Higher LF/HF ratio, indicating a deviation in sympathovagal imbalance toward sympathetic activity, was associated with an increased risk of incident diabetes (HR 1.31; 95% CI 1.13-1.53).
Cohort (n=54,075)
No
Does altered heart rate variability predict the risk of incident diabetes in adults without diabetes?
Abnormal heart rate variability, characterized by decreased vagal activity and increased sympathetic activity, independently precedes and predicts the development of incident diabetes.
Hazard Ratio: 1.31 (95% CI 1.13–1.53)
OBJECTIVE: The objective of this study was to examine whether altered heart rate variability (HRV) could predict the risk of diabetes in Asians. RESEARCH DESIGN AND METHODS: A cohort study was conducted in 54,075 adults without diabetes who underwent 3-min HRV measurement during health checkups between 2011 and 2014 at Kangbuk Samsung Hospital. We analyzed the time domain (SD of the normal-to-normal interval SDNN and root mean square differences of successive normal-to-normal intervals RMSSD) and the frequency domain (total power, normalized low-frequency power LF, and normalized high-frequency power HF and LF/HF ratio). We compared the risk of diabetes until 2017 according to tertiles of heart rate and HRV variables, with tertile 1 serving as the reference group. RESULTS: During 243,758.2 person-years, 1,369 subjects were diagnosed with diabetes. Both time and frequency domain variables were lower in the group with diabetes, with the exception of those with normalized LF and LF/HF ratio. In Cox analysis, as SDNN, RMSSD, and normalized HF tertiles increased, the risk of diabetes decreased (hazard ratios 95% CIs of tertile 3: 0.81 0.70-0.95, 0.76 0.65-0.90, and 0.78 0.67-0.91, respectively), whereas the risk of diabetes increased in the case of heart rate, normalized LF, and LF/HF ratio (hazard ratios 95% CIs of tertile 3: 1.41 1.21-1.65, 1.32 1.13-1.53, and 1.31 [1.13-1.53), respectively) after adjusting for age, sex, BMI, smoking, drinking, systolic blood pressure, lipid level, CRP, and HOMA of insulin resistance. CONCLUSIONS: Abnormal HRV, especially decreased vagal activity and deviation in sympathovagal imbalance to sympathetic activity, might precede incident diabetes.
Lee et al. (Wed,) conducted a cohort in Diabetes (n=54,075). Altered heart rate variability (e.g., LF/HF ratio) vs. Lowest tertile of heart rate variability variables was evaluated on Incident diabetes (HR 1.31, 95% CI 1.13-1.53). Higher LF/HF ratio, indicating a deviation in sympathovagal imbalance toward sympathetic activity, was associated with an increased risk of incident diabetes (HR 1.31; 95% CI 1.13-1.53).
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