Department of General Surgery, Shenyang.
Graduate Institute of Sports and Health Management, National Chung Hsing University, Taichung; Department of Kinesiology, National Tsing Hua University, Hsinchu City, Taiwan; Department of Behavioural Science and Health, University College London, London, United Kingdom.
Am J Kidney Dis. 2024 Oct;84(4):437-446.e1. doi: 10.1053/j.ajkd.2024.03.022. Epub 2024 May 14.
RATIONALE & OBJECTIVE: Kidney stone disease (KSD), a significant health care problem within both developed and developing countries, has been associated with genetic risk factors. An association between physical activity and KSD risk also has been hypothesized, but studies have yielded inconsistent findings. This study investigated the association between the intensity of physical activity and the incidence of KSD accounting for genetic risk. STUDY DESIGN: Prospective cohort study. SETTING & PARTICIPANTS: A total of 80,473 participants from the UK Biobank Study. EXPOSURE: Physical activity levels, including total physical activity (TPA), moderate-to-vigorous intensity physical activity (MVPA), and light-intensity physical activity (LPA), were measured using accelerometers and quantified using a machine learning model. A polygenic risk score (PRS) for KSD was also constructed. OUTCOME: Individuals with KSD were identified using the International Classification of Diseases, Tenth Revision (ICD-10), and procedure codes for KSD surgery. ANALYTICAL APPROACH: A Fine and Gray survival model was used to estimate the associations of incident KSD with TPA, MVPA, LPA, and PRS (as categorical variables). Restricted cubic splines were used to examine potential nonlinear associations within the fully adjusted models. RESULTS: During an average follow-up of 6.19 years, 421 participants developed KSD. Participants in the highest quartiles of TPA, MVPA, and LPA had lower adjusted rates of KSD compared with those in the lowest quartiles: HR, 0.50 (95% CI, 0.44-0.56), 0.57 (95% CI, 0.51-0.64), and 0.66 (95% CI, 0.59-0.74), respectively. TPA, MVPA, and LPA were associated with a lower risk of KSD in participants with low and high genetic predisposition for KSD. LIMITATIONS: Selection bias as participants who provided accelerometry data may have been more adherent to health care. CONCLUSIONS: Physical activity was negatively associated with the risk of KSD, regardless of the genetic risk. Future large studies are warranted to confirm and explain the mechanisms underlying these associations. PLAIN-LANGUAGE SUMMARY: The association between the intensity of physical activity (PA) and the incidence of kidney stone disease (KSD) after accounting for genetic risk is unclear. We conducted a comprehensive prospective cohort study utilizing participants from the UK Biobank to assess the intensity of PA using accelerometers. Our study findings indicated that greater total PA, moderate-to-vigorous-intensity PA, and light-intensity PA were each associated with a lower risk of KSD irrespective of an individual's genetic risk. Our study informs the understanding of risk factors for KSD.
背景与目的：肾结石疾病（KSD）是发达国家和发展中国家都面临的重大医疗保健问题，与遗传风险因素有关。也有人假设身体活动与 KSD 风险之间存在关联，但研究结果并不一致。本研究旨在探讨身体活动强度与 KSD 风险之间的关联，同时考虑遗传风险。
研究设计：前瞻性队列研究。
地点与参与者：共纳入英国生物库研究的 80473 名参与者。
暴露情况：使用加速度计测量身体活动水平，包括总身体活动（TPA）、中高强度身体活动（MVPA）和低强度身体活动（LPA），并使用机器学习模型进行量化。还构建了 KSD 的多基因风险评分（PRS）。
结局：使用国际疾病分类第 10 版（ICD-10）和 KSD 手术的程序代码识别 KSD 患者。
分析方法：使用 Fine 和 Gray 生存模型估计 KSD 与 TPA、MVPA、LPA 和 PRS（作为分类变量）之间的关联。在完全调整后的模型中，使用限制三次样条检验潜在的非线性关联。
结果：在平均 6.19 年的随访期间，421 名参与者发生 KSD。与最低四分位数相比，TPA、MVPA 和 LPA 最高四分位数的参与者发生 KSD 的调整后率较低：HR 分别为 0.50（95%CI，0.44-0.56）、0.57（95%CI，0.51-0.64）和 0.66（95%CI，0.59-0.74）。在遗传易感性低和高的参与者中，TPA、MVPA 和 LPA 与 KSD 风险降低相关。
局限性：选择偏倚，因为提供加速度计数据的参与者可能更遵守医疗保健。
结论：无论遗传风险如何，身体活动与 KSD 风险呈负相关。需要进一步开展大型研究以证实并解释这些关联的机制。
通俗语言摘要：目前尚不清楚身体活动强度（PA）与遗传风险因素校正后与肾结石疾病（KSD）发生率之间的关联。我们利用英国生物库的参与者进行了一项全面的前瞻性队列研究，使用加速度计评估 PA 强度。我们的研究结果表明，无论个体的遗传风险如何，较高的总 PA、中高强度 PA 和低强度 PA 均与 KSD 风险降低相关。我们的研究为 KSD 的风险因素提供了新的认识。
Cancer Epidemiol Biomarkers Prev. 2024-8-1
Am J Kidney Dis. 2024-10
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