Effects of physical activity on nontuberculous mycobacterial pulmonary disease incidence and mortality

Data on the effects of physical activity (PA) on nontuberculous mycobacterial pulmonary disease (NTM-PD) incidence and mortality are limited. This retrospective cohort study followed individuals in South Korea who underwent health examinations between 2009 and 2010 within the National Health Insurance Service-Health Screening Cohort. After excluding those with baseline NTM-PD or insufficient data, incident NTM-PD and mortality were identified via claims linkage. PA changes were assessed in participants with a follow-up examination within 4 years of the 2009–2010 baseline. Cox proportional hazards regression was used to evaluate associations between PA and NTM-PD incidence and mortality. Of 360,946 participants, 58.7% had insufficient PA. Compared to the sufficient PA group, this group was older and had a lower proportion of Charlson comorbidity index 0–1 scores. During follow-up, 656 individuals were newly diagnosed with NTM-PD (incidence 17.7/100,000 person-years), and 103 died (mortality 39.0/1,000 person-years). After adjusting for covariates, insufficient PA was associated with higher all-cause mortality (adjusted hazard ratio 1.57, 95% confidence interval 1.03–2.40), whereas increased PA between examinations was associated with lower incidence of NTM-PD (adjusted hazard ratio 0.71, 95% confidence interval 0.53–0.95). These findings suggest that PA is a modifiable factor associated with NTM-PD risk and all-cause mortality, supporting the potential benefit of promoting PA for the prevention and management of NTM-PD.