Wang Liang, Cui Liufu, Wang Yanxue, Vaidya Anand, Chen Shuohua, Zhang Caifeng, Zhu Ying, Li Dongqing, Hu Frank B, Wu Shouling, Gao Xiang
Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA, Department of Internal Medicine, Kailuan Hospital Affiliated to Hebei United University, Tangshan, China, Division of Endocrinology, Diabetes, and Hypertension (A.V.), Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA, Department of Health Care Center, Kailuan Hospital Affiliated to Hebei United University, Tangshan, China, Graduate School, Hebei United University, Tangshan, China, Department of Nutrition, Harvard University School of Public Health, Boston, MA, USA and Department of Nutritional Science, Pennsylvania State University, University Park, PA, USA.
Department of Biostatistics and Epidemiology, East Tennessee State University, Johnson City, TN, USA, Department of Internal Medicine, Kailuan Hospital Affiliated to Hebei United University, Tangshan, China, Division of Endocrinology, Diabetes, and Hypertension (A.V.), Brigham and Women's Hospital & Harvard Medical School, Boston, MA, USA, Department of Health Care Center, Kailuan Hospital Affiliated to Hebei United University, Tangshan, China, Graduate School, Hebei United University, Tangshan, China, Department of Nutrition, Harvard University School of Public Health, Boston, MA, USA and Department of Nutritional Science, Pennsylvania State University, University Park, PA, USA
Int J Epidemiol. 2015 Apr;44(2):689-99. doi: 10.1093/ije/dyv079. Epub 2015 May 22.
To investigate the association between resting heart rate and the risk of developing impaired fasting glucose (IFG), diabetes and conversion from IFG to diabetes.
The prospective analysis included 73,357 participants of the Kailuan cohort (57,719 men and 15,638 women). Resting heart rate was measured via electrocardiogram in 2006. Incident diabetes was defined as either the fasting blood glucose (FBG) ≥ 7.0 mmol/l or new active use of diabetes medications during the 4-year follow-up period. IFG was defined as a FBG between 5.6 and 6.9 mmol/l. A meta-analysis including seven published prospective studies focused on heart rate and diabetes risk, and our current study was then conducted using random-effects models.
During 4 years of follow-up, 17,463 incident IFG cases and 4,649 incident diabetes cases were identified. The corresponding adjusted hazard ratios (HRs) for each 10 beats/min increase in heart rate were 1.23 [95% confidence interval (CI): 1.19, 1.27] for incident diabetes, 1.11 (95% CI: 1.09, 1.13) for incident IFG and 1.13 (95% CI: 1.08, 1.17) for IFG to diabetes conversion. The risks of incident IFG and diabetes were significantly higher among participants aged < 50 years than those aged ≥ 50 years (P-interaction < 0.02 for both). A meta-analysis confirmed the positive association between resting heart rate and diabetes risk (pooled HR for the highest vs lowest heart rate quintile = 1.59, 95% CI:1.27, 2.00; n = 8).
Faster resting heart rate is associated with higher risk of developing IFG and diabetes, suggesting that heart rate could be used to identify individuals with a higher future risk of diabetes.
探讨静息心率与空腹血糖受损(IFG)、糖尿病发生风险以及IFG向糖尿病转化之间的关联。
前瞻性分析纳入了开滦队列的73357名参与者(57719名男性和15638名女性)。2006年通过心电图测量静息心率。在4年随访期内,将空腹血糖(FBG)≥7.0 mmol/l或新开始积极使用糖尿病药物定义为新发糖尿病。IFG定义为FBG在5.6至6.9 mmol/l之间。一项纳入七项已发表的关于心率与糖尿病风险的前瞻性研究的荟萃分析随后采用随机效应模型进行。
在4年随访期间,共识别出17463例新发IFG病例和4649例新发糖尿病病例。心率每增加10次/分钟,新发糖尿病的相应调整后风险比(HR)为1.23 [95%置信区间(CI):1.19,1.27],新发IFG为1.11(95% CI:1.09,1.13),IFG向糖尿病转化为1.13(95% CI:1.08,1.17)。年龄<50岁的参与者发生新发IFG和糖尿病的风险显著高于年龄≥50岁的参与者(两者的P交互作用均<0.02)。荟萃分析证实静息心率与糖尿病风险之间存在正相关(最高与最低心率五分位数的合并HR = 1.59,95% CI:1.27,2.00;n = 8)。
静息心率较快与发生IFG和糖尿病的风险较高相关,提示心率可用于识别未来患糖尿病风险较高的个体。