Heart rate, autonomic function, and future changes in glucose metabolism in individuals without diabetes

The whitehall II cohort study

Christian Stevns Hansen, Kristine Færch, Marit Eika Jørgensen, Marek Malik, Daniel R. Witte, Eric J. Brunner, A. Tabák, Mika Kivimäki, Dorte Vistisen

Research output: Contribution to journalArticle

Abstract

OBJECTIVE Autonomic nervous system dysfunction is associated with impaired glucose metabolism, but the temporality of this association remains unclear in individuals without diabetes. We investigated the association of autonomic function with 5-year changes in glucose metabolism in individuals without diabetes. RESEARCH DESIGN AND METHODS Analyses were based on 9,000 person-examinations for 3,631 participants without diabetes in the Whitehall II cohort. Measures of autonomic function included 5-min resting heart rate and six heart rate variability (HRV) indices. Associations between baseline autonomic function measures and 5-year changes in fasting and 2-h plasma glucose, serum insulin concentrations, insulin sensitivity (insulin sensitivity index [ISI 0120 ] and HOMA of insulin sensitivity), and b-cell function (HOMA of b-cell function) were estimated in models adjusting for age, sex, ethnicity, metabolic factors, and medication. RESULTS A 10-bpm higher resting heart rate was associated with 5-year changes in fasting and 2-h insulin and ISI 0120 of 3.3% change (95% CI 1.8; 4.8), P < 0.001; 3.3% change (1.3; 5.3), P = 0.001; and 21.4% change (22.4; 20.3), P = 0.009, respectively. In models adjusted for age, sex, and ethnicity, higher baseline values of several HRV indices were associated with a 5-year decrease in fasting and 2-h insulin and ISI 0 –120. However, significance was lost by full adjustment. A majority of HRV indices exhibited a trend toward higher values being associated with lower insulin levels and higher insulin sensitivity. CONCLUSIONS Higher resting heart rate in individuals without diabetes is associated with future unfavorable changes in insulin levels and insulin sensitivity. Associations may be mediated via autonomic function; however, results are inconclusive. Resting heart rate may be a risk marker for future pathophysiological changes in glucose metabolism.

Original languageEnglish
Pages (from-to)867-874
Number of pages8
JournalDiabetes care
Volume42
Issue number5
DOIs
Publication statusPublished - May 1 2019

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Cohort Studies
Heart Rate
Glucose
Insulin Resistance
Insulin
Fasting
Social Adjustment
antineoplaston A10
Autonomic Nervous System
Serum

ASJC Scopus subject areas

  • Internal Medicine
  • Endocrinology, Diabetes and Metabolism
  • Advanced and Specialised Nursing

Cite this

Hansen, C. S., Færch, K., Jørgensen, M. E., Malik, M., Witte, D. R., Brunner, E. J., ... Vistisen, D. (2019). Heart rate, autonomic function, and future changes in glucose metabolism in individuals without diabetes: The whitehall II cohort study. Diabetes care, 42(5), 867-874. https://doi.org/10.2337/dc18-1838

Heart rate, autonomic function, and future changes in glucose metabolism in individuals without diabetes : The whitehall II cohort study. / Hansen, Christian Stevns; Færch, Kristine; Jørgensen, Marit Eika; Malik, Marek; Witte, Daniel R.; Brunner, Eric J.; Tabák, A.; Kivimäki, Mika; Vistisen, Dorte.

In: Diabetes care, Vol. 42, No. 5, 01.05.2019, p. 867-874.

Research output: Contribution to journalArticle

Hansen, CS, Færch, K, Jørgensen, ME, Malik, M, Witte, DR, Brunner, EJ, Tabák, A, Kivimäki, M & Vistisen, D 2019, 'Heart rate, autonomic function, and future changes in glucose metabolism in individuals without diabetes: The whitehall II cohort study', Diabetes care, vol. 42, no. 5, pp. 867-874. https://doi.org/10.2337/dc18-1838
Hansen, Christian Stevns ; Færch, Kristine ; Jørgensen, Marit Eika ; Malik, Marek ; Witte, Daniel R. ; Brunner, Eric J. ; Tabák, A. ; Kivimäki, Mika ; Vistisen, Dorte. / Heart rate, autonomic function, and future changes in glucose metabolism in individuals without diabetes : The whitehall II cohort study. In: Diabetes care. 2019 ; Vol. 42, No. 5. pp. 867-874.
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AU - Witte, Daniel R.

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N2 - OBJECTIVE Autonomic nervous system dysfunction is associated with impaired glucose metabolism, but the temporality of this association remains unclear in individuals without diabetes. We investigated the association of autonomic function with 5-year changes in glucose metabolism in individuals without diabetes. RESEARCH DESIGN AND METHODS Analyses were based on 9,000 person-examinations for 3,631 participants without diabetes in the Whitehall II cohort. Measures of autonomic function included 5-min resting heart rate and six heart rate variability (HRV) indices. Associations between baseline autonomic function measures and 5-year changes in fasting and 2-h plasma glucose, serum insulin concentrations, insulin sensitivity (insulin sensitivity index [ISI 0 – 120 ] and HOMA of insulin sensitivity), and b-cell function (HOMA of b-cell function) were estimated in models adjusting for age, sex, ethnicity, metabolic factors, and medication. RESULTS A 10-bpm higher resting heart rate was associated with 5-year changes in fasting and 2-h insulin and ISI 0 – 120 of 3.3% change (95% CI 1.8; 4.8), P < 0.001; 3.3% change (1.3; 5.3), P = 0.001; and 21.4% change (22.4; 20.3), P = 0.009, respectively. In models adjusted for age, sex, and ethnicity, higher baseline values of several HRV indices were associated with a 5-year decrease in fasting and 2-h insulin and ISI 0 –120. However, significance was lost by full adjustment. A majority of HRV indices exhibited a trend toward higher values being associated with lower insulin levels and higher insulin sensitivity. CONCLUSIONS Higher resting heart rate in individuals without diabetes is associated with future unfavorable changes in insulin levels and insulin sensitivity. Associations may be mediated via autonomic function; however, results are inconclusive. Resting heart rate may be a risk marker for future pathophysiological changes in glucose metabolism.

AB - OBJECTIVE Autonomic nervous system dysfunction is associated with impaired glucose metabolism, but the temporality of this association remains unclear in individuals without diabetes. We investigated the association of autonomic function with 5-year changes in glucose metabolism in individuals without diabetes. RESEARCH DESIGN AND METHODS Analyses were based on 9,000 person-examinations for 3,631 participants without diabetes in the Whitehall II cohort. Measures of autonomic function included 5-min resting heart rate and six heart rate variability (HRV) indices. Associations between baseline autonomic function measures and 5-year changes in fasting and 2-h plasma glucose, serum insulin concentrations, insulin sensitivity (insulin sensitivity index [ISI 0 – 120 ] and HOMA of insulin sensitivity), and b-cell function (HOMA of b-cell function) were estimated in models adjusting for age, sex, ethnicity, metabolic factors, and medication. RESULTS A 10-bpm higher resting heart rate was associated with 5-year changes in fasting and 2-h insulin and ISI 0 – 120 of 3.3% change (95% CI 1.8; 4.8), P < 0.001; 3.3% change (1.3; 5.3), P = 0.001; and 21.4% change (22.4; 20.3), P = 0.009, respectively. In models adjusted for age, sex, and ethnicity, higher baseline values of several HRV indices were associated with a 5-year decrease in fasting and 2-h insulin and ISI 0 –120. However, significance was lost by full adjustment. A majority of HRV indices exhibited a trend toward higher values being associated with lower insulin levels and higher insulin sensitivity. CONCLUSIONS Higher resting heart rate in individuals without diabetes is associated with future unfavorable changes in insulin levels and insulin sensitivity. Associations may be mediated via autonomic function; however, results are inconclusive. Resting heart rate may be a risk marker for future pathophysiological changes in glucose metabolism.

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