Beddhu Srinivasan, Wei Guo, Marcus Robin L, Chonchol Michel, Greene Tom
Veterans Affairs Salt Lake City Healthcare System, Salt Lake City, Utah; Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah;
Department of Medicine, University of Utah School of Medicine, Salt Lake City, Utah;
Clin J Am Soc Nephrol. 2015 Jul 7;10(7):1145-53. doi: 10.2215/CJN.08410814. Epub 2015 Apr 30.
Sedentary behavior is associated with increased mortality in the general population. Whether replacing sedentary behavior with low- or light-intensity activities confers a survival benefit in the general or CKD populations is unknown.
DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: This observational analysis of the 2003-2004 National Health and Nutrition Examination Survey examined the associations of low- and light-intensity activities with mortality. On the basis of the number of counts/min recorded by an accelerometer, durations of sedentary (<100/min), low (100-499/min), light (500-2019/min), and moderate/vigorous (≥2020/min) activity were defined and normalized to 60 minutes. The mortality associations of 2 min/hr less sedentary duration in conjunction with 2 min/hr more (tradeoff) spent in one of the low, light, or moderate/vigorous activity durations while controlling for the other two activity durations were examined in multivariable Cox regression models in the entire cohort and in the CKD subgroup.
Of the 3626 participants included, 383 had CKD. The mean sedentary duration was 34.4±7.9 min/hr in the entire cohort and 40.8±6.8 in the CKD subgroup. Tradeoff of sedentary duration with low activity duration was not associated with mortality in the entire cohort or the CKD subgroup. Tradeoff of sedentary duration with light activity duration was associated with a lower hazard of death in the entire cohort (hazard ratio, 0.67; 95% confidence interval, 0.48 to 0.93) and CKD subgroup (hazard ratio, 0.59; 95% confidence interval, 0.35 to 0.98). Tradeoff of sedentary duration with moderate/vigorous activity duration had a nonsignificant lower hazard in the entire cohort and CKD subgroup.
Patients with CKD are sedentary nearly two thirds of the time. Interventions that replace sedentary duration with an increase in light activity duration might confer a survival benefit.
久坐行为与普通人群死亡率升高相关。用低强度或轻度活动取代久坐行为是否能使普通人群或慢性肾脏病(CKD)人群获得生存益处尚不清楚。
设计、地点、参与者及测量方法:这项对2003 - 2004年美国国家健康与营养检查调查的观察性分析研究了低强度和轻度活动与死亡率之间的关联。根据加速度计记录的每分钟计数,定义了久坐(<100次/分钟)、低强度(100 - 499次/分钟)、轻度(500 - 2019次/分钟)以及中度/剧烈(≥2020次/分钟)活动的持续时间,并将其归一化为60分钟。在多变量Cox回归模型中,在整个队列和CKD亚组中,研究了在控制其他两种活动持续时间的情况下,每小时减少2分钟久坐时间并同时增加2分钟低强度、轻度或中度/剧烈活动时间(权衡)与死亡率的关联。
纳入的3626名参与者中,383人患有CKD。整个队列的平均久坐时间为34.4±7.9分钟/小时,CKD亚组为40.8±6.8分钟/小时。在整个队列或CKD亚组中,久坐时间与低强度活动时间的权衡与死亡率无关。久坐时间与轻度活动时间的权衡与整个队列(风险比,0.67;95%置信区间,0.48至0.93)和CKD亚组(风险比,0.59;95%置信区间,0.35至0.98)较低的死亡风险相关。久坐时间与中度/剧烈活动时间的权衡在整个队列和CKD亚组中死亡风险降低不显著。
CKD患者近三分之二的时间处于久坐状态。用增加轻度活动时间来取代久坐时间的干预措施可能会带来生存益处。