Physical Activity, Sedentary Behavior, And Skeletal Muscle Strength In Patients With Chronic Kidney Disease: An Isotemporal Substitution Approach
Physical Activity, Sedentary Behavior, And Skeletal Muscle Strength In Patients With Chronic Kidney Disease: An Isotemporal Substitution Approach
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慢性肾病患者的体力活动、久坐行为和骨骼肌力量：等时替代方法
DOI：
10.1093/ptj/pzab101
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发表时间：
2021
期刊：
影响因子：
3.2
通讯作者：
Maeda Seiji
中科院分区：
文献类型：
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作者：
Yoshioka Masaki;Kosaki Keisei;Matsui Masahiro;Takahashi Kanako;Shibata Ai;Oka Koichiro;Kuro-o Makoto;Saito Chie;Yamagata Kunihiro;Maeda Seiji
身体活动不足和过度久坐行为可能导致骨骼肌强度下降，这与慢性肾脏病（CKD）患者的死亡率增加密切相关。然而，在这些个体中，用身体活动代替久坐行为对骨骼肌力量的潜在影响仍然不清楚。本研究的目的是研究CKD患者的体力活动、久坐行为和骨骼肌强度之间的关系，使用等时替代模型来估计从一种行为到另一种行为的替代时间，同时保持总时间和其他行为固定。（平均年龄= 65 [SD = 9] y;平均估计肾小球滤过率= 57 [SD = 22] mL/min/1.73 m2）参与了这项横断面分析研究。使用三轴加速度计评估久坐行为、轻强度体力活动和中等至剧烈强度体力活动（MVPA）所花费的时间。握力，等长膝关节伸展强度，和30秒的椅子站测试被用来测量骨骼肌strength.ResultsIn多变量分析（单因素和分区模型），在MVPA花费的时间是有益的，与等长膝关节伸展强度和30秒的椅子站测试。此外，等时替代模型发现，用相等的MVPA时间替代10分钟/天的久坐行为或轻强度体力活动与等长膝关节伸展强度和30秒椅子站立<？TeX \nobreak？> <? TeX \hbox\bgroup？>结论这些横截面的研究结果表明，MVPA时间是有益的下肢肌肉力量，并在MVPA时间略有增加可能有助于维持骨骼肌力量在CKD患者。ImpactIncreasing的时间花费在MVPA（10分钟/天）可能是一个可行的策略，在CKD患者谁有一个高患病率的身体功能受损。
ObjectiveInsufficient physical activity and excessive sedentary behavior can contribute to decreased skeletal muscle strength, which is strongly associated with increased mortality in patients with chronic kidney disease (CKD). However, the potential impact of replacing sedentary behavior with physical activity on skeletal muscle strength remains unclear in these individuals. The purpose of this study was to examine the associations of physical activity, sedentary behavior, and skeletal muscle strength in patients with CKD using an isotemporal substitution model to estimate the associations on replacing time from one behavior to another while keeping the total time and other behaviors fixed.MethodsA total of 108 patients with CKD (mean age = 65 [SD = 9] y; mean estimated glomerular filtration rate = 57 [SD = 22] mL/min/1.73 m2) participated in this cross-sectional analysis study. The time spent in sedentary behavior, light-intensity physical activity, and moderate- to vigorous-intensity physical activity (MVPA) was assessed using a triaxial accelerometer. Handgrip strength, isometric knee extension strength, and 30-second chair stand test were used to measure skeletal muscle strength.ResultsIn multivariate analyses (single-factor and partition models), the time spent in MVPA was beneficially associated with both isometric knee extension strength and 30-second chair stand test. Furthermore, the isotemporal substitution model found that replacing 10 min/d of sedentary behavior or light-intensity physical activity with equivalent MVPA time was beneficially associated with both isometric knee extension strength and 30-second chair stand<?TeX \nobreak?><?TeX \hbox\bgroup?>test.ConclusionThese cross-sectional findings indicate that MVPA time is beneficially associated with lower extremity muscle strength and that a slight increase in the MVPA time may contribute to maintaining skeletal muscle strength in patients with CKD.ImpactIncreasing the time spent in MVPA (10 min/d) may be a feasible strategy in patients with CKD who have a high prevalence of impaired physical function.