TY - JOUR
T1 - Association of heart rate and diabetes among 0.5 million adults in the China Kadoorie biobank
T2 - Results from observational and Mendelian randomization analyses
AU - China Kadoorie Biobank (CKB) collaborative group
AU - Wang, Wenxiu
AU - Wang, Jingjia
AU - Lv, Jun
AU - Yu, Canqing
AU - Shao, Chunli
AU - Tang, Yida
AU - Guo, Yu
AU - Bian, Zheng
AU - Du, Huaidong
AU - Yang, Ling
AU - Millwood, Iona Y
AU - Walters, Robin G
AU - Chen, Yiping
AU - Chang, Liang
AU - Fan, Lei
AU - Chen, Junshi
AU - Chen, Zhengming
AU - Huang, Tao
AU - Li, Liming
PY - 2021/7/22
Y1 - 2021/7/22
N2 - 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.
AB - 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.
KW - Adult
KW - Aged
KW - China/epidemiology
KW - Diabetes Mellitus, Type 2/diagnosis
KW - Female
KW - Genetic Predisposition to Disease
KW - Heart Rate/genetics
KW - Humans
KW - Incidence
KW - Male
KW - Mendelian Randomization Analysis
KW - Middle Aged
KW - Phenotype
KW - Polymorphism, Single Nucleotide
KW - Risk Assessment
KW - Risk Factors
KW - Time Factors
UR - http://www.scopus.com/inward/record.url?scp=85106868653&partnerID=8YFLogxK
U2 - 10.1016/j.numecd.2021.04.015
DO - 10.1016/j.numecd.2021.04.015
M3 - Article
C2 - 34052074
VL - 31
SP - 2328
EP - 2337
JO - Nutrition, Metabolism and Cardiovascular Diseases
JF - Nutrition, Metabolism and Cardiovascular Diseases
SN - 0939-4753
IS - 8
ER -