{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T22:54:40Z","timestamp":1791413680794,"version":"4.3.3"},"reference-count":27,"publisher":"The Endocrine Society","issue":"10","license":[{"start":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T00:00:00Z","timestamp":1680739200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100003061","name":"Erasmus MC","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001828","name":"Erasmus University Rotterdam","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001828","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"Netherlands Organization for Health Research and Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003245","name":"Netherlands Ministry of Education, Culture and Science","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003245","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Netherlands Ministry of Health, Welfare and Sports"},{"DOI":"10.13039\/501100000780","name":"European Commission","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000780","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004543","name":"China Scholarship Council","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004543","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,9,18]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Context<\/jats:title>\n                    <jats:p>Hyperglycemia and autonomic dysfunction are bidirectionally related.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We investigated the association of longitudinal evolution of heart rate variability (HRV) with incident type 2 diabetes (T2D) among the general population.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We included 7630 participants (mean age 63.7 years, 58% women) from the population-based Rotterdam Study who had no history of T2D and atrial fibrillation at baseline and had repeated HRV assessments at baseline and during follow-up. We used joint models to assess the association between longitudinal evolution of heart rate and different HRV metrics (including the heart rate\u2013corrected SD of the normal-to-normal RR intervals [SDNNc], and root mean square of successive RR-interval differences [RMSSDc]) with incident T2D. Models were adjusted for cardiovascular risk factors. Bidirectional Mendelian randomization (MR) using summary-level data was also performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>During a median follow-up of 8.6 years, 871 individuals developed incident T2D. One SD 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. The HRs were 1.54 (95% CI, 1.08-2.06) for participants younger than 62 years and 1.15 (95% CI, 1.01-1.31) for those older than 62 years for heart rate (P for interaction &amp;lt;.001). Results from bidirectional MR analyses suggested that HRV and T2D were not significantly related to each other.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Autonomic dysfunction precedes development of T2D, especially among younger individuals, while MR analysis suggests no causal relationship. More studies are needed to further validate our findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1210\/clinem\/dgad200","type":"journal-article","created":{"date-parts":[[2023,4,6]],"date-time":"2023-04-06T13:03:33Z","timestamp":1680786213000},"page":"2510-2516","source":"Crossref","is-referenced-by-count":19,"title":["Heart Rate Variability and Incident Type 2 Diabetes in General Population"],"prefix":"10.1210","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0294-7594","authenticated-orcid":false,"given":"Kan","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam , 3000 CA Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6261-9445","authenticated-orcid":false,"given":"Fariba","family":"Ahmadizar","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Erasmus MC, University 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Erasmus MC, University Medical Center Rotterdam , 3000 CA Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9397-0900","authenticated-orcid":false,"given":"Dimitris","family":"Rizopoulos","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam , 3000 CA Rotterdam , The Netherlands"},{"name":"Department of Biostatistics, Erasmus MC, University Medical Center Rotterdam , 3000 CA Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric J G","family":"Sijbrands","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Erasmus MC, University Medical Center Rotterdam , 3000 CA Rotterdam , The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M Arfan","family":"Ikram","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Erasmus MC, 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