Department of Clinical and Experimental Medicine, University of Sassari, Sassari, Italy.
Sardinia Longevity Blue Zone Observatory, Ogliastra, Italy.
PLoS One. 2018 Apr 20;13(4):e0190888. doi: 10.1371/journal.pone.0190888. eCollection 2018.
The relationship between body height and the risk of non‒communicable diseases such as cardiovascular disease and cancer has been the subject of much debate in the epidemiological literature. Concerns have recently arisen over spurious associations due to confounding factors like birth cohort, especially in the context of epidemiological transition. The population of Sardinia represents an interesting case study, as the average physical stature of inhabitants was the lowest recorded in Europe until a few decades ago. In this population we tested whether height is an independent risk factor for cardiovascular disease and cancer. We analysed the stature of 10,427 patients undergoing endoscopy for any reason, for whom a detailed clinical history of cardiovascular disease and/or malignancies had been documented. Poisson regression modelling was used to test the association between stature and disease risk. When patients were subdivided according to sex and height tertiles, the risk of cardiovascular disease proved significantly greater for subjects in the lowest tertile irrespective of sex (men: 1.87; 95%CI 1.41‒2.47; women: 1.23; 95%CI 0.92‒1.66) and smaller for those in the highest tertile (men: 0.51; 95%CI 0.35‒0.75; women: 0.41; 95%CI 0.27‒0.61). However, after adjusting the risk for birth cohort and established risk factors, it mostly resulted in non-significant values, although the overall trend persisted. Similar results were obtained for all-cancer risk (relative risk for men and women in the lowest tertile: 1.44; 95%CI 1.09-1.90 and 1.17; 95%CI 0.93-1.48, in the highest tertile: 0.51; 95%CI 0.36-0.72 and 0.62; 95%CI 0.47-0.81, respectively) as well as for some of the most common types of cancer. We concluded that the risk of developing cardiovascular disease and malignancies does not vary significantly with stature in the Sardinian population, after adjusting for birth cohort and more obvious risk factors.
身高与心血管疾病和癌症等非传染性疾病风险之间的关系一直是流行病学文献中的热门话题。由于出生队列等混杂因素的影响，最近人们对虚假关联产生了担忧，尤其是在流行病学转变的背景下。撒丁岛的人口代表了一个有趣的案例研究，因为直到几十年前，那里居民的平均身高仍是欧洲记录中最低的。在这个人群中，我们检验了身高是否是心血管疾病和癌症的独立风险因素。我们分析了因任何原因接受内镜检查的 10427 名患者的身高，这些患者的心血管疾病和/或恶性肿瘤的详细临床病史都有记录。我们使用泊松回归模型来检验身高与疾病风险之间的关联。当根据性别和身高三分位数对患者进行细分时，无论性别如何，最矮三分位的患者心血管疾病风险显著更高（男性：1.87；95%CI 1.41-2.47；女性：1.23；95%CI 0.92-1.66），而最高三分位的患者风险较小（男性：0.51；95%CI 0.35-0.75；女性：0.41；95%CI 0.27-0.61）。然而，在调整出生队列和已确定的风险因素后，大多数结果都变得不显著，尽管总体趋势仍然存在。对于所有癌症风险，也得到了类似的结果（男性和女性最低三分位的相对风险：1.44；95%CI 1.09-1.90 和 1.17；95%CI 0.93-1.48，最高三分位：0.51；95%CI 0.36-0.72 和 0.62；95%CI 0.47-0.81），以及一些最常见的癌症类型。我们得出结论，在调整出生队列和更明显的风险因素后，撒丁岛人群的心血管疾病和恶性肿瘤的发病风险与身高没有显著差异。
