Park Chan Soon, Choi Eue-Keun, Yoo Juhwan, Ahn Hyo-Jeong, Kwon Soonil, Lee So-Ryoung, Oh Seil, Lip Gregory Y H
Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea.
Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea.
Diabetes Care. 2023 Feb 1;46(2):434-440. doi: 10.2337/dc22-1655.
We investigated the association between alterations in regular physical activity (PA) and the risk of developing AF in patients with type 2 diabetes mellitus (T2DM) and the optimal PA range based on energy expenditure.
In a nationwide database, subjects who underwent health examinations twice at a 2-year interval between 2009 and 2012 were studied. After 1,815,330 patients with T2DM who did not have a history of AF were identified, they were followed until 2018. Regular PA alterations over time were used to divide individuals into four groups: persistent nonexercisers (n = 1,181,837), new exercisers (n = 242,968), exercise dropouts (n = 225,124), and exercise maintainers (n = 165,401).
During a mean follow-up period of 5.6 ± 1.3 years, 46,589 cases (2.6%) of new-onset AF occurred. Compared with the persistent nonexerciser group, both the exercise dropout group (adjusted hazard ratio [HR] 0.96, 95% CI 0.94-0.99) and new exerciser group (HR 0.95, 95% CI 0.93-0.98) had lower risks of incident AF. The exercise maintainer group showed the lowest risk (HR 0.91, 95% CI 0.89-0.94). When we stratified patients with T2DM according to energy expenditure, undergoing regular PA with ≥1,500 MET-min/week in new exercisers and ≥1,000 MET-min/week in exercise maintainers was associated with lower risks of incident AF than nonexercisers.
In patients with T2DM, starting and maintaining regular PA were both associated with lower risk of incident AF. Optimal PA ranges based on energy expenditure, which were associated with lower risks of incident AF, can be defined.
我们研究了2型糖尿病（T2DM）患者规律体力活动（PA）的变化与发生房颤（AF）风险之间的关联，以及基于能量消耗的最佳PA范围。
在一个全国性数据库中，对2009年至2012年期间每两年接受一次健康检查的受试者进行了研究。在识别出1,815,330例无AF病史的T2DM患者后，对他们进行随访直至2018年。根据随时间变化的规律PA改变将个体分为四组：持续不运动者（n = 1,181,837）、新运动者（n = 242,968）、运动放弃者（n = 225,124）和运动维持者（n = 165,401）。
在平均5.6±1.3年的随访期内，发生了46,589例（2.6%）新发AF病例。与持续不运动者组相比，运动放弃者组（调整后风险比[HR] 0.96，95%可信区间[CI] 0.94 - 0.99）和新运动者组（HR 0.95，95% CI 0.93 - 0.98）发生AF的风险均较低。运动维持者组显示出最低风险（HR 0.91，95% CI 0.89 - 0.94）。当我们根据能量消耗对T2DM患者进行分层时，新运动者每周进行≥1,500代谢当量 - 分钟的规律PA以及运动维持者每周进行≥1,000代谢当量 - 分钟的规律PA与不运动者相比，发生AF的风险较低。
在T2DM患者中，开始并维持规律PA均与较低的新发AF风险相关。可以确定基于能量消耗且与较低的新发AF风险相关的最佳PA范围。
