Chung Chiwook, Lee Kyu Na, Han Kyungdo, Park Junhee, Shin Dong Wook, Lee Sei Won
Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea.
Sci Rep. 2025 Jul 9;15(1):24701. doi: 10.1038/s41598-025-09593-9.
One of the crucial risk factors for tuberculosis (TB) is diabetes mellitus (DM), and physical activity could afford protective effects for the former disease entity. We aimed to evaluate the association between physical activity (intensity and amount) and TB development in individuals with type 2 DM (T2DM) among the South Korean nationwide cohort. Using the Korean National Health Information Database, we screened individuals who underwent the national health examination between 2009 and 2012 and identified 2,437,443 eligible individuals with T2DM. They were followed up to the date of TB notification, death, censor, or until December 2018. We identified 21,275 individuals with newly developed TB (active TB, either pulmonary or extrapulmonary). Physical activity was evaluated according to the health examination questionnaire, categorized them by activity intensity (walking, moderate, and vigorous) and amount measured by metabolic equivalent task minutes per week (METs-min/week). To estimate the adjusted hazard ratio (aHR) of risk factors for TB, we used the multivariate Cox proportional hazard models. The risk of developing TB declined with increasing activity intensity. Individuals with vigorous activity had the lowest risk for TB (aHR 0.85, 95% confidence interval [CI] 0.82-0.89) compared with individuals without vigorous activity. The risk of TB development decreased with increasing amount of activity. Individuals ≥ 1,500 METs-min/week had the lowest risk for TB (incidence rate 1.22/1000 person-years, aHR 0.84, 95% CI 0.80-0.88) compared with individuals < 500 METs-min/week. Physical activity intensity and amount were inversely correlated with TB risk in individuals with T2DM.
糖尿病是结核病的关键危险因素之一，而体育活动对结核病具有保护作用。我们旨在评估韩国全国队列中2型糖尿病（T2DM）患者的体育活动（强度和量）与结核病发生之间的关联。利用韩国国家健康信息数据库，我们筛选了2009年至2012年间接受全国健康检查的个体，确定了2437443名符合条件的T2DM患者。对他们进行随访，直至结核病通报、死亡、审查日期或2018年12月。我们确定了21275名新发生结核病的个体（活动性结核病，包括肺结核或肺外结核）。根据健康检查问卷评估体育活动情况，按活动强度（步行、中度和剧烈）进行分类，并通过每周代谢当量任务分钟数（METs - min/周）来衡量活动量。为了估计结核病危险因素的调整后风险比（aHR），我们使用了多变量Cox比例风险模型。结核病发病风险随活动强度增加而降低。与无剧烈活动的个体相比，剧烈活动的个体患结核病的风险最低（aHR 0.85，95%置信区间[CI] 0.82 - 0.89）。结核病发病风险随活动量增加而降低。与每周活动量<500 METs - min/周的个体相比，每周活动量≥1500 METs - min/周的个体患结核病的风险最低（发病率1.22/1000人年，aHR 0.84，95% CI 0.80 - 0.88）。T2DM患者的体育活动强度和量与结核病风险呈负相关。
