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BACKGROUND: An elevated heart rate has been reported to be associated with an increased incidence of type 2 diabetes mellitus (T2DM). We investigated whether heart rate was independently and interactively with body mass index (BMI) or blood pressure (BP), associated with the incidence of T2DM in a rural Chinese population. METHODS: We measured the association between heart rate and T2DM in the Tongxiang China Kadoorie Biobank prospective cohort study using Cox proportional hazard models. Analyses included 53,817 participants without any history of diabetes, cancer, cardiovascular or rheumatic heart disease at baseline. Incident T2DM cases were identified through the linkage with established Disease Registries and the China National Health Insurance System. RESULTS: After a mean follow up of 6.9 years, 1,766 people had developed T2DM with an incidence of 4.75 per 1000 person-years. Multivariable-adjusted hazard ratios and 95% confidence intervals for T2DM across increasing quintiles of heart rate were 1.00 (reference), 1.24 (1.05- 1.45), 1.21 (1.03 - 1.41), 1.24 (1.05 - 1.47) and 1.49 (1.28 - 1.74), respectively, with a Ptrend < 0.001. This relationship was particularly evident among non-overweight/obese participants. A significant interaction between heart rate and BMI on incident T2DM was observed with a P for interaction = 0.005. CONCLUSIONS: Elevated heart rate is independently and, in interaction with a higher BMI, associated with a higher incidence of T2DM. This article is protected by copyright. All rights reserved.

Original publication




Journal article


J Diabetes Investig

Publication Date



Heart rate, Interaction, Type 2 diabetes mellitus