9% (4.6–5.3). Diabetes prevalence increased with increasing WBIG: countries with low-income economies (LICs) 6.7% (5.5–8.1), lowermiddle-income economies (LMIs) 7.1% (6.6–7.6), and upper-middle-income economies (UMIs) 8.2% (7.5–9.0). Compared with no formal education, greater educational attainment was associated with an increased risk of diabetes across WBIGs, after adjusting for BMI (LICs RR 1.47 [95% CI 1.22–1.78], LMIs 1.14 [1.06– 1.23], and UMIs 1.28 [1.02–1.61]). CONCLUSIONS Among 29 LMICs, diabetes prevalence was substantial and increased with increasing WBIG. In contrast to the association seen in high-income countries, diabetes risk was highest among those with greater educational attainment, independent of BMI. LMICs included in this analysis may be at an advanced stage in the nutrition transition but with no reversal in the socioeconomic gradient of diabetes risk.