Objectively measured sedentary time, physical activity and kidney function in people with recently diagnosed Type 2 diabetes: a prospective cohort analysis

• Published in: Diabetic medicine Vol. 33; no. 9; pp. 1222 - 1229
• Main Authors: Guo, V. YW, Brage, S., Ekelund, U., Griffin, S. J., Simmons, R. K.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.09.2016; Wiley Subscription Services, Inc; John Wiley and Sons Inc
• Subjects: Adult; Aged; Albuminuria - urine; Cohort Studies; Creatinine - blood; Creatinine - urine; Diabetes; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Disease Progression; Energy Metabolism; Exercise; Female; Follow-Up Studies; Glomerular Filtration Rate; Humans; Hypoglycemic Agents - therapeutic use; Linear Models; Logistic Models; Male; Middle Aged; Multivariate Analysis; Prospective Studies; Renal Insufficiency, Chronic - metabolism; Research: Epidemiology; Sedentary Behavior; Time Factors
• ISSN: 0742-3071; 1464-5491
• DOI: 10.1111/dme.12886

Aim To assess the prospective association between objectively measured physical activity and kidney function over 4 years in people with Type 2 diabetes. Methods Individuals (120 women and 206 men) participating in the ADDITION‐Plus trial underwent assessment of sedentary time (SED‐time), time spent in moderate‐to‐vigorous‐intensity physical activity (MVPA) and total physical activity energy expenditure (PAEE) using a combined heart rate and movement sensor, and kidney function [estimated glomerular filtration rate (eGFR), serum creatinine and urine albumin‐to‐creatinine ratio (ACR)] at baseline and after 4 years of follow‐up. Multivariate regression was used to quantify the association between change in SED‐time, MVPA and PAEE and kidney measures at four‐year follow‐up, adjusting for change in current smoking status, waist circumference, HbA1c, systolic blood pressure, triglycerides and medication usage. Results Over 4 years, there was a decline in eGFR values from 87.3 to 81.7 ml/min/1.73m2 (P < 0.001); the prevalence of reduced eGFR (eGFR < 60 ml/min/1.73m2) increased from 6.1 to 13.2% (P < 0.001). There were small increases in serum creatinine (median: 81–84 μmol/l, P < 0.001) and urine ACR (median: 0.9–1.0 mg/mmol, P = 0.005). Increases in SED‐time were associated with increases in serum creatinine after adjustment for MVPA and cardiovascular risk factors (β = 0.013, 95% CI: 0.001, 0.03). Conversely, increases in PAEE were associated with reductions in serum creatinine (β = –0.001, 95% CI: –0.003, –0.0001). Conclusion Reducing time spent sedentary and increasing overall physical activity may offer intervention opportunities to improve kidney function among individuals with diabetes. (Trial Registry no. ISRCTN 99175498) What's new? Little is known about the prospective association between objectively measured physical activity and kidney function among individuals with Type 2 diabetes. Over 4 years of follow‐up, reductions in sedentary time and increases in total physical activity energy expenditure were associated with reductions in serum creatinine. Reducing time spent sedentary and increasing overall physical activity may offer intervention opportunities to improve kidney function among individuals with diabetes.