The association between resting heart rate and HbA1c-assessed glycemic control in patients with type 2 diabetes in Eastern China

ObjectivesThis study aimed to explore the association between resting heart rate (RHR) and HbA1c-assessed glycemic control in patients with type 2 diabetes mellitus (T2DM).MethodsThis cross-sectional study was conducted in Zhejiang Province, Eastern China, from March to November 2018. The associatio...

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Main Authors: Xiangyu Chen, Feng Lu, Jie Zhang, Xiaofu Du, Chunxiao Xu, Mingbin Liang, Lijin Chen, Jieming Zhong
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-06-01
Series:Frontiers in Endocrinology
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Online Access:https://www.frontiersin.org/articles/10.3389/fendo.2025.1478575/full
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author Xiangyu Chen
Feng Lu
Jie Zhang
Xiaofu Du
Chunxiao Xu
Mingbin Liang
Lijin Chen
Jieming Zhong
author_facet Xiangyu Chen
Feng Lu
Jie Zhang
Xiaofu Du
Chunxiao Xu
Mingbin Liang
Lijin Chen
Jieming Zhong
author_sort Xiangyu Chen
collection DOAJ
description ObjectivesThis study aimed to explore the association between resting heart rate (RHR) and HbA1c-assessed glycemic control in patients with type 2 diabetes mellitus (T2DM).MethodsThis cross-sectional study was conducted in Zhejiang Province, Eastern China, from March to November 2018. The association between RHR and inadequate glycemic control was analyzed using multivariable logistic regression and restricted cubic spline models. Additionally, a generalized additive model was employed to examine the association between RHR and HbA1c levels.ResultsA total of 1,756 patients with T2DM were included in this study. The prevalence of inadequate glycemic control was 48.92% in this population. After adjusting for age, sex, educational level, body mass index, hypertension, abnormal total cholesterol, abnormal triglyceride, cigarette smoking, and duration of diabetes, when compared to the first quintile of RHR (< 70 beats per minute [bpm]), patients in the second quintile (70–75 bpm), third quintile (76–80 bpm), fourth quintile (81–87 bpm), and fifth quintile (≥88 bpm) had increased risks of inadequate glycemic control, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were: 1.11 (0.82-1.49), 1.50 (1.10-2.06), 1.70 (1.25-2.31), and 2.14 (1.56-2.94), respectively. When RHR was treated as a continuous variable, each 10 bpm increase was associated with a 27% higher risk of inadequate glycemic control (OR: 1.27; 95% CI: 1.16-1.39). Moreover, HbA1c levels were positively correlated with increasing RHR in this population (Spearman correlation coefficient=0.15, P<0.001). Subgroup analyses confirmed that the association between elevated RHR and inadequate glycemic control persisted across all key demographic strata (all p < 0.05). Notably, BMI significantly modified this relationship (p for interaction < 0.05), with a more pronounced effect observed in individuals with higher BMI.ConclusionsElevated RHR is associated with inadequate glycemic control and higher HbA1c levels. Our findings suggest a potential bidirectional relationship between RHR and glycemic control in T2DM patients. These results may contribute to individualized clinical management and inform targeted public health strategies aimed at early identification and intervention in high-risk T2DM populations.
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spelling doaj-art-afab057a971b4996a086d34465eaecfc2025-08-20T02:06:47ZengFrontiers Media S.A.Frontiers in Endocrinology1664-23922025-06-011610.3389/fendo.2025.14785751478575The association between resting heart rate and HbA1c-assessed glycemic control in patients with type 2 diabetes in Eastern ChinaXiangyu ChenFeng LuJie ZhangXiaofu DuChunxiao XuMingbin LiangLijin ChenJieming ZhongObjectivesThis study aimed to explore the association between resting heart rate (RHR) and HbA1c-assessed glycemic control in patients with type 2 diabetes mellitus (T2DM).MethodsThis cross-sectional study was conducted in Zhejiang Province, Eastern China, from March to November 2018. The association between RHR and inadequate glycemic control was analyzed using multivariable logistic regression and restricted cubic spline models. Additionally, a generalized additive model was employed to examine the association between RHR and HbA1c levels.ResultsA total of 1,756 patients with T2DM were included in this study. The prevalence of inadequate glycemic control was 48.92% in this population. After adjusting for age, sex, educational level, body mass index, hypertension, abnormal total cholesterol, abnormal triglyceride, cigarette smoking, and duration of diabetes, when compared to the first quintile of RHR (< 70 beats per minute [bpm]), patients in the second quintile (70–75 bpm), third quintile (76–80 bpm), fourth quintile (81–87 bpm), and fifth quintile (≥88 bpm) had increased risks of inadequate glycemic control, the adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were: 1.11 (0.82-1.49), 1.50 (1.10-2.06), 1.70 (1.25-2.31), and 2.14 (1.56-2.94), respectively. When RHR was treated as a continuous variable, each 10 bpm increase was associated with a 27% higher risk of inadequate glycemic control (OR: 1.27; 95% CI: 1.16-1.39). Moreover, HbA1c levels were positively correlated with increasing RHR in this population (Spearman correlation coefficient=0.15, P<0.001). Subgroup analyses confirmed that the association between elevated RHR and inadequate glycemic control persisted across all key demographic strata (all p < 0.05). Notably, BMI significantly modified this relationship (p for interaction < 0.05), with a more pronounced effect observed in individuals with higher BMI.ConclusionsElevated RHR is associated with inadequate glycemic control and higher HbA1c levels. Our findings suggest a potential bidirectional relationship between RHR and glycemic control in T2DM patients. These results may contribute to individualized clinical management and inform targeted public health strategies aimed at early identification and intervention in high-risk T2DM populations.https://www.frontiersin.org/articles/10.3389/fendo.2025.1478575/fullresting heart rateglycemic controlcross-sectional studytype 2 diabetes mellitusautonomic dysfunction
spellingShingle Xiangyu Chen
Feng Lu
Jie Zhang
Xiaofu Du
Chunxiao Xu
Mingbin Liang
Lijin Chen
Jieming Zhong
The association between resting heart rate and HbA1c-assessed glycemic control in patients with type 2 diabetes in Eastern China
Frontiers in Endocrinology
resting heart rate
glycemic control
cross-sectional study
type 2 diabetes mellitus
autonomic dysfunction
title The association between resting heart rate and HbA1c-assessed glycemic control in patients with type 2 diabetes in Eastern China
title_full The association between resting heart rate and HbA1c-assessed glycemic control in patients with type 2 diabetes in Eastern China
title_fullStr The association between resting heart rate and HbA1c-assessed glycemic control in patients with type 2 diabetes in Eastern China
title_full_unstemmed The association between resting heart rate and HbA1c-assessed glycemic control in patients with type 2 diabetes in Eastern China
title_short The association between resting heart rate and HbA1c-assessed glycemic control in patients with type 2 diabetes in Eastern China
title_sort association between resting heart rate and hba1c assessed glycemic control in patients with type 2 diabetes in eastern china
topic resting heart rate
glycemic control
cross-sectional study
type 2 diabetes mellitus
autonomic dysfunction
url https://www.frontiersin.org/articles/10.3389/fendo.2025.1478575/full
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