Liu Qiaoling, Celis-Morales Carlos, Lees Jennifer S, Sattar Naveed, Ho Frederick K, Pell Jill P, Mark Patrick B, Welsh Paul
School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK.
Human Performance Lab, Education, Physical Activity and Health Research Unit, University Católica del Maule, Talca, Chile.
J Cachexia Sarcopenia Muscle. 2024 Oct;15(5):2046-2055. doi: 10.1002/jcsm.13551. Epub 2024 Aug 18.
Previous research on the association between physical activity (PA) and kidney function is inconsistent. The association between muscle mass and serum creatinine (SCr) may have implications for interpreting the effect of PA on estimated glomerular filtration rate (eGFR). Few studies have reported changes in physical activity and changes in kidney function.
A cohort study was constructed using the UK Biobank. Changes in physical activity were self-reported as metabolic equivalent task (MET) minutes/week. eGFR was calculated using SCr and cystatin C (CysC). Cox and nonlinear regressions with restricted cubic splines were applied to explore the association between changes in physical activity and rapid decline of kidney function (RDKF, eGFR annual decrease ≥3 mL/min/1.73 m), and the annual change of eGFR. An exploratory analysis of cardiorespiratory fitness as the exposure was conducted.
Among 11 757 participants, the median follow-up time was 4.4 years. Participants whose PA decreased by 1000 MET minutes/week at the follow-up assessment had a 2% reduction in risk of developing RDKF (HR = 0.98, 95% CI: 0.96, 1.00). In contrast, a 1000 MET minutes/week increase in PA was associated with a 4% reduction in risk of developing RDKF (HR = 0.96, 95% CI: 0.93, 0.99). A PA increase of 1000 MET minutes/week was associated with eGFR annual increase of 0.04 mL/min/1.73 m (95% CI: 0.03, 0.06) but no significant changes in eGFR.
In this general population study, there are differing associations between changes in PA and changes in kidney function depending on the kidney biomarker used. Increasing PA is modestly associated with improving annual eGFR and reduced risk of RDKF.
先前关于体力活动（PA）与肾功能之间关联的研究结果并不一致。肌肉量与血清肌酐（SCr）之间的关联可能对解释PA对估计肾小球滤过率（eGFR）的影响具有重要意义。很少有研究报告体力活动的变化和肾功能的变化情况。
利用英国生物银行构建了一项队列研究。体力活动的变化通过自我报告代谢当量任务（MET）分钟/周来体现。eGFR通过SCr和胱抑素C（CysC）计算得出。应用Cox回归和带有受限立方样条的非线性回归来探究体力活动变化与肾功能快速下降（RDKF，eGFR每年下降≥3 mL/min/1.73 m²）之间的关联，以及eGFR的年度变化情况。还进行了以心肺适能为暴露因素的探索性分析。
在11757名参与者中，中位随访时间为4.4年。在随访评估中，PA每周减少1000 MET分钟的参与者发生RDKF的风险降低2%（HR = 0.98，95%CI：0.96，1.00）。相比之下，PA每周增加1000 MET分钟与发生RDKF的风险降低4%相关（HR = 0.96，95%CI：0.93，0.99）。PA每周增加1000 MET分钟与eGFR每年增加0.04 mL/min/1.73 m²相关（95%CI：0.03，0.06），但eGFR无显著变化。
在这项一般人群研究中，根据所使用的肾脏生物标志物不同，PA变化与肾功能变化之间存在不同的关联。增加PA与改善年度eGFR以及降低RDKF风险存在适度关联。
