Michishita Ryoma, Matsuda Takuro, Kawakami Shotaro, Kiyonaga Akira, Tanaka Hiroaki, Morito Natsumi, Higaki Yasuki
Department of Health Development, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, 1-1 Iseigaoka, Yahatanishi-ku, Kitakyushu, 807-8555, Japan.
The Fukuoka University Institute for Physical Activity, Fukuoka, Japan.
Environ Health Prev Med. 2016 May;21(3):129-37. doi: 10.1007/s12199-016-0506-6. Epub 2016 Jan 21.
This study was retrospectively designed to evaluate the influence of healthy lifestyle behaviors on the incidence of chronic kidney disease (CKD) during a 5-year follow-up period in middle-aged and older males.
The subjects included 252 males without a history of cardiovascular disease, stroke, renal dysfunction and/or dialysis treatment who were not taking any medications. Their lifestyle behaviors were evaluated using a standardized self-administered questionnaire and defined as follows: (1) habitual moderate exercise, (2) daily physical activity, (3) fast walking speed, (4) slow eating speed, (5) no late-night dinner, (6) no bedtime snacking and (7) no skipping breakfast. The participants were divided into four categories, which were classified into quartile distributions according to the number of healthy lifestyle behaviors (7-6, 5, 4 and ≤3 groups).
After 5 years, the incidence of CKD [estimated glomerular filtration rate (eGFR) <60 ml/min/1.73 m(2) and/or proteinuria] was observed in 23 subjects (9.1%). The Kaplan-Meier survival curves showed that the cumulative incidence of CKD significantly decreased according to an increase in the number of healthy lifestyle behaviors (log-rank test: p = 0.003). According to a multivariate analysis, habitual moderate exercise [hazard ratio (HR) 0.20, 95% confidence of interval (CI) 0.06-0.69, p = 0.011] and no bedtime snacking (HR 0.19, 95 % CI 0.08-0.48, p = 0.004) were significantly associated with the incidence of CKD.
These results suggest that the accumulation of healthy lifestyle behaviors, especially those related to habitual moderate exercise and no bedtime snacking, is considered to be important to reduce the risk of CKD.
本研究为回顾性研究,旨在评估中年及老年男性在5年随访期内健康生活方式行为对慢性肾脏病(CKD)发病率的影响。
研究对象为252名无心血管疾病、中风、肾功能不全和/或透析治疗史且未服用任何药物的男性。采用标准化的自填问卷对他们的生活方式行为进行评估,定义如下:(1)习惯性适度运动;(2)日常身体活动;(3)快走速度;(4)慢进食速度;(5)不吃晚餐;(6)睡前不吃零食;(7)不不吃早餐。参与者被分为四类,根据健康生活方式行为的数量分为四分位数分布(7 - 6、5、4和≤3组)。
5年后,23名受试者(9.1%)出现CKD(估计肾小球滤过率(eGFR)<60 ml/min/1.73 m²和/或蛋白尿)。Kaplan-Meier生存曲线显示,随着健康生活方式行为数量的增加,CKD的累积发病率显著降低(对数秩检验:p = 0.003)。多因素分析显示,习惯性适度运动(风险比(HR)0.20,95%置信区间(CI)0.06 - 0.69,p = 0.011)和睡前不吃零食(HR 0.19,95% CI 0.08 - 0.48,p = 0.004)与CKD的发病率显著相关。
这些结果表明,健康生活方式行为的积累,尤其是与习惯性适度运动和睡前不吃零食相关的行为,被认为对降低CKD风险很重要。