Adult height has directionally opposing relationships with risk of death from several different major causes of chronic diseases.

IMPORTANCE The value of measuring levels of glycated hemoglobin (HbA1c) for the prediction of first cardiovascular events is uncertain. OBJECTIVE To determine whether adding information on HbA1c values to conventional cardiovascular risk factors is associated with improvement in prediction of cardiovascular disease (CVD) risk. DESIGN, SETTING, AND PARTICIPANTS Analysis of individual-participant data available from 73 prospective studies involving 294 998 participants without a known history of diabetes mellitus or CVD at the baseline assessment. MAIN OUTCOMES AND MEASURES Measures of risk discrimination for CVD outcomes (eg, C-index) and reclassification (eg, net reclassification improvement) of participants across predicted 10-year risk categories of low (<5%), intermediate (5%to <7.5%), and high (≥7.5%) risk. RESULTS During a median follow-up of 9.9 (interquartile range, 7.6-13.2) years, 20 840 incident fatal and nonfatal CVD outcomes (13 237 coronary heart disease and 7603 stroke outcomes) were recorded. In analyses adjusted for several conventional cardiovascular risk factors, there was an approximately J-shaped association between HbA1c values and CVD risk. The association between HbA1c values and CVD risk changed only slightly after adjustment for total cholesterol and triglyceride concentrations or estimated glomerular filtration rate, but this association attenuated somewhat after adjustment for concentrations of high-density lipoprotein cholesterol and C-reactive protein. The C-index for a CVD risk prediction model containing conventional cardiovascular risk factors alone was 0.7434 (95% CI, 0.7350 to 0.7517). The addition of information on HbA1c was associated with a C-index change of 0.0018 (0.0003 to 0.0033) and a net reclassification improvement of 0.42 (−0.63 to 1.48) for the categories of predicted 10-year CVD risk. The improvement provided by HbA1c assessment in prediction of CVD risk was equal to or better than estimated improvements for measurement of fasting, random, or postload plasma glucose levels. CONCLUSIONS AND RELEVANCE In a study of individuals without known CVD or diabetes, additional assessment of HbA1c values in the context of CVD risk assessment provided little incremental benefit for prediction of CVD risk.

Aim-To examine the influence of socioeconomic status on growth pattern in height from age 7 to 23 years. Methods-Prospective cohort study. A total of 10 200 white singleton born children from the 1958 British birth cohort (National Child Development Study) were analysed. Results-DiVerences in height by birth weight persisted throughout the follow up period. However, the mean diVerences in height between low birth weight infants (<2500 g) and adequate birth weight infants (>2500 g) were less notable in social classes I and II than in the lower social classes. The catching up of growth in height of low birth weight infants was also more pronounced in social classes I and II than in other social classes. That is, the mean height deficits of low birth weight infants were decreased from 2.9 cm at age 7, to 1.6 cm at age 16, and 2.5 cm at age 23; the significant diVerence disappeared after age 16 in social classes I and II. Although such improving tendency was more pronounced among the preterm born infants, a similar growth pattern was observed among the term infants. Such improvement was not observed in the other social classes. Conclusion-The growth retardation in height by birth weight can be overcome by improved social conditions and proper health care from childhood to adulthood. (Arch Dis Child 2001;84:218-221)

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