Fig. 1Selection of the study population. ICD-10, International Classification of Diseases 10th; NHIS, National Health Insurance Service.
Fig. 2Hazard ratio for development of diabetes according to seven groups divided by standard deviations of height. SD, standard deviation.
Fig. 3Hazard ratio for development of diabetes according to subgroups of various diseases. Adjusted for age, sex, smoking, alcohol drinking, regular exercise, income status, hypertension, dyslipidemia, ischemic heart disease, cancer, chronic obstructive pulmonary disease, chronic kidney disease, and baseline body weight. HR, hazard ratio; CI, confidence interval.
Fig. 4Hazard ratio for development of diabetes according to 1-standard deviation increase of height in five groups divided by baseline body mass index.
Table 1Baseline characteristics of the participants according to age- and sex-dependent quintilesa of height
Characteristic |
Total |
Quintile 1 |
Quintile 2 |
Quintile 3 |
Quintile 4 |
Quintile 5 |
Number |
21,122,422 |
4,385,064 |
4,038,552 |
4,054,072 |
4,772,708 |
3,872,026 |
Age, yr |
46.6±14.1 |
48.6±14.4 |
48.2±14.6 |
46.0±14.5 |
45.5±13.1 |
44.6±13.7 |
Male sex |
10,577,336 (50.1) |
2,170,664 (49.5) |
1,927,488 (47.7) |
2,178,411 (53.7) |
2,364,968 (49.6) |
1,935,805 (50.0) |
Body weight, kg |
63.3±11.7 |
57.7±9.7 |
60.7±10.2 |
63.5±10.9 |
65.5±11.4 |
69.2±12.6 |
Height, cm |
163.6±9.2 |
155.8±7.5 |
160.2±7.1 |
164.1±7.2 |
166.6±7.5 |
171.6±8.0 |
Waist circumference, cm |
79.5 ±9.2 |
78.1±8.7 |
78.9±8.9 |
79.6±9.1 |
80.0±9.2 |
81.0±9.7 |
BMI, kg/m2
|
23.6±3.2 |
23.7±3.2 |
23.6±3.2 |
23.5±3.2 |
23.5±3.2 |
23.4±3.3 |
Proportion of participants with BMI ≥25 kg/m2
|
6,423,973 (30.4) |
1,399,744 (31.9) |
1,229,699 (30.5) |
1,246,410 (30.7) |
1,429,971 (30.0) |
1,118,149 (28.9) |
SBP, mm Hg |
121.5±14.9 |
122.2±15.5 |
121.8±15.3 |
121.5±14.9 |
121.1±14.6 |
121.1±14.4 |
DBP, mm Hg |
75.8±10.1 |
76.1±10.2 |
75.9±10.1 |
75.8±10.0 |
75.7±10.0 |
75.6±9.9 |
Fasting blood glucose, mg/dL |
92.7±11.4 |
92.8±11.6 |
92.8±11.4 |
92.7±11.4 |
92.7±11.2 |
92.6±11.2 |
Total cholesterol, mg/dL |
194.7±36.3 |
197.1±37.1 |
195.9±36.6 |
194.1±36.2 |
194.2±35.9 |
191.7±35.3 |
HDL-C, mg/dL |
55.9±16.5 |
56.0±16.8 |
56.0±16.7 |
55.7±16.6 |
55.9±16.3 |
55.9±16.3 |
LDL-C, mg/dL |
113.7±33.2 |
115.6±34.1 |
114.8±33.5 |
113.2±33.1 |
113.4±32.8 |
111.4±32.2 |
Triglyceride, mg/dL |
108.5 (35.9–327.6) |
111.2 (37.1–333.1) |
109.3 (36.5–327.4) |
109.1 (35.8–332.4) |
107.6 (35.6–325.0) |
105.2 (34.7–318.9) |
Proportion of participants with hypertension |
4,854,026 (23.0) |
1,135,269 (25.9) |
1,006,190 (24.9) |
925,330 (22.8) |
1,003,075 (21.0) |
784,162 (20.3) |
Proportion of participants with dyslipidemia |
3,534,940 (16.7) |
832,197 (19.0) |
730,843 (18.1) |
665,271 (16.4) |
754,696 (15.8) |
551,933 (14.3) |
Proportion of participants with IHD |
571,222 (2.7) |
131,836 (3.0) |
123,277 (3.1) |
111,092 (2.7) |
112,769 (2.4) |
92,248 (2.4) |
Proportion of participants with COPD |
1,155,182 (5.5) |
263,648 (6.0) |
238,106 (5.9) |
218,717 (5.4) |
239,122 (5.0) |
195,589 (5.1) |
Proportion of participants with history of cancer |
365,220 (1.7) |
71,352 (1.6) |
72,990 (1.8) |
67,255 (1.7) |
83,637 (1.8) |
69,986 (1.8) |
Proportion of participants with CKD |
1,017,703 (4.8) |
207,192 (4.7) |
208,944 (5.2) |
197,136 (4.9) |
216,212 (4.5) |
188,219 (4.9) |
Tertiles of income |
|
|
|
|
|
|
1 |
6,882,519 (32.6) |
1,625,109 (37.1) |
1,347,305 (33.4) |
1,289,776 (31.8) |
1,473,319 (30.87) |
1,147,010 (29.6) |
2 |
8,734,095 (41.4) |
1,813,727 (41.4) |
1,668,931 (41.3) |
1,712,645 (42.3) |
1,953,896 (40.9) |
1,584,896 (40.9) |
3 |
5,505,808 (26.1) |
946,228 (21.6) |
1,022,316 (25.3) |
1,051,651 (25.9) |
1,345,493 (28.2) |
1,140,120 (29.5) |
Smoking |
|
|
|
|
|
|
Never smoker |
13,152,963 (62.3) |
2,852,804 (65.1) |
2,605,932 (64.5) |
2,414,374 (59.6) |
2,937,103 (61.5) |
2,342,750 (60.5) |
Ex-smoker |
2,768,679 (13.1) |
515,802 (11.8) |
507,310 (12.6) |
577,399 (14.2) |
634,675 (13.3) |
533,493 (13.9) |
Current smoker |
5,200,780 (24.6) |
1,016,458 (23.2) |
925,310 (22.9) |
1,062,299 (26.2) |
1,200,930 (25.2) |
995,783 (25.7) |
Levels of drinking |
|
|
|
|
|
|
Not drinking alcohol |
11,164,853 (52.9) |
2,497,108 (57.0) |
2,238,531 (55.4) |
2,045,772 (50.5) |
2,456,010 (51.5) |
1,927,432 (49.8) |
Drinking less than 30 g/day |
8,593,386 (40.7) |
1,646,310 (37.5) |
1,565,403 (38.8) |
1,730,863 (42.7) |
1,991,976 (41.7) |
1,658,834 (42.8) |
Drinking equal to or more than 30 g/day |
1,364,183 (6.5) |
241,646 (5.5) |
234,618 (5.8) |
277,437 (6.8) |
324,722 (6.8) |
285,760 (7.4) |
Proportion of participants with regular physical activity |
10,549,886 (50.0) |
1,970,740 (44.9) |
1,946,087 (48.2) |
2,059,534 (50.8) |
2,498,300 (52.4) |
2,075,225 (53.6) |
Table 2Hazard ratio for development of diabetes according to age- and sex-dependent quintiles of baseline height
Quintiles of heighta |
No. |
No. of participants with event |
Incidence duration, person-years |
Incidence rate |
Model 1 |
Model 2 |
Model 3 |
Model 4 |
Model 5 |
Model 6 |
Total population |
|
|
|
|
|
|
|
|
|
|
1 |
4,385,064 |
150,352 |
23,333,538.73 |
6.4 |
1.073 (1.064–1.081) |
1.055 (1.046–1.063) |
2.108 (2.09–2.127) |
1.04 (1.031–1.048) |
1.345 (1.335–1.356) |
1.234 (1.224–1.244) |
2 |
4,038,552 |
131,661 |
21,488,387.42 |
6.1 |
1.029 (1.02–1.037) |
1.016 (1.007–1.024) |
1.67 (1.656–1.685) |
1.006 (0.998–1.015) |
1.213 (1.203–1.224) |
1.141 (1.132–1.151) |
3 |
4,054,072 |
120,743 |
21,556,903.78 |
5.6 |
1.021 (1.013–1.03) |
1.007 (0.998–1.015) |
1.459 (1.446–1.471) |
0.997 (0.989–1.006) |
1.147 (1.137–1.157) |
1.097 (1.088–1.107) |
4 |
4,772,708 |
130,162 |
25,300,006.39 |
5.1 |
1.026 (1.018–1.035) |
1.019 (1.011–1.028) |
1.279 (1.268–1.29) |
1.011 (1.003–1.02) |
1.106 (1.097–1.115) |
1.076 (1.067–1.085) |
5 |
3,872,026 |
100,907 |
20,340,528.52 |
5.0 |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
P for trend |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
|
|
|
|
Continuous HR per 1 SD |
|
|
|
|
0.989 (0.987–0.991) |
1.012 (1.009–1.015) |
0.855 (0.853–0.858) |
1.026 (1.023–1.029) |
0.966 (0.963–0.969) |
0.983 (0.98–0.986) |
Males |
|
|
|
|
|
|
|
|
|
|
1 |
2,170,664 |
78,080 |
11,576,632.29 |
6.7 |
1.048 (1.037–1.06) |
1.039 (1.028–1.051) |
2.234 (2.206–2.261) |
1.049 (1.037–1.06) |
1.442 (1.426–1.458) |
1.27 (1.256–1.285) |
2 |
1,927,488 |
67,984 |
10,300,140.31 |
6.6 |
1.018 (1.006–1.029) |
1.009 (0.998–1.02) |
1.749 (1.728–1.77) |
1.011 (0.999–1.022) |
1.276 (1.262–1.291) |
1.172 (1.159–1.185) |
3 |
2,178,411 |
70,442 |
11,648,480.25 |
6.0 |
1.022 (1.01–1.033) |
1.014 (1.002–1.025) |
1.524 (1.506–1.541) |
1.018 (1.007–1.029) |
1.205 (1.191–1.218) |
1.134 (1.122–1.147) |
4 |
2,364,968 |
69,600 |
12,628,162.87 |
5.5 |
1.016 (1.005–1.028) |
1.011 (1–1.023) |
1.299 (1.285–1.314) |
1.008 (0.997–1.019) |
1.124 (1.111–1.136) |
1.084 (1.072–1.096) |
5 |
1,935,805 |
55,989 |
10,254,702.21 |
5.5 |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
P for trend |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
|
|
|
|
Continuous HR per 1 SD |
|
|
|
|
0.987 (0.983–0.99) |
0.988 (0.985–0.992) |
0.733 (0.73–0.736) |
0.984 (0.98–0.987) |
0.873 (0.87–0.876) |
0.917 (0.914–0.921) |
Females |
|
|
|
|
|
|
|
|
|
|
1 |
2,214,400 |
72,272 |
11,756,906.44 |
6.1 |
1.096 (1.083–1.109) |
1.072 (1.059–1.085) |
1.972 (1.947–1.996) |
1.024 (1.012–1.037) |
1.257 (1.242–1.272) |
1.182 (1.168–1.196) |
2 |
2,111,064 |
63,677 |
11,188,247.12 |
5.7 |
1.041 (1.029–1.054) |
1.024 (1.011–1.036) |
1.577 (1.557–1.597) |
0.998 (0.986–1.01) |
1.152 (1.138–1.166) |
1.099 (1.085–1.112) |
3 |
1,875,661 |
50,301 |
9,908,423.54 |
5.1 |
1.011 (0.998–1.024) |
0.994 (0.981–1.007) |
1.38 (1.362–1.398) |
0.97 (0.958–0.983) |
1.089 (1.075–1.103) |
1.048 (1.035–1.061) |
4 |
2,407,740 |
60,562 |
12,671,843.52 |
4.8 |
1.035 (1.023–1.048) |
1.028 (1.015–1.041) |
1.246 (1.231–1.261) |
1.014 (1.002–1.026) |
1.087 (1.074–1.1) |
1.061 (1.048–1.074) |
5 |
1,936,221 |
44,918 |
10,085,826.31 |
4.5 |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
1 (reference) |
P for trend |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
<0.0001 |
|
|
|
|
Continuous HR per 1 SD |
|
|
|
|
1.043 (1.04–1.047) |
1.041 (1.038–1.045) |
0.855 (0.851–0.858) |
1.047 (1.044–1.051) |
0.988 (0.985–0.991) |
1.007 (1.003–1.01) |