Renal Division and Channing Laboratory, Department of Medicine, Brigham and Women'sHospital, and Harvard Medical School, Boston, Massachusetts 02115, USA.
Am J Epidemiol. 2010 Mar 1;171(5):515-21. doi: 10.1093/aje/kwp442. Epub 2010 Feb 4.
Higher urinary albumin excretion predicts future cardiovascular disease, hypertension, and chronic kidney disease. Physical activity improves endothelial function so activity may reduce albuminuria. Among diabetics, physical activity decreases albuminuria. In nondiabetics, prior studies have shown no association. The authors explored the cross-sectional association between physical activity and albuminuria in 3,587 nondiabetic women in 2 US cohorts, the Nurses' Health Study I in 2000 and the Nurses' Health Study II in 1997. Physical activity was expressed as metabolic equivalents per week. The outcome was the top albumin/creatinine ratio (ACR) decile. Multivariate logistic regression was used. Secondary analyses explored the ACR association with strenuous activity and walking. The mean age was 58.6 years. Compared with women in the lowest physical activity quintile, those in the highest quintile had a multivariate-adjusted odds ratio for the top ACR decile of 0.65 (95% confidence interval (CI): 0.46, 0.93). The multivariate-adjusted odds ratio for the top ACR decile for those with greater than 210 minutes per week of strenuous activity compared with no strenuous activity was 0.61 (95% CI: 0.37, 0.99), and for those in the highest quintile of walking compared with the lowest quintile, it was 0.69 (95% CI: 0.47, 1.02). Greater physical activity is associated with a lower ACR in nondiabetic women.
较高的尿白蛋白排泄预示着未来的心血管疾病、高血压和慢性肾脏病。身体活动可改善内皮功能,因此活动可能会减少白蛋白尿。在糖尿病患者中,身体活动可降低白蛋白尿。在非糖尿病患者中,先前的研究并未显示出相关性。作者在 2 项美国队列研究(Nurses' Health Study I 于 2000 年和 Nurses' Health Study II 于 1997 年)中,探索了 3587 名非糖尿病女性的身体活动与白蛋白尿之间的横断面相关性。身体活动用每周代谢当量表示。结局是白蛋白/肌酐比值(ACR)最高的十分位数。采用多变量逻辑回归进行分析。次要分析探讨了 ACR 与剧烈活动和步行的相关性。平均年龄为 58.6 岁。与处于最低体力活动五分位数的女性相比,处于最高五分位数的女性,其 ACR 最高十分位数的多变量调整比值比为 0.65(95%置信区间[CI]:0.46,0.93)。与无剧烈活动相比,每周剧烈活动超过 210 分钟的女性,其 ACR 最高十分位数的多变量调整比值比为 0.61(95%CI:0.37,0.99),而与五分位数最低的女性相比,处于最高五分位数的女性,其比值比为 0.69(95%CI:0.47,1.02)。更高的身体活动与非糖尿病女性的 ACR 降低相关。