Page 87 - 《运动与健康科学》(英文)2024年第2期

TaggedAPTARAFigure TaggedAPTARAEndAssociation of PA with risk of chronic kidney disease in China 209

Fig. 3. Associations of intensity-specific physical activity with risk of CKD. Usual LPA in different categories were 6.44, 8.73, 9.85, and 10.75 MET-h/day, and
usual MVPA in different categories were 5.65, 6.90, 9.29, and 16.52 MET-h/day, respectively. Models were stratified by baseline age groups and study regions
and adjusted for age; sex; education; occupation; household income; marital status; tobacco smoking; alcohol consumption; sedentary leisure time; MVPA (or
LPA); consumption frequency of red meat, fresh vegetables, and fresh fruits; BMI; prevalent hypertension and diabetes at baseline. The squares represent HRs,
and the vertical lines represent 95%CIs. The dashed lines represent a linear trend of the association between usual intensity-specific physical activity and the risk
of CKD. The numbers above the vertical lines are point estimates for HRs. 95%CI = 95% confidence interval; BMI = body mass index; CKD = chronic kidney
disease; DKD = diabetic kidney disease; HR = hazard ratio; HTN = hypertensive nephropathy; LPA = low-intensity physical activity; MET-h/day = metabolic
equivalent of task hours per day; MVPA = moderate-to-vigorous-intensity physical activity.TaggedAPTARAEnd

Fortunately, our study reported no harmful effects of occupa- nonoccupational PA, LPA, and MVPA, was inversely associ-
tional PA on CKD, thus normal levels of occupational PA can ated with DKD risk. This should motivate individuals, espe-
be maintained. Our results indicated that nonoccupational PA cially those with diabetes, to maintain sufficient and regular
played a more critical role in CKD risk among participants. PA. As for HTN risk, there is limited evidence. Our study
Similarly, Kronborg et al. 25 showed that high PA during non- showed PA to be associated with a lower risk of HTN. Chang
working hours among women predicted an increase in esti- et al. 32 reported a similar result in hypertensive patients and
mated glomerular filtration rate. Previous studies focusing on demonstrated that a higher risk of CKD was significantly asso-
4,5,9 26
PA during leisure time and commuting also demon- ciated with low (odds ratio = 1.39; 95%CI: 1.011.90) and
strated inverse associations with CKD. Therefore, we can say moderate levels of PA (odds ratio = 1.39; 95%CI: 1.041.86)
that sufficient nonoccupational PA, including leisure-time, as compared to a high level of PA.TaggedAPTARAEnd
household, and commuting physical activities, is beneficial for TaggedAPTARAPThere are several biological pathways that could be contrib-
uting to the beneficial effects of PA on CKD. 33 First, PA has
preventing CKD.TaggedAPTARAEnd
TaggedAPTARAPAccording to recommendations from the World Health been shown to regulate the synthesis and degradation of nitric
Organization, 27 the intensity of PA is also critical to health. oxide to maintain normal endothelial and renal function. 34
Jafar et al. 28 reported that a 24% lower risk of end-stage Second, PA can reduce insulin resistance, which was associ-
kidney disease was associated with MVPA compared to those ated with a higher incidence of CKD in the Atherosclerosis
with no PA, and the association appeared to be dose dependent Risk in Communities Study. 35,36 Third, systematic inflamma-
with higher intensities of PA. Our results confirmed a benefi- tion can lead to albuminuria and decreased renal function,
cial association with MVPA and, furthermore, found an associ- while exercise may reverse the inflammatory process by
ation with LPA, which suggests that for those unable to engage reducing inflammatory cytokines such as leptin, tumor
necrosis factor-a, interleukin-1, and interleukin-6 and by culti-
in MVPA, LPA is a viable alternative for lowering CKD risk.TaggedAPTARAEnd
TaggedAPTARAPPrevious studies have demonstrated a significantly lower vating an anti-inflammatory environment. 37 Diabetes and
risk of DKD among people with high levels of PA, 2931 but hypertension may lead to oxidative stress, insulin resistance,
these studies were mainly focused on leisure-time PA. Our and endothelial dysfunction, whereas PA has beneficial effects
24
study went further, finding that total PA, including in terms of these metabolic disorders. TaggedAPTARAEnd