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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.


Related in: MedlinePlus

Correlations of physical activity measured by accelerometry with metrics of metabolic health. Scatter plots with linear regression lines stratified by CKD status. Controls are indicated in red and controls in black
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Fig2: Correlations of physical activity measured by accelerometry with metrics of metabolic health. Scatter plots with linear regression lines stratified by CKD status. Controls are indicated in red and controls in black

Mentions: Compared to non-CKD control subjects, participants with CKD had lower mean insulin sensitivity (-1.1 (mg/min)/(μU/mL)), higher mean total fat mass (+2.6 kg), and higher mean triglycerides (+53.6 mg/dL) (Table 4). The associations of physical activity with insulin sensitivity and triglycerides did not differ significantly among participants with and without CKD (Fig. 2 and Table 4). However, the association of physical activity with fat mass appeared weaker among participants with CKD, with a p-value for interaction that was of borderline statistical significance (p = 0.045 without accounting for multiple comparisons).Table 4


Physical activity and metabolic health in chronic kidney disease: a cross-sectional study
Correlations of physical activity measured by accelerometry with metrics of metabolic health. Scatter plots with linear regression lines stratified by CKD status. Controls are indicated in red and controls in black
© Copyright Policy - OpenAccess
Related In: Results  -  Collection

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

Fig2: Correlations of physical activity measured by accelerometry with metrics of metabolic health. Scatter plots with linear regression lines stratified by CKD status. Controls are indicated in red and controls in black
Mentions: Compared to non-CKD control subjects, participants with CKD had lower mean insulin sensitivity (-1.1 (mg/min)/(μU/mL)), higher mean total fat mass (+2.6 kg), and higher mean triglycerides (+53.6 mg/dL) (Table 4). The associations of physical activity with insulin sensitivity and triglycerides did not differ significantly among participants with and without CKD (Fig. 2 and Table 4). However, the association of physical activity with fat mass appeared weaker among participants with CKD, with a p-value for interaction that was of borderline statistical significance (p = 0.045 without accounting for multiple comparisons).Table 4

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.


Related in: MedlinePlus