Height Identified as a Risk Factor for Several Common Health Conditions

Associations of selected traits with genetically predicted height after stratifying by coronary heart disease status.

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People with greater height show a greater risk of peripheral neuropathy, bone and dermatological infections, but a lower risk of heart disease, high blood pressure and hypercholesterolemia.

A large genetic study conducted by the US Department of Veterans Affairs’ Million Veteran Program (MVP) found that a person’s height can affect their risk for several common health conditions in adulthood. Significant findings include a link between height and a lower risk of coronary heart disease, and a link between height and an increased risk of peripheral neuropathy and circulatory disorders.

Dr. Sridharan Raghavan of the VA Eastern Colorado Health Care System, who led the study, described the results as "a significant contribution to understanding how height relates to clinical conditions from an epidemiological perspective." More research is needed before the findings can lead to changes in clinical care, Raghavan says. However, the results highlight the association between height and clinical conditions that affect the lives of veterans, he explains.

“The broad scope of our study produced a catalog of clinical conditions associated with genetically predicted height. In other words, these are conditions for which height could be a risk factor or protective factor, independent of other environmental conditions that could also affect height and health.

Height is not usually considered a risk factor for disease. But previous research has shown correlations between a person’s height and their likelihood of experiencing a number of health conditions. What is not well understood is whether this correlation has a biological basis or is due to other factors.

The height of an adult person is due in part to the genes inherited from their parents. But environmental factors such as nutrition, socioeconomic status, and demographics (for example, age or gender) also play a role in determining final height. This is why it can be difficult to determine a connection between height and disease risk.

To explore this connection, VA researchers analyzed genetic and medical data from more than 280,000 veterans enrolled in MVP. They compared this data to a list of 3,290 genetic variants associated with height from a recent genomic analysis.

They found that risk levels for 127 different medical conditions can be linked to genetically predicted height in white patients. Because black patients are less represented in genetic studies, less data is available on this population. But in this analysis, the medical traits associated with height were generally consistent between white and black patients. About 21% of the Veterans in the MVP study were black.

At least 48 of the links identified in white patients also held true for black patients. All of the most significant findings—height is linked to a lower risk of coronary heart disease and a higher risk of atrial fibrillation, peripheral neuropathy, and circulatory disorders—were found in white and black participants, according to the researchers.

Overall, genetically predicted height was linked to both lower and higher disease risk, depending on the condition. Being tall appears to protect people from cardiovascular problems. The study linked being taller with a lower risk of high blood pressure, high cholesterol, and coronary heart disease . But the risk of atrial fibrillation was higher in taller participants. These connections have been demonstrated before in previous research.

On the contrary, being tall may increase the risk of most of the non-cardiovascular conditions considered in the study. This was especially true for peripheral neuropathy and circulatory disorders involving the veins.

Peripheral neuropathy is damage to the nerves outside the brain and spinal cord, particularly in the extremities. Previous studies have linked height to slower nerve conduction and nerve problems. The MVP study confirms this link using genetic tools to suggest an increased risk of nerve problems in tall people. The researchers linked genetically predicted height to conditions such as erectile dysfunction and urinary retention, both of which are associated with neuropathy.

Raghavan called the findings on peripheral neuropathy "particularly interesting." He discussed this finding with clinical colleagues who often see patients with peripheral neuropathy. Raghavan’s colleagues confirmed that tall people often show the worst neuropathy, but they were unaware of other studies describing this association.

Conditions such as cellulitis, skin abscesses, chronic leg ulcers and osteomyelitis were also linked to height. Being tall also appears to increase the risk of circulatory conditions such as varicose veins and thrombosis - blood clots in the veins.

Height may also increase the risk of other conditions unrelated to neuropathy or circulation. Toe and foot deformities, conditions that could be caused by the increased weight bearing of tall people, were more common in people whose genetics predicted they would be tall.

The study also showed that height increases the risk of asthma and non-specific nervous disorders in women, but not in men.

Taken together, the results suggest that height may be an unrecognized but biologically important and unalterable risk factor for several common conditions, particularly those affecting the extremities, according to the researchers. It may be helpful to consider a person’s height when assessing disease risk and surveillance, they say.

More work is needed before this research can be translated into clinical care, Raghavan says. “I think our findings are a first step toward disease risk assessment in that we identify conditions for which height might actually be a risk factor,” he explains. “Future work will need to evaluate whether incorporating height into disease risk assessments can inform strategies to modify other risk factors for specific conditions.”

Future work will also focus on possible mechanisms linking height to these health conditions.

In conclusion , we found genetic evidence supporting associations between height and 127 EHR traits in non-Hispanic White individuals, 48 ​​of which exhibited nominally significant associations with genetically predicted height in non-Hispanic Black individuals. While much of the work has focused on inverse associations of genetically predicted height with CHD and its risk factors, this MR-PheWAS analysis suggests that taller height is associated with a higher prevalence of many other clinically-related traits. relevant.

In particular, we describe associations of genetically predicted height with conditions that may result from the effects of increased weight bearing, such as acquired deformities of the toes and feet, and with traits of peripheral neuropathy and venous circulatory disorders, conditions for which epidemiological and physiological studies have previously suggested a height dependence.

Finally, we highlight the potential importance of height as a risk factor that may impact care for common chronic diseases by demonstrating interactions of height with diabetes mellitus in skin and bone infections.

Taken together, we conclude that height may be an underrecognized non-modifiable risk factor for a wide variety of common clinical conditions that may have implications for risk stratification and disease surveillance.