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用身体活动替代慢性肾脏病患者的久坐时间对骨密度的影响。

Replacing sedentary time for physical activity on bone density in patients with chronic kidney disease.

机构信息

Graduate School of Comprehensive Human Sciences, University of Tsukuba, 1-1-1 Tennodai, Tsukuba, Ibaraki, 305-8574, Japan.

Japan Society for the Promotion of Science, 5-3-1 Kouzimachi, Chiyoda-ku, Tokyo, 102-8472, Japan.

出版信息

J Bone Miner Metab. 2021 Nov;39(6):1091-1100. doi: 10.1007/s00774-021-01255-w. Epub 2021 Jul 28.

Abstract

INTRODUCTION

This study aimed to examine the cross-sectional associations of sedentary time and physical activity time with bone density in patients with chronic kidney disease (CKD). The isotemporal substitution (IS) modeling was used to estimate the beneficial effects of behavioral changes (e.g., replacing sedentary time with physical activity time) on bone density in these patients.

MATERIALS AND METHODS

A total of 92 patients with CKD (age: 65 ± 9 years; estimated glomerular filtration rate: 57 ± 22 mL/min/1.73 m) were included in this cross-sectional study. The times spent in sedentary behavior (SB), light-intensity physical activity (LPA), and moderate- to vigorous-intensity physical activity (MVPA) were assessed using a triaxial accelerometer. Through quantitative ultrasound measurements, the stiffness index, as a measure of bone density, was calculated using the speed of sound and broadband ultrasound attenuation.

RESULTS

In multivariate analyses, the stiffness index was beneficially associated with the MVPA time (β = 0.748), but was not significantly associated with the SB and LPA times. The IS models showed that replacing 10 min/day of SB with the equivalent LPA time was not significantly associated with the stiffness index; however, replacing 10 min/day of SB with the equivalent MVPA time was beneficially associated with the stiffness index (β = 0.804).

CONCLUSION

These results suggest that a small increase in MVPA time (e.g., 10 min/day) may attenuate the decline in bone density in patients with CKD. Our findings may provide insight for the development of novel strategies for improving bone health in patients with CKD.

摘要

简介

本研究旨在探讨慢性肾脏病(CKD)患者久坐时间和体力活动时间与骨密度的横断面关联。采用等时替代(IS)模型来估算行为改变(例如,用体力活动时间替代久坐时间)对这些患者骨密度的有益影响。

材料和方法

共纳入 92 例 CKD 患者(年龄:65±9 岁;估计肾小球滤过率:57±22 mL/min/1.73 m)进行横断面研究。使用三轴加速度计评估久坐行为(SB)、低强度体力活动(LPA)和中高强度体力活动(MVPA)的时间。通过定量超声测量,使用声速和宽带超声衰减计算刚度指数,作为骨密度的衡量指标。

结果

在多变量分析中,刚度指数与 MVPA 时间呈正相关(β=0.748),但与 SB 和 LPA 时间无显著相关性。IS 模型显示,用等量的 LPA 时间替代 10 分钟/天的 SB 与刚度指数无显著相关性;然而,用等量的 MVPA 时间替代 10 分钟/天的 SB 与刚度指数呈正相关(β=0.804)。

结论

这些结果表明,MVPA 时间的少量增加(例如,每天 10 分钟)可能会减缓 CKD 患者骨密度的下降。我们的发现可能为制定改善 CKD 患者骨骼健康的新策略提供思路。

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