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Do Short Thighs Boost Diabetes Risk? Do women with shorter upper legs run a greater risk of diabetes? A new study by researchers at John Hopkins University says that's a possibility. They presented their findingsat the American Heart Association's annual conference on cardiovascular disease epidemiology and prevention in Miami. Leg length, by itself, isn't the issue, the researchers emphasize. Rather, upper leg length is considered a marker for childhood growth, so factors affecting growth in childhood may contribute to the development of blood sugar problems later in life. "I don't want to make people with short legs worry too much," says Dr. Keiko Asao, a Hopkins researcher and lead author of the study. "Diabetes is a multi-factorial, complex disease." Leg length is but a single clue and doesn't predict with certainty that someone will develop diabetes, she adds. Asao and her colleagues evaluated government data, obtained from the U.S. Centers for Disease Control and Prevention's Third National Health and Nutrition Examination survey (NHANES III), looking at 8,738 black, white and Hispanic men and women, aged 40 to 74. Using self-reports of physician diagnoses, they divided the adults into three groups: those with Type 2 diabetes, those with impaired glucose tolerance (which can lead to diabetes), and those with normal glucose tolerance. They grouped the participants by race and gender, then compared them based on upper leg length — measuring from the inguinal crease (between the leg and abdomen) to the kneecap — and their glucose status. Glucose is the form of sugar in the blood, and is the main source of fuel for the body. Shorter upper leg lengths were more likely to be found in those who had glucose intolerance or diabetes. The average upper leg length for those with normal glucose tolerance was 40.2 centimeters, or 15.8 inches. For those with impaired glucose tolerance, the average was 39.1 centimeters, or 15.39 inches, and for those with diabetes, 38.3 centimeters, or 15 inches. After adjusting for other risk factors, however, the inverse association only remained significant for white women and Hispanic women. For each centimeter (2.54 inches) less of upper leg length, white women were 19 percent more likely to have diabetes and Hispanic women 13 percent more likely, compared to those with normal glucose status. Diabetes can increase your risk of both heart disease and stroke. About 17 million people in the United States have diabetes, according to the American Diabetes Association. Most of them have Type 2 diabetes, which occurs when the body fails to use insulin properly to break down glucose. This study is not the first to look at leg length and disease risk. At least two recent British studies have found a link between shorter total leg length and glucose problems, but the Asao study is thought to be the first to focus on upper leg length. "Our study confirms their findings," Asao says. Dr. Russell Luepker, a cardiologist and head of epidemiology at the University of Minnesota School of Public Health, says, "There is a body of literature that says tall people do better" in terms of certain disease risk. Of the Asao study, he says, "I think it's interesting." These days, with increasing numbers of Americans being diagnosed with diabetes, "any insight into what may be underlying it may be helpful," he says. On the other hand, Luepker adds, "Height is in no small part genetically controlled. I wouldn't lie awake nights worrying about this." If you have impaired glucose tolerance, you can take steps to reduce the risk of getting Type 2 diabetes. The American Diabetes Association suggests talking with your doctor about changing your diet, getting more exercise and losing weight if necessary. Resources Keiko Asao, M.D., M.P.H, researcher, Johns Hopkins University, Baltimore; Russell Luepker, M.D., M.S., cardiologist, head of epidemiology, School of Public Health, University of Minnesota, Minneapolis; March 7, 2003, presentation, American Heart Association, annual conference on cardiovascular disease epidemiology and prevention, Miami; American Diabetes Association; American Heart Association

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