Objectively measured sedentary time, physical activity and kidney function in people with recently diagnosed Type 2 diabetes: a prospective cohort analysis.
To assess the prospective association between objectively measured physical activity and kidney function over 4 years in people with Type 2 diabetes.



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.



Over 4 years, there was a decline in eGFR values from 87.3 to 81.7 ml/min/1.73m(2) (P < 0.001); the prevalence of reduced eGFR (eGFR < 60 ml/min/1.73m(2) ) 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).



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).
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.|Division of Biostatistics, School of Public Health, Faculty of Medicine, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong.
V Yw
VY
Guo
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
S
S
Brage
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.|Department of Sports Medicine, Norwegian School of Sport Sciences, Oslo, Norway.
U
U
Ekelund
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.|The Primary Care Unit, Institute of Public Health, University of Cambridge, Cambridge, UK.
S J
SJ
Griffin
MRC Epidemiology Unit, University of Cambridge School of Clinical Medicine, Cambridge, UK.
R K
RK
Simmons
D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000652:urine; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood / Q000652:urine; D003924:Diabetes Mellitus, Type 2 / Q000188:drug therapy / Q000378:metabolism*; D018450:Disease Progression; D004734:Energy Metabolism; D015444:Exercise; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate; D006801:Humans; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011446:Prospective Studies; D051436:Renal Insufficiency, Chronic / Q000378:metabolism*; D057185:Sedentary Behavior; D013997:Time Factors
D007004:Hypoglycemic Agents; D003404:Creatinine