Benefits of a 12-week lifestyle modification program including diet and combined aerobic and resistance exercise on albuminuria in diabetic and non-diabetic Japanese populations.
BACKGROUND
Albuminuria is a biomarker for chronic kidney disease and an independent predictor of cardiovascular and all-cause mortality. A recent meta-analysis concluded that these risks increase with urinary albumin concentration, even when below the microalbuminuria threshold. Thus, minimizing urinary albumin may be a valuable therapeutic goal regardless of disease status.


METHODS
We investigated the benefits and safety of a 12-week lifestyle modification program including diet and combined aerobic and resistance exercise for reducing albuminuria in 295 normoalbuminuric or microalbuminuric Japanese adults, including 30 with type 2 diabetes mellitus (T2DM), 104 with metabolic syndrome (MS), and 145 with hypertension (HT).


RESULTS
In the study population, the urinary albumin:creatinine ratio (UACR) was reduced significantly (ΔUACR -3.8 ± 16.8 mg/g, P < 0.001) with no change in estimated glomerular filtration rate (eGFR) (ΔeGFR -0.4 ± 7.4 mL/min/1.73 m(2), P = 0.343). The reduction in UACR was associated with decreased fasting plasma glucose (P < 0.05). The UACR was also reduced in the T2DM, MS, and HT groups with no change in eGFR. Reduced UACR was associated with decreased fasting plasma glucose in the MS group and decreased systolic blood pressure in the HT group. The UACR was also reduced in 46 subjects using renin-angiotensin system inhibitors with no change in eGFR.


CONCLUSIONS
Our 12-week lifestyle modification program reduced UACR, maintained eGFR, and improved multiple fitness findings in Japanese subjects including T2DM, MS, and HT patients.
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.
Keiko
K
Yamamoto-Kabasawa
Department of Clinical Nutrition Science, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.
Michihiro
M
Hosojima
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.
Yusuke
Y
Yata
Niigata Institute for Health and Sports Medicine, 67-12 Seigoro, Chuo-ku, Niigata, Niigata, 950-0933, Japan.
Mariko
M
Saito
Niigata Institute for Health and Sports Medicine, 67-12 Seigoro, Chuo-ku, Niigata, Niigata, 950-0933, Japan.
Noriko
N
Tanaka
Department of Health Promotion Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.
Junta
J
Tanaka
Department of Health and Nutrition, Faculty of Human Life Studies, University of Niigata Prefecture, 471 Ebigase, Higashi-ku, Niigata, Niigata, 950-8680, Japan.
Naohito
N
Tanabe
Division of Clinical Nephrology and Rheumatology, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan.
Ichiei
I
Narita
Niigata Institute for Health and Sports Medicine, 67-12 Seigoro, Chuo-ku, Niigata, Niigata, 950-0933, Japan.
Masaaki
M
Arakawa
Department of Applied Molecular Medicine, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Chuo-ku, Niigata, Niigata, 951-8510, Japan. akisaito@med.niigata-u.ac.jp.
Akihiko
A
Saito
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000150:complications / Q000178:diet therapy / Q000628:therapy*; D015415:Biomarkers; D001786:Blood Glucose / Q000378:metabolism; D003924:Diabetes Mellitus, Type 2 / Q000178:diet therapy / Q000628:therapy*; D015444:Exercise; D005081:Exercise Therapy / Q000009:adverse effects / Q000379:methods*; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000178:diet therapy / Q000628:therapy; D007564:Japan; D008019:Life Style; D008297:Male; D024821:Metabolic Syndrome / Q000178:diet therapy / Q000628:therapy; D008875:Middle Aged; D061214:Patient Safety; D055070:Resistance Training / Q000009:adverse effects; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers; D001786:Blood Glucose
Albuminuria; Hypertension; Lifestyle modification; Metabolic syndrome; Type 2 diabetes mellitus