Adiposity measures, lean body mass, physical activity and mortality: NHANES 1999–2004

BMC Nephrology

Jesse D Schold²  Susana Arrigain²  John P Kirwan³  Sankar D Navaneethan¹ 

[1] Cleveland Clinic Lerner College of Medicine of CWRU, Cleveland Clinic, Cleveland, OH, USA;Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA;Department of Pathobiology, Lerner Research Institute, Cleveland Clinic, Cleveland, OH, USA

关键词: Kidney disease and death;    Muscle mass;    Physical activity;    Obesity;   

Others  :  848329
DOI  :  10.1186/1471-2369-15-108

 received in 2014-01-06, accepted in 2014-05-21,  发布年份 2014

【 摘 要 】

Background

Obesity and physical inactivity are major public health problems. We studied the associations between measures of adiposity, lean body mass, leisure time physical activity (LTPA), and death in those with and without chronic kidney disease (CKD).

Methods

Associations between body mass index (BMI), waist circumference (WC), percent body fat, lean body mass (assessed with Dual-Energy X-ray Absorptiometry[DEXA]), leisure time physical activity (LTPA) and death were examined using the National Health and Nutrition Examination Surveys (NHANES 1999–2004). All-cause mortality was ascertained by linkage of NHANES files with the National Death Index.

Results

9,433 non-CKD participants and 2,153 CKD participants who had fat mass measured using DEXA, BMI, WC, LTPA and mortality data were included. After adjusting for demographics, comorbid conditions, kidney function measures, C-Reactive Protein (CRP), and sodium intake there was no significant risk for death noted with higher WC, fat mass and BMI in those with and without CKD. When examining normal, overweight, and obese groups based on BMI criteria, being overweight (BMI 25–29.9 kg/m²) was associated with lower risk of death in those without CKD (Hazard ratio 0.62, 95% CI 0.40, 0.95). Higher lean body mass was associated with lower risk for death in those without kidney disease but not in the CKD population. There was a significantly higher risk for death among those who did not meet the minimum LTPA goals compared to those who met or exceeded the recommended activity levels (>450 MET/min/week) in those with and without CKD (CKD Hazard ratio: 1.36, 95% CI 1.003, 1.85; non-CKD HR 1.65, 95% CI 1.21, 2.26).

Conclusions

In a representative sample of the US population, higher LTPA levels and lean body mass were associated with lower mortality in those without kidney disease. In CKD, higher LTPA was associated with lower risk of death. There was no association between adiposity measures and death in those with and without CKD except for lower mortality associated with overweight among those without CKD. The data suggests the need to develop programs to facilitate an increase in physical activity in people with and without kidney disease.

【 授权许可】

   
2014 Navaneethan et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

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