To assess the effect of physical activity in patients with type 2 diabetes mellitus on prevention of diabetes with chronic kidney disease.
This is a cohort study on stratified selected subjects in Taiwan from 2004/01/01 to 2005/12/31. Demographic data, lifestyle factors and clinical characteristics were analyzed for an association with the occurrence of chronic kidney disease. Applicable analysis weights, Stata 11.0, were applied to adjust the design variables for clustering and stratification.
During the two year study period, the univariate Cox proportional hazards model showed significant associations of age, physical activity, and the Charlson comorbidity index (CCI) with chronic kidney disease. Physical activity had a beneficial effect in diabetic subjects with chronic kidney disease (HR: 0.31, p < 0.01). Older age and a CCI greater than 2 were both harmful in diabetic subjects with chronic kidney disease (1.06 and 3.44, respectively). The results of a multivariate Cox proportional hazards evaluation model were similar to those of a univariate evaluation model, except that CCI was not significantly different. Moreover, medications for hypertension of diabetic subjects created an increased risk of chronic kidney disease (HR: 5.85 and 3.74, respectively), indicating that the presence of hypertension is a strong risk factor for the progression of chronic kidney disease.
In this study, physical activity was not only a healthful lifestyle factor but also a treatment to decrease incidence of chronic kidney disease in diabetic patients.
Abbreviations:CCI (Charlson comorbidity index), CHF (chronic heart failure), CKD (chronic kidney disease), CVD (cardiovascular disease), ESRD (end-stage renal disease), UAE (urinary albumin excretion)
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- Diabetic nephropathy: diagnosis, prevention, and treatment.Diabetes Care. 2005; 28: 164-176
- Albuminuria and risk of cardiovascular events, death, and heart failure in diabetic and nondiabetic individuals.J. Am. Med. Assoc. 2001; 286: 421-426
- Diabetic dyslipidaemia in Asian populations in the Western Pacific Region: what we know and don’t know.Diabetes Res. Clin. Pract. 2011; 94: 1-13
- Recognition, pathogenesis, and treatment of different stages of nephropathy in patients with type 2 diabetes mellitus.Mayo Clin. Proc. 2011; 86: 444-456
- Effect of a chicken based diet on renal function and lipid profile in patients with type 2 diabetes: a randomized crossover trial.Diabetes Care. 2002; 25: 645-651
- Physical exercise for the prevention and treatment of type 2 diabetes.Diabetes Metab. 2010; 36: 346-351
- Exercise training and blood lipids in hyperlipidemic and normolipidemic adults: a meta-analysis of randomized, controlled trials.Eur. J. Clin. Nutr. 1999; 53: 514-522
- Effect of aerobic exercise training on serum levels of high-density lipoprotein cholesterol: a meta-analysis.Arch. Intern. Med. 2007; 167: 999-1008
- Role of exercise training in the prevention and treatment of insulin resistance and non-insulin-dependent diabetes mellitus.Sports Med. 1997; 24: 236-321
- Exercise and the nitric oxide vasodilator system.Sports Med. 2003; 33: 1013-1035
- Standards of medical care in diabetes-2010.Diabetes Care. 2010; 33: 11-61
- Regular moderate exercise reduces advanced glycation and ameliorates early diabetic nephropathy in obese Zucker rats.Metab. Clin. Exp. 2009; 58: 1669-1677
- Design and sample characteristics of the 2005–2008 Nutrition and Health Survey in Taiwan.Asia Pac. J. Clin. Nutr. 2011; 20: 225-237
- Management of hypertension in people with diabetes mellitus: translating the 2012 Canadian Hypertension Education Program Recommendations into Practice.Can. J. Diabetes. 2012; 36: 345-353
- Acute response of blood glucose to short-term excise training in patients with type 2 diabetes.J. Sci. Med. Sport. 2011; 14: 238-242
- Insulin therapy and excise.Diabetes Res. Clin. Pract. 2011; 93: 73-77
- Dietary strategies for improving post-prandial glucose, lipids, inflammation, and cardiovascular health.J. Am. Coll. Cardiol. 2008; 51: 249-255
- Hypertension and exercise.Rev. Port. Cardiol. 2012; 31: 151-158
- The effects of regular aerobic exercise on renal functions in streptozotocin induced diabetic rats.J. Sports Sci. Med. 2010; 9: 294-299
- The effect of reactive oxidant generation in acute exercise-induced proteinuria in trained and untrained rats.Eur. J. Appl. Physiol. 2003; 90: 526-532
- Influence of running different distances on renal glomerular and tubular impairment in humans.Eur. J. Appl. Physiol. 1996; 72: 522-527
- Nephropathy in diabetes.Diabetes Care. 2004; 27: 79-83
- Renoprotective effect of the angiotensin-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes.N. Engl. J. Med. 2001; 345: 851-860
- Progression of pre- hypertension, stage 1 and 2 hypertension (JNC 7): a population-based study in Keelung, Taiwan (Keelung Community based Integrated Screening No. 9).J. Hypertens. 2006; 24: 821-828
- Effects of different blood pressure-lowering regimens on major cardiovascular events in individuals with and without diabetes mellitus: results of prospectively designed overviews of randomized trials.Arch. Intern. Med. 2005; 165: 1410-1419
- Trigonelline ameliorates diabetic hypertensive nephropathy by suppression of oxidative stress in kidney and reduction in renal cell apoptosis and fibrosis in streptozotocin induced neonatal diabetic (nSTZ) rats.Int. Immunopharmacol. 2012; 14: 740-748
Published online: May 06, 2014
Accepted: April 6, 2014
Received in revised form: March 27, 2014
Received: January 9, 2014
© 2014 Primary Care Diabetes Europe. Published by Elsevier Inc. All rights reserved.