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We assessed the effect of physical activity on incident AF in patients with DM with respect to known DM duration.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients with type 2 DM who underwent the Korean National Health Insurance Service health examination in 2015\u20132016 were grouped by DM duration: new onset and &lt;\u20095, 5\u20139, and \u2265\u200910 years. Physical activity was classified into four levels: 0, &lt;\u2009500, 500\u2013999, 1,000\u20131,499, and \u2265\u20091,500 metabolic equivalent task (MET)-min\/week, with the primary outcome being new-onset AF.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The study enrolled 2,392,486 patients (aged 59.3\u2009\u00b1\u200912.0 years, 39.8% female) with an average follow-up of 3.9\u2009\u00b1\u20090.8 years and mean DM duration of 5.3\u2009\u00b1\u20095.1 years. Greater physical activity was associated with a lower AF risk. Lowering of incident AF risk varied with different amounts of physical activity in relation to known DM duration. Among patients with new-onset DM, DM duration\u2009&lt;\u20095 years and 5\u20139 years and 1,000\u20131,499 MET-min\/week exhibited the lowest AF risk. Physical activity\u2009\u2265\u20091,500 MET-min\/week was associated with the lowest incident AF risk in patients with DM duration\u2009\u2265\u200910 years (by 15%), followed DM duration of 5\u20139 years (12%) and &lt;\u20095 years (9%) (\n                      <jats:italic>p<\/jats:italic>\n                      -for-interaction\u2009=\u20090.002).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Longer DM duration was associated with a high risk of incident AF, while increased physical activity generally reduced AF risk. Engaging in &gt;\u20091,500 MET-min\/week was associated with the greatest AF risk reduction in patients with longer DM duration, highlighting the potential benefits of higher activity levels for AF prevention.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12933-024-02194-2","type":"journal-article","created":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T15:01:32Z","timestamp":1711810892000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Effect of physical activity on incident atrial fibrillation in individuals with varying duration of diabetes: a nationwide population study"],"prefix":"10.1186","volume":"23","author":[{"given":"JungMin","family":"Choi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"So\u2011Ryoung","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eue-Keun","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung-Yeon","family":"Lee","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyo-Jeong","family":"Ahn","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soonil","family":"Kwon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung\u2011Do","family":"Han","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seil","family":"Oh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory Y. 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Diabetes Care. 2007;30(2):203\u20139.","journal-title":"Diabetes Care"}],"container-title":["Cardiovascular Diabetology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12933-024-02194-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12933-024-02194-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12933-024-02194-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,30]],"date-time":"2024-03-30T16:01:44Z","timestamp":1711814504000},"score":1,"resource":{"primary":{"URL":"https:\/\/cardiab.biomedcentral.com\/articles\/10.1186\/s12933-024-02194-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,3,30]]},"references-count":46,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2024,12]]}},"alternative-id":["2194"],"URL":"https:\/\/doi.org\/10.1186\/s12933-024-02194-2","relation":{},"ISSN":["1475-2840"],"issn-type":[{"value":"1475-2840","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,3,30]]},"assertion":[{"value":"20 November 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"10 March 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"30 March 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study adhered to the principles outlined in the Declaration of Helsinki. The data were anonymized; therefore, they were exempt from review by the Institutional Review Board (IRB) of Seoul National University Hospital (IRB no. E-2307-129-1452). Additionally, obtaining informed consent was not possible because the data from the NHIS were de-identified. The utilization of the NHIS database from 2015 to 2020 was authorized in 2023.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"SRL: Speaking fees from Bayer, BMS\/Pfizer, Biosense Webster, Daiichi-Sankyo, Sanofi-Aventis, Daewoong Pharmaceutical Co., Samjinpharm, Seers Technology, Biotronik, Boston Scientific, and Medtronic. Consultant for Biosense Webster. EKC: Research grants or speaking fees from Abbott, Bayer, BMS\/Pfizer, Biosense Webster, Chong Kun Dang, Daewoong Pharmaceutical Co., Daiichi-Sankyo, DeepQure, Dreamtech Co., Ltd., Jeil Pharmaceutical Co. Ltd., Medtronic, Samjin Pharm, Seers Technology, and Skylabs. GYHL: Consultant and speaker for BMS\/Pfizer, Boehringer Ingelheim, Anthos, and Daiichi-Sankyo. GYHL is a National Institute for Health and Care Research (NIHR) Senior Investigator and co-principal investigator of the AFFIRMO project on multimorbidity in AF, which has received funding from the European Union\u2019s Horizon 2020 research and innovation program under grant agreement No. 899871. No personal fees were received. The remaining authors have nothing to disclose.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"115"}}