Association of heart rate and diabetes among 0.5 million adults in the China Kadoorie biobank: Results from observational and Mendelian randomization analyses

Wenxiu Wang, Jingjia Wang, Jun Lv, Canqing Yu, Chunli Shao, Yida Tang, Yu Guo, Zheng Bian, Huaidong Du, Ling Yang, Iona Y Millwood, Robin G Walters, Yiping Chen, Liang Chang, Lei Fan, Junshi Chen, Zhengming Chen, Tao Huang, Liming Li, China Kadoorie Biobank (CKB) collaborative group

    Research output: Contribution to journalArticlepeer-review

    4 Citations (Scopus)

    Abstract

    BACKGROUND AND AIMS: Observational studies have associated resting heart rate with incident diabetes. Whether the associations are causal remains unclear. We aimed to examine the shape and strength of the associations and assessed the causal relevance of such associations in Chinese adults.

    METHODS AND RESULTS: The China Kadoorie Biobank enrolled 512,891 adults in China. Cox proportional hazard regression models was conducted to estimate hazard ratios (HRs) for the associations of resting heart rate with type 2 diabetes and total diabetes. Among 92,724 participants, 36 single-nucleotide polymorphisms (SNPs) related to resting heart rate were used to construct genetic risk score. We used Mendelian randomization analyses to make the causal inferences. During a median follow-up of 9 years, 7872 incident type 2 diabetes and 13,349 incident total diabetes were documented. After regression dilution bias adjustment, each 10 bpm higher heart rate was associated with about a 26% higher risk of type 2 diabetes (HR, 1.26 [95% CI, 1.23, 1.29]) and 23% higher risk of total diabetes (HR, 1.23 [95% CI, 1.20, 1.26]). Instrumental variable analyses showed participants at top quintile compared with those at bottom quintile had 30% higher risk for type 2 diabetes (HR, 1.30 [95% CI, 1.17, 1.43]), and 10% higher risk for total diabetes (HR, 1.10 [95% CI, 1.02, 1.20]).

    CONCLUSIONS: This study provides evidence that resting heart rate is an important risk factor for diabetes risk. The results suggest that novel treatment approaches targeting reduction of high heart rate for incidence of diabetes may be worth further investigation.

    Original languageEnglish
    Pages (from-to)2328-2337
    Number of pages10
    JournalNutrition, metabolism, and cardiovascular diseases : NMCD
    Volume31
    Issue number8
    Early online date27 Apr 2021
    DOIs
    Publication statusPublished - 22 Jul 2021

    Funder

    The study was supported by grants from the National Key R&D Program of China (2019YFC2003400), High-performance Computing Platform of Peking University, and National Natural Science Foundation of China (81941018, 91846303, 91843302). The CKB baseline survey and the first re-survey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants (2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2016YFC1303904) from the National Key R&D Program of China, National Natural Science Foundation of China (81390540, 81390541, 81390544), and Chinese Ministry of Science and Technology (2011BAI09B01).

    Funding

    The study was supported by grants from the National Key R&D Program of China (2019YFC2003400), High-performance Computing Platform of Peking University, and National Natural Science Foundation of China (81941018, 91846303, 91843302). The CKB baseline survey and the first re-survey were supported by a grant from the Kadoorie Charitable Foundation in Hong Kong. The long-term follow-up is supported by grants (2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2016YFC1303904) from the National Key R&D Program of China, National Natural Science Foundation of China (81390540, 81390541, 81390544), and Chinese Ministry of Science and Technology (2011BAI09B01).

    FundersFunder number
    National Natural Science Foundation of China81941018, 91846303, 91843302, 81390540, 81390541, 81390544
    Chinese Ministry of Science and Technology2011BAI09B01
    National Key Research and Development Program of China2019YFC2003400, 2016YFC0900500, 2016YFC0900501, 2016YFC0900504, 2016YFC1303904
    Kadoorie Charitable Foundation

      Keywords

      • Adult
      • Aged
      • China/epidemiology
      • Diabetes Mellitus, Type 2/diagnosis
      • Female
      • Genetic Predisposition to Disease
      • Heart Rate/genetics
      • Humans
      • Incidence
      • Male
      • Mendelian Randomization Analysis
      • Middle Aged
      • Phenotype
      • Polymorphism, Single Nucleotide
      • Risk Assessment
      • Risk Factors
      • Time Factors

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