Anderton Natalie, Giri Ajay, Wei Guo, Marcus Robin L, Chen Xiaorui, Bjordahl Terrence, Habib Arsalan, Herrera Jenice, Beddhu Srinivasan
Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah; Department of Physical Therapy, University of Utah College of Health, Salt Lake City, Utah.
Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah.
J Ren Nutr. 2015 Jul;25(4):364-70. doi: 10.1053/j.jrn.2015.01.018. Epub 2015 Mar 5.
The objective of this study was to examine whether more advanced kidney failure is associated with sedentary behavior and whether demographics, comorbidity, nutritional, and inflammatory markers explain this association.
Observational study.
Outpatients recruited from outpatient clinics and dialysis units.
One hundred sixty patients with chronic kidney disease (CKD) or receiving maintenance hemodialysis (MHD).
Standardized questionnaires including Baecke physical activity questionnaire, standardized anthropometry examination, and blood draw.
Sedentary behavior (defined as answering "very often" for "during leisure time I watch television" or answering "never" for "during leisure time I walk") and being physically active (top 25th percentile of the total Baecke score).
Nineteen percent of CKD and 50% of MHD patients were sedentary (P < .001) and 38.8% of CKD and 11.3% of MHD patients were physically active. In separate multivariable logistic regression models, compared with CKD patients, MHD patients were more sedentary (odds ratio 3.84; 95% confidence interval, 1.18-12.51) and less physically active (odds ratio 0.07; 95% confidence interval 0.01-0.40) independent of demographics, comorbidity, smoking, body size, serum high sensitivity C-reactive protein (hsCRP) and albumin. Congestive heart failure, peripheral vascular disease, and higher body mass index were independently associated with sedentary behavior, whereas younger age, lower body mass index, lower serum hsCRP, and higher serum albumin were associated with being physically active.
Sedentary behavior is highly prevalent among diabetic CKD or MHD patients. The strong association of MHD status with sedentary behavior is not explained by demographics, smoking, comorbidity, nutritional, and inflammatory markers. Interventions targeting obesity might improve sedentary behavior and physical activity, whereas interventions targeting inflammation might improve physical activity in these populations.
本研究的目的是探讨更晚期的肾衰竭是否与久坐行为相关，以及人口统计学、合并症、营养和炎症标志物是否能解释这种关联。
观察性研究。
从门诊诊所和透析单位招募的门诊患者。
160例慢性肾脏病（CKD）患者或接受维持性血液透析（MHD）的患者。
采用标准化问卷，包括贝克体力活动问卷、标准化人体测量检查和血液采集。
久坐行为（定义为在“休闲时间我看电视”一项中回答“非常频繁”，或在“休闲时间我散步”一项中回答“从不”）和身体活跃（贝克总分处于前25%）。
19%的CKD患者和50%的MHD患者久坐不动（P <.001），38.8%的CKD患者和11.3%的MHD患者身体活跃。在单独的多变量逻辑回归模型中，与CKD患者相比，MHD患者久坐不动的可能性更大（优势比3.84；95%置信区间，1.18 - 12.51），身体活跃的可能性更小（优势比0.07；95%置信区间0.01 - 0.40），且不受人口统计学、合并症、吸烟、体型、血清高敏C反应蛋白（hsCRP）和白蛋白的影响。充血性心力衰竭、外周血管疾病和较高的体重指数与久坐行为独立相关，而较年轻的年龄、较低的体重指数、较低的血清hsCRP和较高的血清白蛋白与身体活跃相关。
久坐行为在糖尿病CKD或MHD患者中非常普遍。MHD状态与久坐行为之间的强关联无法通过人口统计学、吸烟、合并症、营养和炎症标志物来解释。针对肥胖的干预措施可能会改善久坐行为和身体活动，而针对炎症的干预措施可能会改善这些人群的身体活动。
