Overweight, resting heart rate and prediabetes/diabetes: A population-based prospective cohort study among Inner Mongolians in China

Abstract

We aimed to investigate the cumulative effect of overweight and resting heart rate on prediabetes/diabetes incidence in an 10-year follow-up study in Inner Mongolians. Among 1729 participants who were free from prediabetes and diabetes at baseline, 503 and 155 subjects developed prediabetes and diabetes, respectively. We categorized the participants into 4 subgroups according to overweight and resting heart rate status. The multivariate-adjusted OR (95% CI) in normal weight with heart rate ≥80 bpm, overweight with heart rate <80 bpm, and overweight with heart rate ≥80 bpm were 1.24 (0.95–1.61), 1.83 (1.29–2.61), 2.20 (1.41–3.45) for prediabetes and 1.52 (0.97–2.40), 3.64 (2.21–6.01), 4.61 (2.47–8.61) for diabetes, respectively, compared with normal weight with heart rate <80 bpm. The area under ROC curve (AUC) for the prediction of diabetes incidence for a model containing overweight and resting heart rate, along with conventional factors (AUC = 0.751), was significantly (P = 0.003) larger than the one containing only conventional factors (AUC = 0.707). Our study indicated that overweight was an independent risk factor of prediabetes and diabetes, and overweight with faster resting heart rate might further increase the risk of prediabetes and diabetes.

Resting heart rate and risk of type 2 diabetes: A prospective cohort study and meta‐analysis

“…Another interesting finding from the current study was that RHR and other known risk factors had a significant joint association with T2D risk. Only a few studies have examined joint association of RHR with BMI, waist‐to‐hip ratio, and blood pressure with T2D . Our study suggests that RHR in combination with other known risk factors (ie, age, BMI, physical activity, diet, smoking status, family history of diabetes, and hypertension) may provide further evidence to predict future T2D risk.…”

“…Only a few studies have examined joint association of RHR with BMI, waist-to-hip ratio, and blood pressure with T2D. 11,15,16 Our study All models were adjusted for age, race (white or non-white), family history of diabetes (yes or no), alcohol consumption (0, 0.1-4.9, 5-9.9, 10-14.9, ≥15 g/ day), total calorie intake (quintiles), smoking status (never, quit≥10 yrs, quit<10 yrs, or current smokers), intake of dietary factors including trans fat, polyunsaturated fat to saturated fat ratio, cereal fibre, whole grain, and glycaemic load (quintiles), body mass index (<18.5, 18.5-24.9, 25-29.9, 30-34.9, ≥35 kg/ m 2 ), high blood pressure at baseline (yes or no), medication use at baseline (ie, beta blocker, thiazide diuretic, furosemide-like diuretic, calcium channel blocker, other antihypertensive drug, and antiarrhythmic drug) (yes or no), and physical activity (<3, 3-8.9, 9-17.9, 18-26.9, ≥27 MET-h/wk) a Number of cases: age (<60, n = 1033; ≥60, n = 1305), body mass index (<25, n = 441; 25-29.9, n = 1277; ≥30, n = 620), physical activity (<25, n = 1512; ≥25, n = 826), diet quality (<median, n = 1384; ≥median, n = 954), ever smoking (no, n = 1137; yes, n = 1201), family history of diabetes (no, n = 1761; yes, n = 577), hypertension (no, n = 1028; yes, n = 1310 All models were adjusted for age, race (white or non-white), family history of diabetes (yes or no), alcohol consumption (0, 0.1-4.9, 5-9.9, 10-14.9, ≥15 g/ day), total calorie intake (quintiles), smoking status (never, quit≥10 y, quit<10 y, or current smokers), intake of dietary factors including transfat, polyunsaturated fat to saturated fat ratio, cereal fibre, whole grain, and glycaemic load (quintiles), body mass index (<18.5, 18.5-24.9, 25-29.9, 30-34.9, ≥35 kg/m 2 ), high blood pressure at baseline (yes or no), medication use at baseline (ie, beta blocker, thiazide diuretic, furosemide-like diuretic, calcium channel blocker, other antihypertensive drug, and antiarrhythmic drug) (yes or no), and physical activity (<3, 3-8.9, 9-17.9, 18-26.9, ≥27 MET-h/wk).…”

“…Resting heart rate (RHR) has been commonly used as a simple and useful diagnostic and predictive tool for cardiovascular disease in clinical settings . More recently, epidemiological studies have found an association between elevated RHR and increased risk of T2D, after adjusting for potential confounders . In these studies, elevated RHR was hypothesized as a maker of an imbalanced autonomic nervous system, favouring sympathetic over‐activity, which is linked to insulin sensitivity, impaired glucose uptake, and hyperglycaemia .…”

“…5 More recently, epidemiological studies have found an association between elevated RHR and increased risk of T2D, after adjusting for potential confounders. [6][7][8][9][10][11][12][13][14][15][16] In these studies, elevated RHR was hypothesized as a maker of an imbalanced autonomic nervous system, favouring sympathetic over-activity, which is linked to insulin sensitivity, impaired glucose uptake, and hyperglycaemia. 17 However, the majority of these studies were small and had short follow-up, which can contribute to publication bias and lead to reverse causation.…”

Independent and interactive associations of heart rate and body mass index or blood pressure with type 2 diabetes mellitus incidence: A prospective cohort study

“…The type 2 diabetes mellitus incidence estimated in the present study is similar to that among previous studies, which ranged from 1.19-9 to 5.39-fold 11 increased risk in the highest heart rate category. Previously, there was some concern that the independent association of heart rate with diabetes incidence might be confounded by other possible confounders, such as BMI, BP and physical activity 27 . The present study confirmed that heart rate was independently associated with type 2 diabetes mellitus incidence after adjusted for the potential confounders including BMI, BP and physical activity.…”