Page 83 - 《运动与健康科学》(英文)2024年第2期

TaggedAPTARAEndAssociation of PA with risk of chronic kidney disease in China 205
TaggedAPTARAPPrevious studies have suggested that physical activity (PA) is studies, 16,17 with additional modifications after a CKB pilot
of significance for the prevention of CKD. 4,5 The MJ longitudinal study. An interviewer-administered questionnaire was used
cohort study conducted in Taiwan, China reported that habitual during the baseline survey and subsequent resurveys to
PA was inversely associated with CKD, with a hazard ratio (HR, collect information about the type, frequency, and duration
95% confidence interval (95%CI)) of 0.91 (0.850.96) in the of PA in 4 domains (occupation, commuting, housework,
high PA level (16.50 metabolic equivalent of task hours per and leisure-time activity) as well as about the number of
week (MET-h/week)) compared to the very low PA level (<3.75 leisure hours spent on sitting activities per week over the
5
MET-h/week). However, prospective studies on the association previous 12 months. Detailed information on the question-
between PA and CKD risk remain insufficient and incon- naire can be found in previous publications (Supplementary
sistent. 68 PA was not associated with CKD in the Framingham Table 1). 11 An MET was assigned to each PA to assess its
6
Heart Study, whereas the Tehran Lipid and Glucose Study intensity level according to the updated 2011 Compendium
8
observed an adverse effect of PA on CKD among males. In addi- of Physical Activity. 18 Each PA level was calculated by
tion, existing studies mainly focus on leisure-time PA. 4,9 Never- multiplying the MET value for that activity by the hours
theless, occupational PA accounts for a large proportion of daily spent on that activity per day (MET-h/day). Domain-specific
PA, and low-intensity PA (LPA) is feasible and sustainable. 10,11 PA level was calculated by summing all the MET-h/day
Although the PA paradox suggests that occupational PA may be spent on occupational or nonoccupational (commuting,
12 13
detrimental, Yamamoto et al. showed a 12% lower risk of housework, and leisure time) PA. Similarly, intensity-spe-
CKD (HR = 0.88, 95%CI: 0.860.96) when comparing standing/ cific PA level, which includes LPA (1.52.9 METs) and
walking at work to sedentary behavior. Thus, further studies on moderate-to-vigorous-intensity PA (MVPA; moderate,
different domains and intensities of PA are needed, especially in 2.95.9 METs; vigorous, 5.9METs), wascalculatedin
the same way. The total PA level was obtained by summing
China where evidence is more limited.TaggedAPTARAEnd
TaggedAPTARAPTherefore, this study aimed to explore the association PA levels in all domains or intensities.TaggedAPTARAEnd
between total, domain-specific, and intensity-specific PA and TaggedAPTARAPAbout 1300 participants completed the same questionnaire
CKD risk based on data from the China Kadoorie Biobank twice within 1.5 years after the baseline survey. We tested the
(CKB) study, so as to help take appropriate measures to reproducibility of total PA between the 2-round surveys. The
19
improve the prevention of CKD.TaggedAPTARAEnd intraclass correlation coefficient was 0.59. TaggedAPTARAEnd

TaggedAPTARAH22.3. Assessment of covariatesTaggedAPTARAEnd
TaggedAPTARAH12. MethodsTaggedAPTARAEnd
TaggedAPTARAPEligible participants completed an interviewer-adminis-
TaggedAPTARAH22.1. Study populationTaggedAPTARAEnd
tered laptop-based questionnaire on their sociodemographic
TaggedAPTARAPThe CKB study is an ongoing population-based prospective characteristics (age, sex, education, occupation, annual house-
cohort of over half a million Chinese adults. Details of the study hold income, and marital status), lifestyle factors (tobacco
design and methods of the CKB have been reported smoking; alcohol consumption; and consumption of red meat,
previously. 14,15 In brief, the study recruited 512,724 participants fresh vegetables, and fresh fruits), and personal medical
aged 3079 years from 10 geographically diverse regions history (hypertension and diabetes) at baseline. Height, body
(5 urban and 5 rural) across China during 20042008 at baseline. weight, waist circumference, and blood pressure were
In addition, about 5% of the surviving participants were randomly measured by trained staff using calibrated instruments at base-
selected for resurveys every 45 years after completing the base- line. All participants provided a 10 mL non-fasting blood
line survey. The study was approved by the Ethical Review sample for a quick on-site test of random plasma glucose. BMI
2
Committee of the Chinese Center for Disease Control and Preven- was calculated as weight (kg) divided by height square (m ).
tion in Beijing, China and the Oxford Tropical Research Ethics According to the National Health Commission of the People’s
Committee at the University of Oxford, UK. All participants Republic of China, prevalent hypertension was defined as
systolic blood pressure 140 mmHg, diastolic blood pressure
provided written informed consent before taking part in the study.TaggedAPTARAEnd
TaggedAPTARAPIn the present study, we excluded participants who were 90 mmHg, self-reported doctor-diagnosed hypertension, or
previously diagnosed by a physician with CKD (n = 7574), self-reported use of antihypertensive drugs at baseline.
coronary heart disease (n = 15,472), stroke (n = 8884), or Prevalent diabetes was defined as fasting blood glucose
cancer (n = 2578) at baseline in order to minimize their reverse 7.0 mmol/L, random blood glucose 11.1 mmol/L, or
causality on PA levels (Some participants have one or more
self-reported doctor-diagnosed diabetes.TaggedAPTARAEnd
disease.). We also excluded those with implausibly small,
large, or conflicting levels of PA (n = 6185), those with
TaggedAPTARAH22.4. Assessment of CKDTaggedAPTARAEnd
missing data for body mass index (BMI; n = 2), and those lost
to follow-up shortly after baseline (n = 1). After exclusions, TaggedAPTARAPIncident CKD cases were obtained through linkage to the
local mortality and disease surveillance points system and the
475,376 participants remained for the final analysis.TaggedAPTARAEnd
national health insurance system and supplemented by annual
active confirmation through visiting local communities or
TaggedAPTARAH22.2. Assessment of PATaggedAPTARAEnd
directly contacting participants. All events were coded using
TaggedAPTARAPThe questions on PA and sedentary leisure time were the International Classification of Disease, 10th Revision by
adapted from validated questionnaires in previous trained staff blinded to the baseline information of participants.