Jafar Tazeen Hasan, Jin Aizhen, Koh Woon-Puay, Yuan Jian-Min, Chow Khuan Yew
Laboratory of Cardiovascular and Renal Risk Reduction, Health Services and Systems Research, Duke-NUS Graduate Medical School, Singapore.
Nephrology (Carlton). 2015 Feb;20(2):61-7. doi: 10.1111/nep.12355.
To explore the relationship between physical activity and risk of end-stage kidney disease (ESKD).
We analysed data on a prospective cohort of 59,552 Chinese adults aged 45-74 years enrolled in the Singapore Chinese Health Study. Information on physical activity was collected with a structured questionnaire. Physically active individuals were defined as those who engaged in any moderate activities for 2 h or more per week and any strenuous activities 30 min or more per week. Incident ESKD was identified via record linkage with the Singapore Registry of Birth and Death and Singapore Renal Registry. Cox proportional hazards regression method was used for analysis for risk of incident ESKD alone or ESKD plus death associated with physical activity.
During a median follow-up of 15.3 years, a total of 642 incident ESKD occurred, and 9808 study participants died. A 24% lower adjusted risk of ESKD (hazard ratio: 0.76; 95% confidence interval: 0.62-0.93) was associated with moderate or strenuous physical activities compared with no regular physical activity. This association appeared to be dose dependent with the lowest risk for subjects at highest intensity of physical activity (P trend <0.003). Similar results were observed for risk of ESKD plus death.
Higher levels of physical activity are associated with lower risk of ESKD. Our findings highlight the role of physical activity for prevention of ESKD, which deserves further evaluation in intervention trials.
探讨体力活动与终末期肾病(ESKD)风险之间的关系。
我们分析了参加新加坡华人健康研究的59552名年龄在45 - 74岁的中国成年人前瞻性队列的数据。通过结构化问卷收集体力活动信息。体力活动活跃的个体定义为每周进行任何中等强度活动2小时或更长时间以及任何剧烈活动30分钟或更长时间的人。通过与新加坡出生和死亡登记处以及新加坡肾脏登记处的记录链接确定新发ESKD。采用Cox比例风险回归方法分析单独新发ESKD或与体力活动相关的ESKD加死亡的风险。
在中位随访15.3年期间,共发生642例新发ESKD,9808名研究参与者死亡。与无规律体力活动相比,中等强度或剧烈体力活动与ESKD调整后风险降低24%相关(风险比:0.76;95%置信区间:0.62 - 0.93)。这种关联似乎呈剂量依赖性,体力活动强度最高的受试者风险最低(P趋势<0.003)。对于ESKD加死亡的风险也观察到类似结果。
较高水平的体力活动与较低的ESKD风险相关。我们的研究结果突出了体力活动在预防ESKD中的作用,这值得在干预试验中进一步评估。