The Association between Sitting Time, Physical Activity Level and Chronic Kidney Disease in the Healthy Adults

Doo Yong Park; On Lee; Yeon Soo Kim

doi:10.5763/kjsm.2017.35.1.32

Journal List > Korean J Sports Med > v.35(1) > 1054602

Go to TopGo to Top Go to BottomGo to Bottom

TOOLS

Park, Lee, and Kim: The Association between Sitting Time, Physical Activity Level and Chronic Kidney Disease in the Healthy Adults

Clinical Article

Korean J Sports Med 2017;35(1):32-39.

Published online: 20 January 2017

DOI: https://doi.org/10.5763/kjsm.2017.35.1.32

The Association between Sitting Time, Physical Activity Level and Chronic Kidney Disease in the Healthy Adults

Doo Yong Park, On Lee, Yeon Soo Kim

Department of Physical Education, Seoul National University, Seoul, Korea

Correspondence: On Lee Department of Physical Education, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Korea Tel: +82-2-880-7794, Fax: +82-2-886-7804 E-mail: fair98@snu.ac.kr

Received 9 December 2016 Revised 13 April 2017 Accepted 19 April 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This study aimed to examine the prevalence of chronic kidney disease (CKD) in association with physical activity and sitting time. Participants of this study are Korean men and women aged 40 to 69, who completed health examination from 2001 to 2003. Physical activity was measured by using an International Physical Activity questionnaire. CKD was defined by estimated glomerular filtration rate that is lower than 60 mL/min/1.73 m². Logistic regression was conducted to evaluate the association of sitting time and physical activity with CKD (p＜0.05). When age, sex, and other risk factor of CKD are adjusted, subjects who reported high level of physical activity participation had a significantly lower odds ratio (OR) of CKD than subjects who reported as sitting low level of physical activity participation (OR, 0.70; 95% confidence interval [CI], 0.50–0.99), and subjects who spend more than 5 hours had significantly higher OR of CKD than subjects who spend less than 1 hours (OR, 1.63; 95% CI, 1.13–2.37). Multivariate-adjusted OR of CKD associated with sitting time more than 5 hours (OR, 2.21; 95% CI, 1.09–4.52) and high physical activity participation more than 1 hours (OR, 0.48; 95% CI, 0.23–0.99) and 5 hours (OR, 0.47; 95% CI, 0.24–0.90) were significant in men. High level of physical activity and low level of sitting time were independently associated with OR of CKD, and this supports the importance of reducing sitting time as well as promoting physical activity participation.

Keywords: Sedentary lifestyle, Physical activity, Chronic kidney disease

References

1. Healy GN, Wijndaele K, Dunstan DW, et al. Objectively measured sedentary time, physical activity, and metabolic risk: the Australian Diabetes, Obesity and Lifestyle Study (AusDiab). Diabetes Care. 2008; 31:369–71.

2. Ministry of Health and Welfare, Korea Centers for Disease Control and Prevention. Korea Health Statistics 2015: Korea National Health and Nutrition Examination Survey (KNHANES VI-3). Cheongju: Korea Centers for Disease Control and Prevention;2015.

3. Thyfault JP, Du M, Kraus WE, Levine JA, Booth FW. Physiology of sedentary behavior and its relationship to health outcomes. Med Sci Sports Exerc. 2015; 47:1301–5.

4. Guo V, Brage S, Ekelund U, Griffin S, Simmons RK. ADDITION-Plus Study Team. Objectively measured sedentary time, physical activity and kidney function in people with recently diagnosed type 2 diabetes: a prospective cohort analysis. Diabet Med. 2016; 33:1222–9.

5. Chronic Kidney Disease Prognosis Consortium. Matsushita K, van der Velde M, et al. Association of estimated glomerular filtration rate and albuminuria with all-cause and cardiovascular mortality in general population cohorts: a collaborative metaanalysis. Lancet. 2010; 375:2073–81.

6. Astor BC, Matsushita K, Gansevoort RT, et al. Lower estimated glomerular filtration rate and higher albuminuria are associated with mortality and end-stage renal disease: a collaborative metaanalysis of kidney disease population cohorts. Kidney Int. 2011; 79:1331–40.

7. Beddhu S, Baird BC, Zitterkoph J, Neilson J, Greene T. Physical activity and mortality in chronic kidney disease (NHANES III). Clin J Am Soc Nephrol. 2009; 4:1901–6.

8. Levey AS, Coresh J. Chronic kidney disease. Lancet. 2012; 379:165–80.

9. Park JI, Baek H, Jung HH. Prevalence of chronic kidney disease in Korea: the Korean National Health and Nutritional Examination Survey 2011–2013. J Korean Med Sci. 2016; 31:915–23.

10. Gould DW, Graham-Brown MP, Watson EL, Viana JL, Smith AC. Physiological benefits of exercise in predialysis chronic kidney disease. Nephrology (Carlton). 2014; 19:519–27.

11. Carney EF. Chronic kidney disease: walking reduces inflammation in predialysis CKD. Nat Rev Nephrol. 2014; 10:300.

12. Robinson-Cohen C, Katz R, Mozaffarian D, et al. Physical activity and rapid decline in kidney function among older adults. Arch Intern Med. 2009; 169:2116–23.

13. Chen IR, Wang SM, Liang CC, et al. Association of walking with survival and RRT among patients with CKD stages 3–5. Clin J Am Soc Nephrol. 2014; 9:1183–9.

14. Garcia LM, da Silva KS, Del Duca GF, da Costa FF, Nahas MV. Sedentary behaviors, leisure-time physical inactivity, and chronic diseases in Brazilian workers: a cross sectional study. J Phys Act Health. 2014; 11:1622–34.

15. Lynch BM, White SL, Owen N, et al. Television viewing time and risk of chronic kidney disease in adults: the AusDiab Study. Ann Behav Med. 2010; 40:265–74.

16. Bharakhada N, Yates T, Davies MJ, et al. Association of sitting time and physical activity with CKD: a cross-sectional study in family practices. Am J Kidney Dis. 2012; 60:583–90.

17. Bowlby W, Zelnick LR, Henry C, et al. Physical activity and metabolic health in chronic kidney disease: a cross-sectional study. BMC Nephrol. 2016; 17:187.

18. Stengel B, Tarver-Carr ME, Powe NR, Eberhardt MS, Brancati FL. Lifestyle factors, obesity and the risk of chronic kidney disease. Epidemiology. 2003; 14:479–87.

19. Yoon J, Kim KK, Hwang IC, Lee KS, Suh HS. Association between body mass index, abdominal obesity defined by waist circumference criteria, and estimated glomerular filtration rate in healthy Korean adults: 2007 the Korea National Health and Nutrition Survey. Korean J Obes. 2011; 20:202–9.

20. Hu B, Liu X, Wang C, et al. Vigorous-intensity physical activity is associated with metabolic syndrome among the Chinese middle-aged population: a cross-sectional study. Int J Sport Nutr Exerc Metab. 2015; 25:119–27.

21. Jafar TH, Jin A, Koh WP, Yuan JM, Chow KY. Physical activity and risk of end-stage kidney disease in the Singapore Chinese Health Study. Nephrology (Carlton). 2015; 20:61–7.

22. Assah FK, Brage S, Ekelund U, Wareham NJ. The association of intensity and overall level of physical activity energy expenditure with a marker of insulin resistance. Diabetologia. 2008; 51:1399–407.

23. Hamburg NM, McMackin CJ, Huang AL, et al. Physical inactivity rapidly induces insulin resistance and microvascular dysfunction in healthy volunteers. Arterioscler Thromb Vasc Biol. 2007; 27:2650–6.

24. Schrage WG. Not a search in vein: novel stimulus for vascular dysfunction after simulated microgravity. J Appl Physiol (1985). 2008; 104:1257–8.

Table 1.

Baseline characteristics of study participants by gender

Characteristics of risk factor	Total			Male			Female
Characteristics of risk factor	Non CKD (n=3,839)	CKD (n=121)	p-value	Non CKD (n=3,839)	CKD (n=121)	p-value	Non CKD (n=4,108)	CKD (n=204)	p-value
Age (yr)	51.53±8.79	56.01±8.52	＜0.001	51.02±8.61	52.67±8.14	0.038	52.00±8.94	57.99±8.13	＜0.001
Sleep duration (hr/day)	6.75±1.37	6.86±1.28	0.133	6.83±1.32	6.84±1.21	0.914	6.67±1.42	6.87±1.32	0.042
% BMI (≥25 kg/m²)	41.79	53.23	＜0.001	39.02	51.24	0.007	44.38	54.41	0.005
Alcohol intake (%)	48.86	35.69	＜0.001	72.73	61.98	0.027	26.56	20.10	0.036
Current smoke (%)	26.34	19.08	0.013	50.51	42.15	0.002	3.75	5.39	0.475
Energy intake (g/day)	1,956.63±704.65	1,887.83±690.63	0.084	2,028.51±669.42	2,001.53±642.27	0.657	1,889.46±729.77	1,820.67±710.81	0.188
Protein intake (g/day)	66.62±30.11	63.60±27.95	0.075	69.79±29.24	68.48±26.83	0.625	63.65±30.60	60.70±28.26	0.178
Serum BUN	13.74±3.61	17.12±5.11	＜0.001	14.47±3.64	18.01±5.24	＜0.001	13.05±3.44	16.59±4.97	＜0.001
C-reactive protein	0.23±0.54	0.28±0.51	0.125	0.25±0.55	0.295±0.53	0.328	0.22±0.54	0.27±0.51	0.191
HOMA-IR	30.61±20.56	31.87±15.93	0.277	29.19±19.20	31.02±13.42	0.297	31.95±21.68	32.37±17.26	0.783
Urine protein test (%)	2.00	5.54	＜0.001	2.32	9.92	＜0.001	1.70	2.94	0.347
History of hypertension	13.14	31.69	＜0.001	11.12	33.88	＜0.001	15.02	30.39	＜0.001
% Lying time (≥5 hr/day)	3.15	3.38	0.128	3.20	3.31	0.036	3.09	3.43	0.729
% Sitting time (≥5 hr/day)	26.61	30.46	0.132	32.66	44.63	0.006	20.96	22.06	0.825
% Light PA (≥5 hr/day)	19.32	16.92	0.398	18.62	14.88	0.544	19.96	18.14	0.811
% Moderate PA (≥5 hr/day)	4.44	1.85	0.017	5.13	0.83	0.059	3.80	2.45	0.294
% Vigorous PA (≥5 hr/day)	17.84	15.69	0.274	18.96	10.74	0.002	16.80	18.63	0.595

Values are presented as mean±standard deviation unless otherwise indicated.

CKD: chronic kidney disease, BMI: body mass index, BUN: blood urea nitrogen, HOMA-IR: homeostasis model assessment of insulin resistance, PA: physical activity.

Table 2.

Association of sedentary behavior and physical activity with CKD in healthy adult

Characteristics of risk factor		Age-sex adjusted OR (95% CI)	Multivariable adjusted OR (95% CI)
Characteristics of risk factor		Age-sex adjusted OR (95% CI)	Model 1	Model 2
Sitting time (hr/day)	＜1	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)
	1−5	1.31 (0.960−1.80)	1.30 (0.95−1.79)	1.33 (0.96−1.84)
	≥5	1.66 (1.17−2.37)	1.62 (1.14−2.32)	1.63 (1.13−2.37)
	p-trend	0.005	0.007	0.01
Low PA (hr/day)	＜1	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)
	1−5	1.03 (0.79−1.35)	1.05 (0.80−1.37)	1.03 (0.78−1.36)
	≥5	0.92 (0.65−1.31)	0.94 (0.66−1.34)	0.90 (0.63−1.31)
	p-trend	0.707	0.801	0.684
Moderate PA (hr/day)	＜1	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)
	1−5	0.84 (0.62−1.14)	0.85 (0.63−1.16)	0.82 (0.59−1.12)
	≥5	0.40 (0.17−0.90)	0.40 (0.18−0.91)	0.40 (0.18−0.94)
	p-trend	0.020	0.025	0.02
Vigorous PA (hr/day)	＜1	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)
	1−5	0.73 (0.50−1.07)	0.74 (0.51−1.07)	0.71 (0.48−1.06)
	≥5	0.67 (0.48−0.94)	0.70 (0.50−0.97)	0.70 (0.50−0.99)
	p-trend	0.011	0.022	0.028

Multivariable model 1 was adjusted for physical activities (low, moderate, vigorous) and sitting time simultaneously as well as age, sex and history of hypertension; Model 2 was adjusted for model 1 as well as sleep duration, lying duration, alcohol consumption, current smoking, protein intake, total energy intake, HOMA-IR, hs-CRP, serum BUN, urine of protein and BMI. CKD: chronic kidney disease, OR: odds ratio, CI: confidence interval, PA: physical activity, HOMA-IR: homeostasis model assessment of insulin resistance, hs-CRP: high-sensitivity C-reactive protein, BUN: blood urea nitrogen, BMI: body mass index.

Table 3.

Association of sedentary behavior physical activity with CKD in healthy adult by gender

Characteristics of risk factor		Male (n=3,960)		Female (n=4,312)
Characteristics of risk factor		Age adjusted OR (95% CI)	Multivariable adjusted OR (95% CI)	Age adjusted OR (95% CI)	Multivariable adjusted OR (95% CI)
Sitting time (hr/day)	＜1	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)
	1−5	1.62 (0.86−3.04)	1.71 (0.87−3.36)	1.17 (0.81−1.68)	1.17 (0.80−1.71)
	≥5	2.00 (1.03−3.88)	2.21 (1.09−4.52)	1.34 (0.85−2.09)	1.29 (0.81−2.05)
	p-trend	0.044	0.029	0.203	0.286
Low PA (hr/day)	＜1	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)
	1−5	0.95 (0.63−1.43)	0.86 (0.56−1.33)	1.16 (0.81−1.66)	1.15 (0.80−1.67)
	≥5	0.74 (0.42−1.32)	0.74 (0.41−1.34)	1.13 (0.71−1.78)	1.05 (0.65−1.70)
	p-trend	0.348	0.298	0.570	0.774
Moderate PA (hr/day)	＜1	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)
	1−5	0.86 (0.54−1.39)	0.85 (0.52−1.40)	0.87 (0.58−1.29)	0.82 (0.54−1.24)
	≥5	0.17 (0.02−1.22)	0.18 (0.24−1.31)	0.57 (0.23−1.43)	0.58 (0.23−1.47)
	p-trend	0.077	0.089	0.194	0.149
Vigorous PA (hr/day)	＜1	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)	1.00 (Reference)
	1−5	0.41 (0.20−0.83)	0.48 (0.23−0.99)	1.03 (0.66−1.61)	0.93 (0.58−1.47)
	≥5	0.43 (0.23−0.81)	0.47 (0.24−0.90)	0.86 (0.58−1.28)	0.90 (0.60−1.37)
	p-trend	0.002	0.01	0.517	0.615

Multivariable model was adjusted for physical activities (low, moderate, vigorous) and sitting time simultaneously as well as age, sex, sleep duration, lying duration, alcohol consumption, current smoking, protein intake, total energy intake, HOMA-IR, hs-CRP, serum BUN, history of hypertension, urine of protein and BMI.

CKD: chronic kidney disease, OR: odds ratio, CI: confidence interval, PA: physical activity, HOMA-IR: homeostasis model assessment of insulin resistance, hs-CRP: high-sensitivity C-reactive protein, BUN: blood urea nitrogen, BMI: body mass index.

TOOLS

Similar articles