Int J Epidemiol：心率较快或和糖尿病发病风险增加直接相关

  近日，来自宾州州立大学(Penn State)等处的研究人员通过研究表明，心率测定或可帮助鉴别未来患高风险糖尿病的个体，相关研究刊登于国际杂志International Journal of Epidemiology上。在对73357名中国成年人进行了长达4年的研究后，研究者观察发现，心率较快或和个体患糖尿病的风险升高之间存在正向关联，心率较快和空腹血糖受损直接相关，而且还和受损空腹血糖向糖尿病转换存在直接关系。
  研究者Xiang Gao教授说道，这项研究中我们测定了10万名中国成年人的静息心率，并且对其进行了4年的追踪研究，结果发现，心率较快的个体，即自控功能较低的个体往往患糖尿病的风险较高，而且从糖尿病前期状态向糖尿病状态转换的风险较高，每分钟心跳增加10下和糖尿病风险增加23%直接相关。
  文章中，研究者将本文研究结果同此前对97653名个体的7项研究相关数据相结合后发现，相比心率较低的个体而言，心率较高的个体患糖尿病的风险会增加59%；而这也就揭示较快的心率或许是指示糖尿病的风险因子或临床前标志物，糖尿病是一种全球性的流行病，大约12%的中国个体都患有糖尿病，而且有50%的个体都处于糖尿病前期阶段，糖尿病前期阶段的主要表现为血糖高于正常水平，但并不足以被诊断为糖尿病。
  最后研究者表示，在4年的跟踪研究调查期间我们鉴别出了17463名前驱糖尿病患者以及4649名糖尿病患者，而本文研究或为后期开发有效抑制糖尿病患者的新型策略提供一定的思路和帮助。（转化医学网360zhyx.com）
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转化医学网推荐的原文摘要：

Resting heart rate and the risk of developing impaired fasting glucose and diabetes: the Kailuan prospective study
Int. J. Epidemiol.    doi: 10.1093/ije/dyv079
Liang Wang1,†, Liufu Cui2,†, Yanxue Wang2, Anand Vaidya3, Shuohua Chen4, Caifeng Zhang5, Ying Zhu2, Dongqing Li2, Frank B Hu6, Shouling Wu2,* and Xiang Gao6,7,*
Background: To investigate the association between resting heart rate and the risk of developing impaired fasting glucose (IFG), diabetes and conversion from IFG to diabetes.

Methods: The prospective analysis included 73 357 participants of the Kailuan cohort (57 719 men and 15 638 women). Resting heart rate was measured via electrocardiogram in 2006. Incident diabetes was defined as either the fasting blood glucose (FBG) ≥ 7.0 mmol/l or new active use of diabetes medications during the 4-year follow-up period. IFG was defined as a FBG between 5.6 and 6.9 mmol/l. A meta-analysis including seven published prospective studies focused on heart rate and diabetes risk, and our current study was then conducted using random-effects models.

Results: During 4 years of follow-up, 17 463 incident IFG cases and 4 649 incident diabetes cases were identified. The corresponding adjusted hazard ratios (HRs) for each 10 beats/min increase in heart rate were 1.23 [95% confidence interval (CI): 1.19, 1.27] for incident diabetes, 1.11 (95% CI: 1.09, 1.13) for incident IFG and 1.13 (95% CI: 1.08, 1.17) for IFG to diabetes conversion. The risks of incident IFG and diabetes were significantly higher among participants aged < 50 years than those aged ≥ 50 years (P-interaction < 0.02 for both). A meta-analysis confirmed the positive association between resting heart rate and diabetes risk (pooled HR for the highest vs lowest heart rate quintile = 1.59, 95% CI:1.27, 2.00; n = 8).

Conclusion: Faster resting heart rate is associated with higher risk of developing IFG and diabetes, suggesting that heart rate could be used to identify individuals with a higher future risk of diabetes.