Tanglai Wirampa, Wattanapisit Apichai, Watanabe Osamu, Jeamjitvibool Thanakrit, Lockwood Mark, Cajita Mia
Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, Illinois, USA.
Princess Agrarajakumari College of Nursing, Chulabhorn Royal Academy, Bangkok, Thailand.
Diabetes Metab Res Rev. 2025 Jul;41(5):e70055. doi: 10.1002/dmrr.70055.
This study aimed to explore the relationship between PA domains, PA intensity, sedentary time, cardiometabolic factors, inflammatory markers, and risk of diabetic kidney disease (DKD) in adults. It also examined potential moderators of the relationship between PA and DKD including age, race and ethnicity.
This cross-sectional study used data from the 2017-2018 National Health and Nutrition Examination Survey and included participants aged ≥ 18 years. The survey subjectively measured PA using the Global Physical Activity Questionnaire. After conducting multiple imputations to address missing data, we performed hierarchical logistic regression to identify factors significantly associated with DKD diagnosis and to examine moderating effects.
DKD prevalence was 13.32%. Non-Hispanic Black participants showed higher odds of DKD than non-Hispanic White participants. Age, waist circumference, systolic blood pressure, fasting glucose levels, haemoglobin A1C, high-sensitivity C-reactive protein, sedentary time, and occupation-related PA were significant predictors of DKD. Although age, race and ethnicity were significant predictors of DKD, we observed no moderating effects of these variables on the PA-DKD risk relationship.
Cardiometabolic markers, inflammatory markers, and sedentary time significantly increase DKD risk, whereas occupation-related PA serves as a protective factor. This study highlights the need for interventions promoting a more active lifestyle in diabetic populations to mitigate their DKD risk.
本研究旨在探讨成年人中身体活动(PA)领域、PA强度、久坐时间、心脏代谢因素、炎症标志物与糖尿病肾病(DKD)风险之间的关系。它还研究了PA与DKD关系的潜在调节因素,包括年龄、种族和民族。
这项横断面研究使用了2017 - 2018年国家健康和营养检查调查的数据,纳入了年龄≥18岁的参与者。该调查使用全球身体活动问卷主观测量PA。在进行多次插补以处理缺失数据后,我们进行了分层逻辑回归,以确定与DKD诊断显著相关的因素并检验调节效应。
DKD患病率为13.32%。非西班牙裔黑人参与者患DKD的几率高于非西班牙裔白人参与者。年龄、腰围、收缩压、空腹血糖水平、糖化血红蛋白、高敏C反应蛋白、久坐时间和与职业相关的PA是DKD的显著预测因素。尽管年龄、种族和民族是DKD的显著预测因素,但我们未观察到这些变量对PA - DKD风险关系有调节作用。
心脏代谢标志物、炎症标志物和久坐时间显著增加DKD风险,而与职业相关的PA是一个保护因素。本研究强调需要采取干预措施,在糖尿病患者群体中促进更积极的生活方式,以降低他们患DKD的风险。