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体力活动与伴有和不伴有慢性肾脏病成年人的血管内皮功能障碍的关系:马斯特里赫特研究。

Association of physical activity with endothelial dysfunction among adults with and without chronic kidney disease: The Maastricht Study.

机构信息

Department of Hygiene, Epidemiology and Medical Statistics, School of Medicine, National and Kapodistrian University of Athens, Greece; Department of Nephrology and Renal Transplantation, Laiko General Hospital, National and Kapodistrian University of Athens, Greece.

Department of Nephrology and Renal Transplantation, Laiko General Hospital, National and Kapodistrian University of Athens, Greece.

出版信息

Atherosclerosis. 2023 Oct;383:117330. doi: 10.1016/j.atherosclerosis.2023.117330. Epub 2023 Oct 5.

Abstract

BACKGROUND AND AIMS

Physical activity (PA) constitutes an established protective factor while sedentary behavior (SB) an emerging independent risk factor for cardiovascular diseases. This study evaluated the association of PA and SB with endothelial dysfunction (ED) depending on kidney function status.

METHODS

Cross-sectional data from the prospective, population-based Maastricht Study were used. PA and SB were measured using the ActivPAL3 accelerometer 24h/day for eight consecutive days. ED was evaluated by plasma levels of soluble vascular cell adhesion protein-1, intercellular adhesion molecule-1, E-selectin and von Willebrand factor, which were combined into an ED score with higher values depicting higher ED.

RESULTS

Overall, 2,668 participants, 323 with chronic kidney disease, were included. In normal kidney function individuals, the ED score presented a significant negative association with total, lower-intensity and moderate-to-vigorous PA duration and a positive association with total sedentary time, sedentary breaks and sedentary bout duration. In participants with chronic kidney disease, a significant negative association of ED score with total [β: -4.42, 95% confidence intervals (95% CI): -7.98; -0.87] and lower-intensity (β: -7.08, 95% CI: -13.41; -0.74) PA duration, as well as a positive association of ED score with sedentary bout duration (β: 43.72, 95% CI: 9.85; 77.59) were noted. The strength of associations did not significantly differ across kidney function subgroups (p > 0.05).

CONCLUSIONS

This analysis showed that PA duration is inversely associated with ED both among patients with normal kidney function and chronic kidney disease. In chronic kidney disease, longer sedentary bouts were associated with greater endothelial dysfunction.

摘要

背景和目的

体力活动(PA)是心血管疾病的既定保护因素,而久坐行为(SB)是新兴的独立危险因素。本研究评估了 PA 和 SB 与内皮功能障碍(ED)的相关性,同时考虑了肾功能状况。

方法

本研究使用前瞻性、基于人群的马斯特里赫特研究的横断面数据。PA 和 SB 使用 ActivPAL3 加速度计 24 小时/天连续 8 天进行测量。ED 通过可溶性血管细胞黏附蛋白-1、细胞间黏附分子-1、E-选择素和血管性血友病因子的血浆水平进行评估,这些指标组合成一个 ED 评分,分值越高表示 ED 越严重。

结果

共纳入 2668 名参与者,其中 323 名患有慢性肾脏病。在肾功能正常的个体中,ED 评分与总、低强度和中高强度 PA 持续时间呈显著负相关,与总久坐时间、久坐休息时间和久坐持续时间呈显著正相关。在慢性肾脏病患者中,ED 评分与总 PA 持续时间[β:-4.42,95%置信区间(95%CI):-7.98;-0.87]和低强度 PA 持续时间[β:-7.08,95%CI:-13.41;-0.74]呈显著负相关,与久坐持续时间呈显著正相关[β:43.72,95%CI:9.85;77.59]。在肾功能亚组中,关联的强度没有显著差异(p>0.05)。

结论

本分析表明,PA 持续时间与 ED 呈负相关,无论患者的肾功能是否正常。在慢性肾脏病中,较长的久坐时间与更大的内皮功能障碍相关。

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