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基于受限立方样条的剂量-反应分析的体力活动与肾结石的关系。

Association between physical activity and kidney stones based on dose-response analyses using restricted cubic splines.

机构信息

School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China.

Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, Guangdong, China.

出版信息

Eur J Public Health. 2020 Dec 11;30(6):1206-1211. doi: 10.1093/eurpub/ckaa162.

Abstract

BACKGROUND

This study aimed to determine whether there is a dose-response relationship between physical activity and the self-reported prevalence of kidney stone, based on a restricted cubic splines (RCS) method.

METHODS

This study analyzed 8931 adults aged ≥20 years who had participated in the National Health and Nutrition Examination Survey (NHANES) during 2013-16. Kidney stones and physical activity were defined using a standard questionnaire, and metabolic equivalents (MET) were used to quantify the physical activity level. Logistic regression was used to assess the association between physical activity and the risk of kidney stones, and the dose-response relationship was explored using RCS.

RESULTS

Kidney stones were present in 10.3% of the analyzed individuals: 11.5% of males and 9.2% of females. After adjusting for potential confounders, compared with the first quartile (Q1) of MET, the odds ratios (ORs) of kidney stones for those with Q2, Q3 and Q4 of MET were 0.72 [95% confidence interval (CI)=0.59-0.87], 0.77 (95% CI = 0.63-0.93) and 0.63 (95% CI = 0.51-0.78), respectively (all P < 0.01). The RCS regression showed that physical activity was related to kidney stones in a non-linear manner (P for non-linearity = 0.0100). The prevalence of kidney stones decreasing as physical activity increased, reaching a plateau for physical activity at approximately 2480 MET-min week-1 (OR = 0.75, 95% CI = 0.63-0.91).

CONCLUSIONS

Physical activity is inversely associated with the prevalence of kidney stones, and the dose-response relationship has a plateau, after which the prevalence of kidney stones does not change with the increase of physical activity.

摘要

背景

本研究旨在基于受限立方样条(RCS)方法,确定体力活动与肾结石自我报告患病率之间是否存在剂量-反应关系。

方法

本研究分析了 2013-2016 年期间参加国家健康与营养调查(NHANES)的 8931 名年龄≥20 岁的成年人。肾结石和体力活动使用标准问卷定义,代谢当量(MET)用于量化体力活动水平。使用 logistic 回归评估体力活动与肾结石风险之间的关联,并使用 RCS 探索剂量-反应关系。

结果

分析人群中肾结石的患病率为 10.3%:男性为 11.5%,女性为 9.2%。在调整潜在混杂因素后,与 MET 的第一四分位数(Q1)相比,MET 的 Q2、Q3 和 Q4 的肾结石比值比(OR)分别为 0.72(95%置信区间[CI]:0.59-0.87)、0.77(95% CI=0.63-0.93)和 0.63(95% CI=0.51-0.78)(均 P<0.01)。RCS 回归显示,体力活动与肾结石之间呈非线性关系(P 非线性=0.0100)。随着体力活动的增加,肾结石的患病率逐渐降低,在大约 2480 MET-min 周-1 的体力活动时达到平台(OR=0.75,95% CI=0.63-0.91)。

结论

体力活动与肾结石的患病率呈负相关,且剂量-反应关系存在平台,之后体力活动的增加不会改变肾结石的患病率。

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