Hansen, CS; Færch, K; Jørgensen, ME; Malik, M; Witte, DR; Brunner, EJ; Tabák, AG; ... Vistisen, D; + view all Hansen, CS; Færch, K; Jørgensen, ME; Malik, M; Witte, DR; Brunner, EJ; Tabák, AG; Kivimäki, M; Vistisen, D; - view fewer (2019) Heart Rate, Autonomic Function, and Future Changes in Glucose Metabolism in Individuals Without Diabetes: The Whitehall II Cohort Study. Diabetes Care , 42 (4) 10.2337/dc18-1838.

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Abstract

OBJECTIVES: 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 β-cell function (HOMA of β-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 −1.4 (−2.4; −0.3), 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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