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体力活动或久坐行为对肾功能的因果影响:基于综合人群规模的观察性分析和孟德尔随机化研究。

Causal effects of physical activity or sedentary behaviors on kidney function: an integrated population-scale observational analysis and Mendelian randomization study.

机构信息

Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea.

Department of Internal Medicine, Armed Forces Capital Hospital, Gyeonggi-do, South Korea.

出版信息

Nephrol Dial Transplant. 2022 May 25;37(6):1059-1068. doi: 10.1093/ndt/gfab153.

Abstract

BACKGROUND

An investigation into the causality of the effects of physical activity and specific sedentary activities on kidney function in the general population is warranted.

METHODS

In this observational cohort study, first, the clinical associations of the prevalence of stages 3-5 chronic kidney disease (CKD) and the estimated glomerular filtration rate (eGFR) with physical activity, determined by self-report or objective wrist-band accelerometer results, and sedentary activities (watching television, using a computer and driving) were investigated in 329 758 UK Biobank participants. To assess causality, a two-sample Mendelian randomization (MR) analysis was performed to investigate the associations of a genetic predisposition to physical activity and a sedentary lifestyle with the risk of kidney function impairment in an independent CKDGen genome-wide association study (N = 567 460). The findings were replicated with the 321 024 UK White British Biobank participants in the allele-score-based one-sample MR.

RESULTS

A higher degree of self-reported or accelerometer-determined moderate-to-vigorous physical activity was associated with a higher eGFR, while a longer time spent watching television was significantly associated with a lower eGFR and a higher prevalence of CKD. The two-sample MR demonstrated that the genetic predisposition to a higher degree of physical activity was associated with a lower risk of CKD and a higher eGFR, while the genetically predicted television watching duration was associated with a higher risk of CKD and a lower eGFR. The other sedentary behaviors yielded inconsistent results. The findings were similarly replicated in the one-sample MR.

CONCLUSION

Physical activity and television watching causally affect kidney function in the general population.

摘要

背景

有必要调查体力活动和特定久坐行为对普通人群肾功能影响的因果关系。

方法

在这项观察性队列研究中,首先,通过自我报告或客观腕带加速度计结果,调查了英国生物库 329758 名参与者中体力活动的流行率与阶段 3-5 慢性肾脏病(CKD)和估计肾小球滤过率(eGFR)的临床相关性,以及久坐行为(看电视、使用电脑和驾驶)。为了评估因果关系,进行了两样本孟德尔随机化(MR)分析,以调查体力活动和久坐生活方式的遗传倾向与 CKDGen 全基因组关联研究中肾功能损害风险的关联(N=567460)。使用基于等位基因评分的单样本 MR,在英国白种人生物库的 321024 名参与者中复制了这些发现。

结果

自我报告或加速度计确定的较高程度的中等至剧烈体力活动与较高的 eGFR 相关,而看电视时间较长与较低的 eGFR 和较高的 CKD 流行率显著相关。两样本 MR 表明,体力活动程度较高的遗传倾向与较低的 CKD 风险和较高的 eGFR 相关,而遗传预测的看电视时间与较高的 CKD 风险和较低的 eGFR 相关。其他久坐行为的结果不一致。在单样本 MR 中也得到了类似的复制。

结论

体力活动和看电视会对普通人群的肾功能产生因果影响。

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