Department of Occupational and Environmental Health and State Key Laboratory of Environmental Health for Incubating, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13 Hangkong Rd, Wuhan, 430030, Hubei, China.
Dongfeng Central Hospital, Dongfeng Motor Corporation and Hubei University of Medicine, Shiyan, Hubei, China.
Acta Diabetol. 2019 Sep;56(9):1037-1044. doi: 10.1007/s00592-019-01344-3. Epub 2019 Apr 15.
Observational studies indicated that resting heart rate (RHR) was associated with diabetes mellitus (DM) risk; however, it remains unclear whether the association between RHR and DM is causal. We aimed to examine whether there was causal association of RHR with DM risk.
A prospective study including 16,201 middle-aged and older Chinese (7031 males and 9170 females) derived from the Dongfeng-Tongji cohort was performed. Cox proportional hazard regression models were conducted to estimate the associations between RHR and incident DM risk. In 7481 participants, 65 single nucleotide polymorphisms related to RHR were genotyped. A genetic risk score (GRS) of RHR was calculated based on the RHR-associated variants. The causal associations of RHR with DM risk were investigated by Mendelian randomization analysis.
During a mean (SD) follow-up of 4.5 (0.5) years, 1110 diabetes were identified. Compared with the referential RHR group (≤ 60 beats per minute [bpm]), individuals with RHR > 80 bpm have a higher incident diabetes risk, with a hazard ratio of 1.40 (95% confidence interval [CI], 1.05-1.88). With per SD increase in the weighted genetic risk score, the resting heart rate increased by 0.71 bpm (95% CI 0.49-0.93). By using the GRS to estimate the unconfounded effect, we found that higher resting heart rate did not have a causal effect on diabetes risk (OR 1.00 [95% CI 0.95-1.05]).
The present study supported a positive but not a causal association of RHR with incident diabetes risk. More studies are needed to verify our findings.
观察性研究表明，静息心率（RHR）与糖尿病（DM）风险相关；然而，RHR 与 DM 之间的关联是否具有因果关系尚不清楚。我们旨在研究 RHR 与 DM 风险之间是否存在因果关系。
本前瞻性研究纳入了来自东风-同济队列的 16201 名中老年中国人（男性 7031 名，女性 9170 名）。采用 Cox 比例风险回归模型来估计 RHR 与新发 DM 风险之间的关联。在 7481 名参与者中，对 65 个与 RHR 相关的单核苷酸多态性进行了基因分型。根据与 RHR 相关的变异计算 RHR 的遗传风险评分（GRS）。采用孟德尔随机化分析来研究 RHR 与 DM 风险之间的因果关系。
在平均（标准差）随访 4.5（0.5）年后，共确诊 1110 例糖尿病。与参考 RHR 组（≤60 次/分钟）相比，RHR>80 次/分钟的个体发生糖尿病的风险更高，风险比为 1.40（95%置信区间 [CI]，1.05-1.88）。GRS 每增加一个标准差，静息心率增加 0.71 次/分钟（95% CI，0.49-0.93）。通过使用 GRS 来估计无偏倚效应，我们发现较高的静息心率对糖尿病风险没有因果影响（OR 1.00 [95% CI，0.95-1.05]）。
本研究支持 RHR 与新发 DM 风险之间存在正相关但无因果关系。需要更多的研究来验证我们的发现。
