The following is a summary of “Heart Rate Variability and Incident Type 2 Diabetes in General Population,” published in the October 2023 issue of Endocrinology by Wang, et al.

The study’s focal point was the intricate relationship between hyperglycemia and autonomic dysfunction, which researchers sought to explore. Researchers specifically addressed the association between the longitudinal evolution of heart rate variability (HRV) and the occurrence of type 2 diabetes (T2D) in the general population.

The study enrolled 7,630 participants (mean age 63.7 years, 58% women) from the Rotterdam Study, a population-based cohort, excluding those with a history of T2D or atrial fibrillation at baseline. These individuals underwent repeated HRV assessments at baseline and during follow-up. To scrutinize the link between the longitudinal evolution of heart rate and various HRV metrics (including heart rate–corrected SD of the normal-to-normal RR intervals [SDNNc] and root mean square of successive RR-interval differences [RMSSDc]) with incident T2D, joint models were utilized. The models were adjusted for cardiovascular risk factors. Bidirectional Mendelian randomization (MR) using summary-level data was also conducted.

Over a median follow-up of 8.6 years, 871 participants developed incident T2D. Notably, a one standard deviation increase in heart rate (hazard ratio [HR] 1.20; 95% CI, 1.09-1.33) and log(RMSSDc) (HR 1.16; 95% CI, 1.01-1.33) were independently associated with incident T2D. Stratification by age revealed stronger associations in participants younger than 62 years, with HRs of 1.54 (95% CI, 1.08-2.06) for heart rate and 1.15 (95% CI, 1.01-1.31) for those older than 62 years (P for interaction <.001). However, bidirectional MR analyses suggested no significant causal relationship between HRV and T2D. 

In conclusion, autonomic dysfunction precedes the development of T2D, particularly among younger individuals, although further studies are imperative to validate these findings.

Source: academic.oup.com/jcem/article/108/10/2510/7110036