Bae Eun Hui, Lim Sang Yup, Kim Bong-Seong, Han Kyung-Do, Suh Sang Heon, Choi Hong Sang, Kim Chang Seong, Ma Seong Kwon, Kim Soo Wan
Department of Internal Medicine, Chonnam National University Medical School, Gwangju 61469, South Korea.
Department of Internal Medicine, Korea University Ansan Hospital, Ansan 15355, South Korea.
World J Diabetes. 2025 Jul 15;16(7):108344. doi: 10.4239/wjd.v16.i7.108344.
Exercise plays a key role in managing chronic conditions such as diabetes mellitus (DM), a major contributor to end-stage renal disease (ESRD), a serious public health issue.
To investigate the relationship between exercise intensity, DM duration, and ESRD incidence.
This retrospective cohort study analyzed data from 2495031 individuals with DM who underwent the Korean National Health Screening between 2015 and 2016, with follow-up through 2022. The Cox proportional hazards model was adjusted for confounders, including age, sex, income, smoking, and baseline comorbidities.
Longer DM duration was associated with a significantly higher risk of ESRD, with durations ≥ 10 years showing the highest risk [hazard ratio (HR): 2.624, 95% confidence interval (CI): 2.486-2.770]. Increased exercise intensity reduced the risk of developing ESRD across all diabetes duration groups, with the highest exercise category (≥ 1500 metabolic equivalents of task-min/week) demonstrating a protective effect compared to that of no exercise (HR: 0.837, 95%CI: 0.791-0.886). Exercise benefits were more pronounced in patients without hypertension, non-smokers, and those with lower alcohol consumption. Additionally, ESRD risk reduction was significant among patients with a body mass index ≥ 25 and those without proteinuria or chronic kidney disease.
Longer diabetes duration is associated with increased ESRD risk, while high-intensity exercise may mitigate this risk. These findings suggest promoting exercise is important for managing diabetes to reduce renal complications.
运动在慢性疾病管理中起着关键作用，如糖尿病（DM），它是终末期肾病（ESRD）的主要促成因素，而ESRD是一个严重的公共卫生问题。
研究运动强度、糖尿病病程和终末期肾病发病率之间的关系。
这项回顾性队列研究分析了2015年至2016年期间接受韩国国民健康筛查的2495031名糖尿病患者的数据，并随访至2022年。使用Cox比例风险模型对混杂因素进行了调整，包括年龄、性别、收入、吸烟和基线合并症。
糖尿病病程越长，发生终末期肾病的风险显著越高，病程≥10年者风险最高[风险比（HR）：2.624，95%置信区间（CI）：2.486 - 2.770]。在所有糖尿病病程组中，运动强度增加均降低了发生终末期肾病的风险，与不运动相比，最高运动类别（≥1500代谢当量任务分钟/周）显示出保护作用（HR：0.837，95%CI：0.791 - 0.886）。运动的益处在无高血压患者、不吸烟者以及饮酒量较低者中更为明显。此外，体重指数≥25且无蛋白尿或慢性肾病的患者中，终末期肾病风险降低显著。
糖尿病病程越长，终末期肾病风险越高，而高强度运动可能降低这种风险。这些发现表明，促进运动对于控制糖尿病以减少肾脏并发症很重要。
