Department of Rehabilitation, Dokkyo Medical University Nikko Medical Center.
Department of Diabetes and Endocrinology, Dokkyo Medical University Nikko Medical Center.
Circ J. 2020 Nov 25;84(12):2190-2197. doi: 10.1253/circj.CJ-20-0407. Epub 2020 Oct 28.
Sedentary behavior may be an independent risk factor for cardiovascular events. This study aimed to clarify the effects of extended sedentary time in patients with diabetic kidney disease (DKD) on the risk of all-cause death and new events.
A prospective cohort study was performed over 39 months. The study included 173 patients with DKD who completed the International Physical Activity Questionnaire (IPAQ) (101 men; mean age, 71±11 years); 37 patients (21.4%) were diagnosed with cardiovascular disease (CVD). New events were defined as all-cause death, cerebral stroke, or CVD requiring hospitalization or commencing hemodialysis (HD). Data were analyzed using a multivariate Cox proportional hazard regression model with variables, including sedentary time. There were 34 cases of new events during the observation period, including 4 cases of stroke, 20 cases of CVD, 4 cases of HD implementation, and 6 cases of death. Hazard ratio (HR) calculations for the new event onset group identified sedentary time as a significant independent variable. The independent variable that was identified as a significant predictor of new events was the sedentary time (60 min/day; HR: 1.23, 95% CI: 1.05-1.45, P=0.012).
Extended sedentary time increased the risk of new cardiovascular or renal events and/or all-cause death in patients with DKD.
久坐行为可能是心血管事件的独立危险因素。本研究旨在阐明糖尿病肾病（DKD）患者久坐时间延长对全因死亡和新发事件风险的影响。
进行了为期 39 个月的前瞻性队列研究。研究纳入了 173 名完成国际体力活动问卷（IPAQ）的 DKD 患者（男性 101 名；平均年龄 71±11 岁）；37 名患者（21.4%）被诊断为心血管疾病（CVD）。新发事件定义为全因死亡、脑卒中和/或需要住院或开始血液透析（HD）的 CVD。使用包括久坐时间在内的多变量 Cox 比例风险回归模型分析数据。在观察期间发生了 34 例新发事件，包括 4 例卒中和 20 例 CVD、4 例 HD 实施和 6 例死亡。新事件发病组的危险比（HR）计算将久坐时间确定为显著的独立变量。被确定为新发事件的显著预测因子的独立变量是久坐时间（60 分钟/天；HR：1.23，95%CI：1.05-1.45，P=0.012）。
久坐时间延长增加了 DKD 患者新发心血管或肾脏事件和/或全因死亡的风险。
