Limits...
Physical activity and metabolic health in chronic kidney disease: a cross-sectional study

View Article: PubMed Central - PubMed

ABSTRACT

Background: Patients with chronic kidney disease (CKD) are at high risk of progression to end stage renal disease and cardiovascular events. Physical activity may reduce these risks by improving metabolic health. We tested associations of physical activity with central components of metabolic health among people with moderate-severe non-diabetic CKD.

Methods: We performed a cross-sectional study of 47 people with CKD (estimated GFR <60 ml/min/1.73 m2) and 29 healthy control subjects. Accelerometry was used to measured physical activity over 7 days, the hyperinsulinemic-euglycemic clamp was used to measure insulin sensitivity, and DXA was used to measured fat mass. We tested associations of physical activity with insulin sensitivity, fat mass, blood pressure, serum lipid concentrations, and serum high sensitivity C-reactive protein concentration using multivariable linear regression, adjusting for possible confounding factors.

Results: Participants with CKD were less active than participants without CKD (mean (SD) 468.1 (233.1) versus 662.3 (292.5) counts per minute) and had lower insulin sensitivity (4.1 (2.1) versus 5.2 (2.0 (mg/min)/(μU/mL)), higher fat mass (32.0 (11.4) versus 29.4 (14.8) kg), and higher triglyceride concentrations (153.2 (91.6) versus 99.6 (66.8) mg/dL). With adjustment for demographics, comorbidity, medications, and estimated GFR, each two-fold higher level of physical activity was associated with a 0.9 (mg/min)/(μU/mL) higher insulin sensitivity (95% CI 0.2, 1.5, p = 0.006), an 8.0 kg lower fat mass (−12.9, −3.1, p = 0.001), and a 37.9 mg/dL lower triglyceride concentration (−71.9, −3.9, p = 0.03). Associations of physical activity with insulin sensitivity and triglycerides did not differ significantly by CKD status (p-values for interaction >0.3).

Conclusions: Greater physical activity is associated with multiple manifestations of metabolic health among people with moderate-severe CKD.

Electronic supplementary material: The online version of this article (doi:10.1186/s12882-016-0400-x) contains supplementary material, which is available to authorized users.

No MeSH data available.


Physical activity among participants with and without CKD. Boxplots compare the physical activity of non-CKD vs CKD participants. Physical activity was quantified as accelerometry counts per minute (panel a), accelerometry active time (panel b), or human activity profile adjusted activity score (panel c). Box plots display median with the 25 and 75th percentiles, with participants outside 1.5 times the IQR noted as data points
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC5120456&req=5

Fig1: Physical activity among participants with and without CKD. Boxplots compare the physical activity of non-CKD vs CKD participants. Physical activity was quantified as accelerometry counts per minute (panel a), accelerometry active time (panel b), or human activity profile adjusted activity score (panel c). Box plots display median with the 25 and 75th percentiles, with participants outside 1.5 times the IQR noted as data points

Mentions: Of the 76 SUGAR participants included in this study, mean age was 62.6 years, 44.7% were female, and race was self-reported as black for 14.5% and Asian or Pacific Islander for 5.3% (Table 1). 47 participants had CKD and 29 did not. Characteristics of the 76 SUGAR participants included in this analysis were similar to those of the 22 SUGAR participants excluded from this analysis (Additional file 1: Table S1). Participants with greater physical activity tended to be younger, weighed less, and had a higher eGFR (Table 1). Among participants with CKD, mean eGFR was 38.7 mL/min/1.73 m2 and median AER was 39.2 mg/24 h (Additional file 1: Table S2). Participants with CKD were less physically active than participants without CKD (Fig. 1 and Additional file 1: Table S2).Table 1


Physical activity and metabolic health in chronic kidney disease: a cross-sectional study
Physical activity among participants with and without CKD. Boxplots compare the physical activity of non-CKD vs CKD participants. Physical activity was quantified as accelerometry counts per minute (panel a), accelerometry active time (panel b), or human activity profile adjusted activity score (panel c). Box plots display median with the 25 and 75th percentiles, with participants outside 1.5 times the IQR noted as data points
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC5120456&req=5

Fig1: Physical activity among participants with and without CKD. Boxplots compare the physical activity of non-CKD vs CKD participants. Physical activity was quantified as accelerometry counts per minute (panel a), accelerometry active time (panel b), or human activity profile adjusted activity score (panel c). Box plots display median with the 25 and 75th percentiles, with participants outside 1.5 times the IQR noted as data points
Mentions: Of the 76 SUGAR participants included in this study, mean age was 62.6 years, 44.7% were female, and race was self-reported as black for 14.5% and Asian or Pacific Islander for 5.3% (Table 1). 47 participants had CKD and 29 did not. Characteristics of the 76 SUGAR participants included in this analysis were similar to those of the 22 SUGAR participants excluded from this analysis (Additional file 1: Table S1). Participants with greater physical activity tended to be younger, weighed less, and had a higher eGFR (Table 1). Among participants with CKD, mean eGFR was 38.7 mL/min/1.73 m2 and median AER was 39.2 mg/24 h (Additional file 1: Table S2). Participants with CKD were less physically active than participants without CKD (Fig. 1 and Additional file 1: Table S2).Table 1

View Article: PubMed Central - PubMed

ABSTRACT

Background: Patients with chronic kidney disease (CKD) are at high risk of progression to end stage renal disease and cardiovascular events. Physical activity may reduce these risks by improving metabolic health. We tested associations of physical activity with central components of metabolic health among people with moderate-severe non-diabetic CKD.

Methods: We performed a cross-sectional study of 47 people with CKD (estimated GFR <60 ml/min/1.73 m2) and 29 healthy control subjects. Accelerometry was used to measured physical activity over 7 days, the hyperinsulinemic-euglycemic clamp was used to measure insulin sensitivity, and DXA was used to measured fat mass. We tested associations of physical activity with insulin sensitivity, fat mass, blood pressure, serum lipid concentrations, and serum high sensitivity C-reactive protein concentration using multivariable linear regression, adjusting for possible confounding factors.

Results: Participants with CKD were less active than participants without CKD (mean (SD) 468.1 (233.1) versus 662.3 (292.5) counts per minute) and had lower insulin sensitivity (4.1 (2.1) versus 5.2 (2.0 (mg/min)/(μU/mL)), higher fat mass (32.0 (11.4) versus 29.4 (14.8) kg), and higher triglyceride concentrations (153.2 (91.6) versus 99.6 (66.8) mg/dL). With adjustment for demographics, comorbidity, medications, and estimated GFR, each two-fold higher level of physical activity was associated with a 0.9 (mg/min)/(μU/mL) higher insulin sensitivity (95% CI 0.2, 1.5, p = 0.006), an 8.0 kg lower fat mass (−12.9, −3.1, p = 0.001), and a 37.9 mg/dL lower triglyceride concentration (−71.9, −3.9, p = 0.03). Associations of physical activity with insulin sensitivity and triglycerides did not differ significantly by CKD status (p-values for interaction >0.3).

Conclusions: Greater physical activity is associated with multiple manifestations of metabolic health among people with moderate-severe CKD.

Electronic supplementary material: The online version of this article (doi:10.1186/s12882-016-0400-x) contains supplementary material, which is available to authorized users.

No MeSH data available.