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中重度体力活动和久坐时间与肾功能降低青少年肾功能指标的剂量-反应关系:一项横断面研究。

Dose-Response Relationships of Moderate to Vigorous Physical Activity and Sedentary Time With Renal Function Indices in Adolescents With Reduced Renal Function: A Cross-Sectional Study.

机构信息

Department of Pediatrics, Third Xiangya Hospital, Central South University, Changsha, China.

出版信息

J Phys Act Health. 2024 Aug 26;21(10):1064. doi: 10.1123/jpah.2023-0597. Print 2024 Oct 1.

Abstract

BACKGROUND

This study aimed to explore the associations between moderate to vigorous physical activity (MVPA) and sedentary time with renal function indices in adolescents with kidney disease.

METHODS

A cross-sectional study was conducted on 719 adolescents (median age 15 y, 40.6% female) with kidney disease from the National Health and Nutrition Examination Survey 2007-2016. The exposures were MVPA time and sedentary time. Renal metabolic parameters included serum uric acid (SUA), creatinine, blood urea nitrogen, the estimated glomerular filtration rate (eGFR), and the albumin creatinine ratio. Weighted multivariate regression analysis was used to estimate associations between exposures and outcomes.

RESULTS

After stratifying MVPA time, the regression effect values β (95% CI) for MVPA on SUA (Q2: -0.22 [-0.41 to -0.03]; Q3: -0.32 [-0.53 to -0.11]) and creatinine (Q2: -0.08 [-0.15 to -0.01]; Q3: -0.04 [-0.11 to 0.03]) gradually decreased with increasing MVPA time. In males (-0.76 [-1.19 to -0.32]), MVPA time was significantly associated with lower SUA levels compared with females (-0.14 [-0.38 to 0.10]). Notably, female adolescents who had an MVPA time exceeding 420 minutes exhibited lower albumin creatinine ratio (-75.37 [-146.63 to -4.11]). In addition, both recreational MVPA time (-0.26 [-0.45 to -0.06]) and sedentary time (-3.15 [-5.83 to -0.46]) were negatively associated with eGFR.

CONCLUSIONS

Our study found an association between MVPA and lower levels of SUA in male adolescents with kidney disease and albuminuria in female adolescents with kidney disease. In addition, MVPA was also negatively associated with creatinine and eGFR, whereas sedentary time was only associated with eGFR. Further studies are needed to confirm these findings.

摘要

背景

本研究旨在探讨青少年肾脏病患者中,中高强度体力活动(MVPA)和久坐时间与肾功能指标之间的关联。

方法

对 2007-2016 年国家健康与营养调查(NHANES)中的 719 名青少年(中位数年龄 15 岁,40.6%为女性)进行横断面研究。暴露因素为 MVPA 时间和久坐时间。肾脏代谢参数包括血尿酸(SUA)、肌酐、血尿素氮、估算肾小球滤过率(eGFR)和白蛋白/肌酐比值。采用加权多变量回归分析来估计暴露与结局之间的关联。

结果

在分层 MVPA 时间后,MVPA 与 SUA(Q2:-0.22 [-0.41 至 -0.03];Q3:-0.32 [-0.53 至 -0.11])和肌酐(Q2:-0.08 [-0.15 至 -0.01];Q3:-0.04 [-0.11 至 0.03])之间的回归效应值β(95%CI)逐渐随 MVPA 时间的增加而降低。在男性中(-0.76 [-1.19 至 -0.32]),与女性相比(-0.14 [-0.38 至 0.10]),MVPA 时间与较低的 SUA 水平显著相关。值得注意的是,MVPA 时间超过 420 分钟的女性青少年的白蛋白/肌酐比值较低(-75.37 [-146.63 至 -4.11])。此外,娱乐性 MVPA 时间(-0.26 [-0.45 至 -0.06])和久坐时间(-3.15 [-5.83 至 -0.46])均与 eGFR 呈负相关。

结论

本研究发现,在青少年肾脏病患者中,MVPA 与男性青少年 SUA 水平降低和女性青少年蛋白尿有关,与女性青少年的白蛋白/肌酐比值降低有关。此外,MVPA 与肌酐和 eGFR 呈负相关,而久坐时间仅与 eGFR 相关。需要进一步的研究来证实这些发现。

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