title: Short stature is an independent risk marker for mortality and incident coronary heart disease only in women: a structural relationship?
abstract: OBJECTIVE
  We evaluated the associations of short stature with coronary heart disease (CHD) risk or overall mortality, which vary with sex and ethnicity/race.
  
  
  METHODS
  Such associations were studied prospectively at a mean 13.5-years' follow-up in a population-based sample of 3394 Turkish adults (mean age 44±11 years) using Cox proportional hazards models. Covariates of height were sought in sex-specific tertiles.
  
  
  RESULTS
  Height averaged 162.7±6.5 cm. Age-adjusted estimated marginal means for serum triglycerides, C-reactive protein and complement C3 in women (but not men) were significantly higher with decreasing height tertiles. In sex- and age-adjusted models, height was associated in men with neither incident CHD, nor death. In women, 1-SD increment (6.5 cm) in height only tended to marginal inverse association with CHD, but predicted significantly all-cause death (HR 0.83, 95% CI 0.59-0.98); HR attenuated only marginally after further adjustment for family income bracket, smoking status, alcohol usage, systolic blood pressure, serum high-density lipoprotein (HDL)- and non HDL-cholesterol. A threshold below 160 cm of female height doubled the adjusted risk of death compared to taller women.
  
  
  CONCLUSIONS
  In contrast to men, short stature in Turkish women tends to be an independent risk marker for CHD, and height below 160 cm is a strong marker of death. Gender-specific early-life influences enhancing pro-inflammatory state may affect death and future CHD.
authors.affiliation: Department of Cardiology, Cerrahpaşa Faculty of Medicine, Turkish Society of Cardiology, Istanbul, Turkey. alt_onat@yahoo.com.tr
authors.forename: Altan
authors.initials: A
authors.lastname: Onat
authors.forename: Ender
authors.initials: E
authors.lastname: Ornek
authors.forename: Günay
authors.initials: G
authors.lastname: Can
authors.forename: Gökhan
authors.initials: G
authors.lastname: Ciçek
authors.forename: Sani
authors.initials: S
authors.lastname: Murat
mesh_terms: D000328:Adult; D001827:Body Height; D015331:Cohort Studies; D003327:Coronary Disease / Q000453:epidemiology / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008875:Middle Aged; D009026:Mortality; D009369:Neoplasms / Q000401:mortality; D012044:Regression Analysis; D012307:Risk Factors; D012737:Sex Factors; D014421:Turkey / Q000453:epidemiology; D055815:Young Adult