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Abstract
Patients with diabetes mellitus (DM) are at a higher risk of infectious diseases, and exercise is an important treatment modality for DM. Despite their susceptibility to infection in diabetic patients, the association between the amount of physical activity and the incidence of infective endocarditis (IE) is unclear. We attempted to demonstrate risk reduction by physical activity in diabetic patients with IE. From the National Health Insurance database, patients with DM were verified, and the incidence of IE was investigated. The level of physical activity was categorized into < 500, 500–999, 1,000–1,499, and ≥ 1,500 metabolic equivalent task (METs) minutes/week. Cox proportional hazard models were used to analyze the relationship between incident IE and physical activity. A total of 2,603,012 patients were included in this study. The incidence rate of IE was 10.06, 9.45, 7.78, and 8.84 in < 500, 500–999, 1,000–1,499, and ≥ 1,500 METs-minutes/week groups, respectively (100,000 person/year). A significant risk reduction of incident IE was observed in the 1,000–1499 and ≥ 1,500 METs-min/week groups compared to the < 500 METs-min/week group (Hazard ratio = 0.82, 95% confidence interval [0.690–0.976], HR = 0.831, 95% CI [0.704–0.981]). An analysis of a large national cohort database demonstrated that physical exercise reduced the risk of IE in patients with DM.
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1 Yonsei University College of Medicine, Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454); Inha University College of Medicine, Division of Infectious Diseases, Department of Internal Medicine, Incheon, Republic of Korea (GRID:grid.202119.9) (ISNI:0000 0001 2364 8385)
2 Korea University College of Medicine, Department of Thoracic and Cardiovascular Surgery, Seoul, Republic of Korea (GRID:grid.222754.4) (ISNI:0000 0001 0840 2678)
3 Yonsei University College of Medicine, Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454); Hanyang University College of Medicine, Division of Infectious Diseases, Department of Internal Medicine, Seoul, Republic of Korea (GRID:grid.49606.3d) (ISNI:0000 0001 1364 9317)
4 Yonsei University College of Medicine, Division of Cardiovascular Surgery, Department of Thoracic and Cardiovascular Surgery, Severance Cardiovascular Hospital, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
5 Yonsei University College of Medicine, Division of Infectious Diseases, Department of Internal Medicine and AIDS Research Institute, Seoul, Republic of Korea (GRID:grid.15444.30) (ISNI:0000 0004 0470 5454)
6 Soongsil University, Department of Statistics and Actuarial Science, Seoul, Republic of Korea (GRID:grid.263765.3) (ISNI:0000 0004 0533 3568)