title: Resting heart rate and risk of metabolic syndrome in adults: a dose-response meta-analysis of observational studies.
abstract: The magnitude of the risk of metabolic syndrome (MetS) with increased resting heart rate (RHR) has been inconsistently reported in some observational studies, and whether a dose-response relationship exists between RHR and MetS is unclear. We performed a meta-analysis including dose-response analysis to quantitatively evaluate this association in adults. We searched PubMed, Web of Knowledge, China National Knowledge Infrastructure, and WanFang databases for articles published up to April 2, 2016. A random-effects model was used to pool relative risks (RRs) and 95% confidence intervals (CIs); restricted cubic spline function was used to assess the dose-response relationship. Seven prospective cohort studies and 10 cross-sectional studies with a total of 169,786 participants were included. The pooled RR was 2.10 (95% CI 1.80-2.46, I2= 79.8%, n = 13) for the highest versus reference RHR category and 1.28 (95% CI 1.23-1.34, I2= 87.7%, n = 15) for each 10 beats per minute (bpm) increment in RHR. We found no evidence of a nonlinear dose-response association between RHR and MetS (Pnonlinearity= 0.201). The relationship was consistent in most subgroup analyses and robust on sensitivity analysis. No significant publication bias was observed. This meta-analysis suggests that risk of MetS may be increased with elevated RHR.
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.
authors.forename: Xuejiao
authors.initials: X
authors.lastname: Liu
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.
authors.forename: Xinping
authors.initials: X
authors.lastname: Luo
authors.affiliation: The Affiliated Luohu Hospital, Health Sciences Center, Shenzhen University, 47 Youyi Road, Shenzhen, 518001, Guangdong, China.
authors.forename: Yu
authors.initials: Y
authors.lastname: Liu
authors.affiliation: The Affiliated Luohu Hospital, Health Sciences Center, Shenzhen University, 47 Youyi Road, Shenzhen, 518001, Guangdong, China.
authors.forename: Xizhuo
authors.initials: X
authors.lastname: Sun
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China.
authors.forename: Chengyi
authors.initials: C
authors.lastname: Han
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China.
authors.forename: Lu
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China.
authors.forename: Bingyuan
authors.initials: B
authors.lastname: Wang
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China.
authors.forename: Yongcheng
authors.initials: Y
authors.lastname: Ren
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China.
authors.forename: Dongdong
authors.initials: D
authors.lastname: Zhang
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China.|The Affiliated Luohu Hospital, Health Sciences Center, Shenzhen University, 47 Youyi Road, Shenzhen, 518001, Guangdong, China.|Department of Epidemiology and Health Statistics, College of Public Health, Zhengzhou University, 100 Kexue Avenue, Zhengzhou, 450001, Henan, China.
authors.forename: Dongsheng
authors.initials: D
authors.lastname: Hu
authors.affiliation: Department of Preventive Medicine, Health Sciences Center, Shenzhen University, 3688 Nanhai Avenue, Nanshan District, Shenzhen, 518060, Guangdong, China. zhangming@szu.edu.cn.
authors.forename: Ming
authors.initials: M
authors.lastname: Zhang
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000209:etiology* / Q000503:physiopathology; D064887:Observational Studies as Topic / Q000706:statistics & numerical data; D011446:Prospective Studies; D012146:Rest / Q000502:physiology; D012307:Risk Factors
keywords: Dose–response analysis; Meta-analysis; Metabolic syndrome; Resting heart rate