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体力活动与糖尿病患者全因及特定原因死亡率的关联:一项全国范围内基于人群的队列研究。

Association of physical activity with total and cause-specific mortality in patients with diabetes: A nationwide population-based cohort study.

机构信息

Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Republic of Korea.

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

出版信息

Diabetes Res Clin Pract. 2023 Aug;202:110819. doi: 10.1016/j.diabres.2023.110819. Epub 2023 Jul 7.

Abstract

AIMS

Physical inactivity is a modifiable risk factor for cardiovascular disease (CVD) in patients with type 2 diabetes mellitus (T2DM); however, little is known about its association with mortality due to other causes. Herein, we investigated the association between physical activity (PA) and cause-specific mortality in patients with T2DM.

METHODS

We analyzed data from the Korean National Health Insurance Service and claims database of adults with T2DM aged >20 years at baseline (n = 2,651,214). Each participant's PA volume was measured as the metabolic equivalent of tasks (METs)-min per week, and hazard ratios of all-cause and cause-specific mortality relative to PA levels were estimated.

RESULTS

During the 7.8 years of follow-up, all-cause, CVD, respiratory, cancer, and other causes of mortality were lowest in patients engaged in vigorous PA. MET-min/week was inversely associated with mortality after adjusting for covariates. The reduction in total and cause-specific mortality was greater in patients aged ≥65 years than in those aged <65 years.

CONCLUSIONS

Increasing PA may facilitate a reduction in mortality from various causes, especially among older patients with T2DM. Clinicians should encourage such patients to increase their daily PA levels to reduce their risk of mortality.

摘要

目的

身体活动不足是 2 型糖尿病(T2DM)患者心血管疾病(CVD)的可改变危险因素;然而,对于其与其他原因导致的死亡率之间的关系知之甚少。在此,我们研究了 T2DM 患者身体活动(PA)与特定原因死亡率之间的关系。

方法

我们分析了韩国国家健康保险服务和 20 岁以上 T2DM 成年人索赔数据库的数据(n=2,651,214)。每位参与者的 PA 量均以代谢当量任务(MET)-min/周来衡量,并根据 PA 水平估计全因和特定原因死亡率的风险比。

结果

在 7.8 年的随访期间,进行剧烈 PA 的患者全因、CVD、呼吸、癌症和其他原因的死亡率最低。在调整了混杂因素后,MET-min/周与死亡率呈负相关。与年龄<65 岁的患者相比,年龄≥65 岁的患者的总死亡率和特定原因死亡率的降低更为明显。

结论

增加 PA 可能有助于降低各种原因导致的死亡率,尤其是在年龄较大的 T2DM 患者中。临床医生应鼓励此类患者增加日常 PA 水平,以降低其死亡率风险。

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