Association of heart rate and diabetes among 0.5 million adults in the China Kadoorie biobank: Results from observational and Mendelian randomization analyses |
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| Authors: | 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 Zhe Qiu |
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| Institution: | 1. Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China;2. State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;3. Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China;4. Peking University Center for Public Health and Epidemic Preparedness & Response, Beijing, China;5. Chinese Academy of Medical Sciences, Beijing, China;6. Medical Research Council Population Health Research Unit at the University of Oxford, Oxford, United Kingdom;7. Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, United Kingdom;8. NCDs Prevention and Control Department, Henan CDC, Henan, China;9. China National Center for Food Safety Risk Assessment, Beijing, China;10. Department of Cardiology, Peking University Third Hospital, Beijing, China |
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| Abstract: | Background and aimsObservational 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 resultsThe 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]).ConclusionsThis 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. |
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| Keywords: | Heart rate Diabetes Mendelian randomization Causal association |
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