Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.
Departamento de Medicina Preventiva, Faculdade de Medicina FMUSP, Universidade de Sao Paulo, Sao Paulo, SP, Brazil.
Diabetes Metab Res Rev. 2019 Feb;35(2):e3095. doi: 10.1002/dmrr.3095. Epub 2018 Nov 20.
Positive association between resting heart rate (RHR) and risk of type 2 diabetes (T2D) has been documented in several studies. However, whether RHR is an independent predictor of T2D and its potential interaction with other risk factors of T2D remain unclear.
We conducted a prospective cohort study of 31 156 men from the Health Professionals Follow-up Study (1992-2012). Cox proportional hazard model was used to examine the association between RHR and T2D risk. We further examined whether this association is modified by known risk factors. Lastly, we conducted a meta-analysis of prospective cohort studies.
During 505 380 person-years of follow-up, we identified 2338 incident T2D cases. The multivariable-adjusted hazard ratio (HR) comparing the highest vs lowest categories of RHR was 1.69 (95% confidence interval [CI], 1.43-2.01). Increase in 10 bpm of RHR was associated with 19% increased risk of T2D in the fully adjusted model (HR, 1.19; 95% CI, 1.14-1.24). The HRs of T2D associated with RHR were stronger among those with normal weight or without hypertension (P interaction < 0.001). Moreover, RHR with other known risk factors cumulatively increased T2D risk. A meta-analysis consistently showed a positive association between RHR and T2D risk (the summary relative risk [RR] for highest vs lowest RHR, 1.53; 95% CI, 1.26-1.86, n = 12, the summary RR per 10 bpm increase, 1.17; 95% CI, 1.09-1.26, n = 13).
High RHR was independently associated with increased risk of T2D. Our findings suggest that RHR, with other known risk factors, could be a useful tool to predict T2D risk.
多项研究表明，静息心率（RHR）与 2 型糖尿病（T2D）风险呈正相关。然而，RHR 是否是 T2D 的独立预测因子及其与 T2D 其他危险因素的潜在相互作用尚不清楚。
我们对来自健康专业人员随访研究（1992-2012 年）的 31156 名男性进行了前瞻性队列研究。Cox 比例风险模型用于检查 RHR 与 T2D 风险之间的关联。我们进一步研究了这种关联是否受到已知危险因素的影响。最后，我们对前瞻性队列研究进行了荟萃分析。
在 505380 人年的随访期间，我们确定了 2338 例新发 T2D 病例。多变量调整后的危险比（HR）比较 RHR 最高与最低分类，HR 为 1.69（95%置信区间[CI]，1.43-2.01）。在完全调整模型中，RHR 增加 10bpm 与 T2D 风险增加 19%相关（HR，1.19；95%CI，1.14-1.24）。在体重正常或无高血压的人群中，RHR 与 T2D 相关的 HR 更强（P 交互<0.001）。此外，与其他已知危险因素一起的 RHR 累积增加了 T2D 风险。荟萃分析一致表明 RHR 与 T2D 风险之间存在正相关（最高与最低 RHR 之间的汇总相对风险[RR]，1.53；95%CI，1.26-1.86，n=12，每增加 10bpm 的汇总 RR，1.17；95%CI，1.09-1.26，n=13）。
高 RHR 与 T2D 风险增加独立相关。我们的研究结果表明，RHR 与其他已知危险因素一起，可以作为预测 T2D 风险的有用工具。
