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Published on: January 23, 2018
Elevated heart rate predicts β cell function in non-diabetic individuals: the RISC cohort
Fabrice Bonnet1, Jean-Philippe Empana2, Andrea Natali2
1Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy Service Endocrinologie-DiabétologieCHU Rennes, Université Rennes 1, Rennes, FranceInserm Centre for research in Epidemiology and Population Health (CESP) U1018Villejuif, FranceParis Cardiovascular Research Centre (PARCC)INSERM UMRS 970, Paris, FranceDepartment of Internal MedicineUniversity of Pisa, Pisa, ItalyDepartment of Internal MedicineCardio-Diabetes and Core Lab, Diabetes Research Institute, IRCCS Ospedale San Raffaele, Milan, ItalyService d'enseignement thérapeutique pour maladies chroniquesHôpitaux Universitaires de Genève, Geneva, SwitzerlandFaculty of Medicine University of BelgradeClinic for Endocrinology, Diabetes and Metabolic Diseases, Belgrade, SerbiaDepartment of Epidemiology and BiostatisticsEMGO Institute for Health and Care Research, Amsterdam, The NetherlandsC N R Institute of NeurosciencePadova, Italy fabrice.bonnet@chu-rennes.fr.
Context:
Elevated heart rate has been associated with insulin resistance and incident type 2 diabetes but its relationship with β-cell function is not known. Our aim was to investigate whether baseline heart rate is associated with β-cell function and hyperglycaemia.
Methods:
We used the prospective RISC cohort with 1005 non-diabetic individuals who had an oral glucose tolerance test (OGTT) at baseline and after 3 years. Impaired glucose regulation was defined as a fasting plasma glucose ≥ 6.1 mmol/l or a 2-h plasma glucose ≥ 7.8 mmol/l. Insulin sensitivity was assessed by the OGIS index and insulin secretion and β-cell glucose sensitivity at both baseline and 3 years.
Results:
Baseline heart rate was positively related to both fasting (P < 0.0001) and 2 h glucose levels (P = 0.02) at year 3 and predicted the presence of impaired glucose regulation at year 3 in a logistic regression model adjusting for insulin sensitivity at inclusion (OR/10 beats per min: 1.31; 95% CI (1.07-1.61); P = 0.01). Baseline heart rate was associated with lower insulin sensitivity (β = -0.11; P < .0001), a decrease in both β-cell glucose sensitivity (β = -0.11; P = 0.003) and basal insulin secretion rate (β = -0.11; P = 0.002) at 3 years in an adjusted multivariable regression model. Baseline heart rate predicted the 3-year decrease in β-cell glucose sensitivity (β = -0.10; P = 0.007) and basal insulin secretion (β = -0.12; P = 0.007).
Conclusions:
Heart rate predicts β-cell function and impaired glucose regulation at 3 years in non-diabetic individuals, independently of the level of insulin sensitivity. These findings suggest a possible effect of the sympathetic nervous system on β-cell dysfunction, which deserves further investigation.
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