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体力活动模式的变化与新发糖尿病患者心力衰竭风险的关系。

Changes in Patterns of Physical Activity and Risk of Heart Failure in Newly Diagnosed Diabetes Mellitus Patients.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.

Department of Statistics and Actuarial Science, Soongsil University, Seoul, Korea.

出版信息

Diabetes Metab J. 2022 Mar;46(2):327-336. doi: 10.4093/dmj.2021.0046. Epub 2021 Nov 24.

Abstract

BACKGROUND

Exercise is recommended for type 2 diabetes mellitus (T2DM) patients to prevent cardiovascular disease. However, the effects of physical activity (PA) for reducing the risk of heart failure (HF) has yet to be elucidated. We aimed to assess the effect of changes in patterns of PA on incident HF, especially in newly diagnosed diabetic patients.

METHODS

We examined health examination data and claims records of 294,528 participants from the Korean National Health Insurance Service who underwent health examinations between 2009 and 2012 and were newly diagnosed with T2DM. Participants were classified into the four groups according to changes in PA between before and after the diagnosis of T2DM: continuously inactive, inactive to active, active to inactive, and continuously active. The development of HF was analyzed until 2017.

RESULTS

As compared with those who were continuously inactive, those who became physically active after diagnosis showed a reduced risk for HF (adjusted hazard ratio [aHR], 0.79; 95% confidence interval [CI], 0.66 to 0.93). Those who were continuously active had the lowest risk for HF (aHR, 0.77; 95% CI, 0.62 to 0.96). As compared with those who were inactive, those who exercised regularly, either performing vigorous or moderate PA, had a lower HF risk (aHR, 0.79; 95% CI, 0.69 to 0.91).

CONCLUSION

Among individuals with newly diagnosed T2DM, the risk of HF was reduced in those with higher levels of PA after diagnosis was made. Our results suggest either increasing or maintaining the frequency of PA after the diagnosis of T2DM may lower the risk of HF.

摘要

背景

运动被推荐给 2 型糖尿病(T2DM)患者以预防心血管疾病。然而,身体活动(PA)降低心力衰竭(HF)风险的效果尚未阐明。我们旨在评估 PA 模式变化对 HF 事件的影响,特别是在新诊断的糖尿病患者中。

方法

我们检查了 294528 名参与者的健康检查数据和韩国国家健康保险服务的索赔记录,这些参与者在 2009 年至 2012 年间接受了健康检查,并被新诊断为 T2DM。参与者根据 T2DM 诊断前后 PA 的变化分为四组:持续不活跃、从不活跃变为活跃、从活跃变为不活跃和持续活跃。HF 的发展情况分析至 2017 年。

结果

与持续不活跃的参与者相比,诊断后变得活跃的参与者 HF 的风险降低(调整后的危险比 [aHR],0.79;95%置信区间 [CI],0.66 至 0.93)。持续活跃的参与者 HF 风险最低(aHR,0.77;95% CI,0.62 至 0.96)。与不活跃的参与者相比,经常进行剧烈或适度 PA 的参与者 HF 风险较低(aHR,0.79;95% CI,0.69 至 0.91)。

结论

在新诊断为 T2DM 的个体中,在做出诊断后 PA 水平较高的个体中,HF 的风险降低。我们的结果表明,在诊断为 T2DM 后增加或维持 PA 的频率可能会降低 HF 的风险。

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