A one SD increase in heart rate (HR 1.20; 95% CI 1.09-1.33) and log(RMSSDc) (HR 1.16; 95% CI 1.01-1.33) were associated with incident type 2 diabetes, though MR suggested no causal relationship.
Cohort (n=7,630)
Is longitudinal evolution of heart rate variability associated with incident type 2 diabetes in the general population?
Autonomic dysfunction, as measured by heart rate and HRV metrics, precedes the development of type 2 diabetes, particularly in younger individuals, though Mendelian randomization suggests no causal relationship.
Effect estimate: HR 1.20 (95% CI 1.09-1.33)
CONTEXT: Hyperglycemia and autonomic dysfunction are bidirectionally related. OBJECTIVE: We investigated the association of longitudinal evolution of heart rate variability (HRV) with incident type 2 diabetes (T2D) among the general population. METHODS: We included 7630 participants (mean age 63.7 years, 58% women) from the population-based Rotterdam Study who had no history of T2D and atrial fibrillation at baseline and had repeated HRV assessments at baseline and during follow-up. We used joint models to assess the association between longitudinal evolution of heart rate and different HRV metrics (including the heart rate-corrected SD of the normal-to-normal RR intervals SDNNc, and root mean square of successive RR-interval differences RMSSDc) with incident T2D. Models were adjusted for cardiovascular risk factors. Bidirectional Mendelian randomization (MR) using summary-level data was also performed. RESULTS: During a median follow-up of 8.6 years, 871 individuals developed incident T2D. One SD increase in heart rate (hazard ratio HR 1.20; 95% CI, 1.09-1.33), and log(RMSSDc) (HR 1.16; 95% CI, 1.01-1.33) were independently associated with incident T2D. The HRs were 1.54 (95% CI, 1.08-2.06) for participants younger than 62 years and 1.15 (95% CI, 1.01-1.31) for those older than 62 years for heart rate (P for interaction <.001). Results from bidirectional MR analyses suggested that HRV and T2D were not significantly related to each other. CONCLUSION: Autonomic dysfunction precedes development of T2D, especially among younger individuals, while MR analysis suggests no causal relationship. More studies are needed to further validate our findings.
Wang et al. (Thu,) conducted a cohort in Incident type 2 diabetes (n=7,630). Heart rate and heart rate variability (HRV) was evaluated on Incident type 2 diabetes (HR 1.20, 95% CI 1.09-1.33). A one SD increase in heart rate (HR 1.20; 95% CI 1.09-1.33) and log(RMSSDc) (HR 1.16; 95% CI 1.01-1.33) were associated with incident type 2 diabetes, though MR suggested no causal relationship.