Department of Endocrinology, Zhongda Hospital, Institute of Diabetes, School of Medicine, Southeast University, Nanjing, P. R. China.
Division of Sports and Rehabilitation Medicine, Ulm University Medical Centre, Ulm, Germany.
Diabet Med. 2017 Dec;34(12):1676-1683. doi: 10.1111/dme.13517. Epub 2017 Oct 17.
To assess the association between attenuated heart rate recovery, a non-invasive measure of autonomic dysfunction, and risk of diabetes in the general population.
Databases were searched for cohort studies up to May 2017 that reported the association of heart rate recovery with the risk of diabetes. The overall hazard ratios for slowest vs fastest heart rate recovery (the referent) and for every 10-beats-per-min decrement in heart rate recovery were calculated using a random effects meta-analysis model.
Four cohort studies with 430 incident cases of diabetes among a total of 9113 participants during a mean follow-up period of 8.1 years were included. Results showed that the slowest heart rate recovery was associated with a higher risk of diabetes (hazard ratio 1.66, 95% CI 1.16 to 2.38) vs the fastest heart rate recovery, and the hazard ratio of risk of diabetes for every 10-beats-per-min decrement in heart rate recovery was 1.29 (95% CI 1.13 to 1.48). No significant interaction effect was observed regarding the efficacy of 1-min and 2-min heart rate recovery in predicting risk of diabetes (both P >0.60); however, a linear dose-response relationship existed for overall studies and for studies using 1-min heart rate recovery as the exposure (both P >0.60 for non-linearity).
Attenuated heart rate recovery is associated with an increased risk of diabetes in a dose-dependent manner, and measurement of heart rate recovery is worth recommending as part of diabetes risk assessment in clinical routines.
评估心率恢复减弱（一种自主神经功能障碍的非侵入性测量方法）与普通人群中糖尿病风险之间的关系。
截至 2017 年 5 月，检索数据库以寻找报告心率恢复与糖尿病风险之间关联的队列研究。使用随机效应荟萃分析模型计算最慢与最快心率恢复（参考）以及心率恢复每降低 10 次/分钟的总体危险比。
纳入了四项队列研究，共纳入了 9113 名参与者，平均随访时间为 8.1 年，其中有 430 例新发糖尿病病例。结果表明，最慢的心率恢复与更高的糖尿病风险相关（危险比 1.66，95%置信区间 1.16 至 2.38），而心率恢复每降低 10 次/分钟，糖尿病风险的危险比为 1.29（95%置信区间 1.13 至 1.48）。关于 1 分钟和 2 分钟心率恢复预测糖尿病风险的效果，未观察到显著的交互效应（两者 P >0.60）；然而，对于整体研究和将 1 分钟心率恢复作为暴露的研究，存在线性剂量-反应关系（两者 P >0.60 均非线性）。
心率恢复减弱与糖尿病风险呈剂量依赖性增加相关，测量心率恢复值得推荐作为临床常规中糖尿病风险评估的一部分。
