Department of Preventive Medicine, Faculty of Medicine, Saga University.
Clinical Research Center, Saga University Hospital.
J Epidemiol. 2023 Jun 5;33(6):285-293. doi: 10.2188/jea.JE20210155. Epub 2022 Feb 22.
Little is known about whether insufficient moderate-to-vigorous physical activity (MVPA) and longer sedentary behavior (SB) are independently associated with estimated glomerular filtration rate (eGFR) and chronic kidney disease (CKD), whether they interact with known risk factors for CKD, and the effect of replacing sedentary time with an equivalent duration of physical activity on kidney function.
We examined the cross-sectional association of MVPA and SB with eGFR and CKD in 66,603 Japanese cohort study in 14 areas from 2004 to 2013. MVPA and SB were estimated using a self-reported questionnaire, and CKD was defined as eGFR <60 mL/min/1.73 m. Multiple linear regression analyses, logistic regression analyses, and an isotemporal substitution model were applied.
After adjusting for potential confounders, higher MVPA and longer SB were independently associated with higher eGFR (P for trend MVPA <0.0001) and lower eGFR (P for trend SB <0.0001), and a lower odds ratio (OR) of CKD (adjusted OR of MVPA ≥20 MET·h/day, 0.76; 95% confidence interval [CI], 0.68-0.85 compared to MVPA <5 MET·h/day) and a higher OR of CKD (adjusted OR of SB ≥16 h/day, 1.81; 95% CI, 1.52-2.15 compared to SB <7 h/day), respectively. The negative association between MVPA and CKD was stronger in men, and significant interactions between sex and MVPA were detected. Replacing 1 hour of SB with 1 hour of physical activity was associated with about 3 to 4% lower OR of CKD.
These findings indicate that replacing SB with physical activity may benefit kidney function, especially in men, adding to the possible evidence on CKD prevention.
对于运动量不足的中度至剧烈体力活动(MVPA)和较长时间的久坐行为(SB)是否与估算肾小球滤过率(eGFR)和慢性肾脏病(CKD)独立相关、它们是否与 CKD 的已知危险因素相互作用,以及用等量的体力活动替代久坐时间对肾功能的影响,人们知之甚少。
我们在 2004 年至 2013 年期间,在日本 14 个地区的 66603 名队列研究参与者中,检测了 MVPA 和 SB 与 eGFR 和 CKD 的横断面相关性。MVPA 和 SB 是通过自报告问卷来估计的,CKD 定义为 eGFR <60 mL/min/1.73 m。采用多元线性回归分析、逻辑回归分析和等时替代模型。
在调整了潜在混杂因素后,较高的 MVPA 和较长的 SB 与较高的 eGFR(MVPA 趋势检验 P<0.0001)和较低的 eGFR(SB 趋势检验 P<0.0001)以及 CKD 的较低比值比(OR)(MVPA 每天≥20 个代谢当量[MET]·h 的调整 OR,0.76;95%置信区间[CI],0.68-0.85 与 MVPA <5 MET·h/天相比)和 CKD 的较高 OR(SB 每天≥16 h 的调整 OR,1.81;95%CI,1.52-2.15 与 SB <7 h/天相比)相关。MVPA 与 CKD 之间的负相关在男性中更强,并且检测到性别与 MVPA 之间存在显著的交互作用。用 1 小时的体力活动替代 1 小时的 SB 与 CKD 的比值比降低约 3%至 4%。
这些发现表明,用体力活动替代 SB 可能有益于肾功能,尤其是在男性中,为 CKD 预防提供了可能的证据。