Division of Population Health Research, Department of Precision Medicine, Korea National Institute of Health, Cheongju, Korea.
Korea National Institute of Health, Cheongju, Korea.
Diabetes Metab J. 2024 Jul;48(4):752-762. doi: 10.4093/dmj.2023.0305. Epub 2024 Feb 2.
To investigate the association between the time-varying resting heart rate (RHR) and change in RHR (∆RHR) over time and the risk of diabetes mellitus (DM) by sex.
We assessed 8,392 participants without DM or atrial fibrillation/flutter from the Korean Genome and Epidemiology Study, a community-based prospective cohort study that was initiated in 2001 to 2002. The participants were followed up until December 31, 2018. Updating RHR with biennial in-study re-examinations, the time-varying ∆RHR was calculated by assessing the ∆RHR at the next follow-up visit.
Over a median follow-up of 12.3 years, 1,345 participants (16.2%) had DM. As compared with RHR of 60 to 69 bpm, for RHR of ≥80 bpm, the incidence of DM was significantly increased for both male and female. A drop of ≥5 bpm in ∆RHR when compared with the stable ∆RHR group (-5< ∆RHR <5 bpm) was associated significantly with lower risk of DM in both male and female. However, an increase of ≥5 bpm in ∆RHR was significantly associated with higher risk of DM only in female, not in male (hazard ratio for male, 1.057 [95% confidence interval, 0.869 to 1.285]; and for female, 1.218 [95% confidence interval, 1.008 to 1.471]).
In this community-based longitudinal cohort study, a reduction in ∆RHR was associated with a decreased risk of DM, while an increase in ∆RHR was associated with an increased risk of DM only in female.
本研究旨在探讨心率变异性(RHR)随时间的变化和 RHR 的变化(∆RHR)与糖尿病(DM)风险之间的关联,并按性别进行分析。
我们评估了来自韩国基因组和流行病学研究(Korean Genome and Epidemiology Study)的 8392 名无 DM 或心房颤动/扑动的参与者。这是一项基于社区的前瞻性队列研究,于 2001 年至 2002 年启动。参与者的随访时间截至 2018 年 12 月 31 日。通过每两年进行一次的研究内复查来更新 RHR,通过评估下一次随访时的 ∆RHR 来计算时间变化的 ∆RHR。
在中位随访 12.3 年期间,1345 名参与者(16.2%)患有 DM。与 60 至 69 bpm 的 RHR 相比,男性和女性的 RHR 均≥80 bpm 时,DM 的发生率显著增加。与稳定的 ∆RHR 组(-5<∆RHR <5 bpm)相比,当 ∆RHR 下降≥5 bpm 时,男性和女性患 DM 的风险显著降低。然而,仅在女性中,∆RHR 增加≥5 bpm 与 DM 风险升高显著相关,而在男性中则无此关联(男性的危险比为 1.057[95%置信区间,0.869 至 1.285];女性的危险比为 1.218[95%置信区间,1.008 至 1.471])。
在这项基于社区的纵向队列研究中,∆RHR 降低与 DM 风险降低相关,而 ∆RHR 增加仅与女性 DM 风险升高相关。