Associations of sleeping patterns and isotemporal substitution of other behavior with the prevalence of CKD in Chinese adults  

作　　者：Yi Ding Xiaoli Xu Zhuojun Xin Qiuyu Cao Jiaojiao Huang Xianglin Wu Yanan Huo Qin Wan Yingfen Qin Ruying Hu Lixin Shi Qing Su Xuefeng Yu Li Yan Guijun Qin Xulei Tang Gang Chen Min Xu Tiange Wang Zhiyun Zhao Zhengnan Gao Guixia Wang Feixia Shen Zuojie Luo Li Chen Qiang Li Zhen Ye Yinfei Zhang Chao Liu Youmin Wang Tao Yang Huacong Deng Lulu Chen Tianshu Zeng Jiajun Zhao Yiming Mu Shengli Wu Yuhong Chen Jieli Lu Weiqing Wang Guang Ning Yu Xu Yufang Bi Mian Li 

机构地区：[1]Department of Endocrine and Metabolic Diseases,Shanghai Institute of Endocrine and Metabolic Diseases,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China [2]Shanghai National Clinical Research Center for Metabolic Diseases,Key Laboratory for Endocrine and Metabolic Diseases of the National Health Commission of China,Shanghai Key Laboratory for Endocrine Tumor,State Key Laboratory of Medical Genomics,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai,200025,China [3]Jiangxi Provincial People’s Hospital,Affiliated to Nanchang University,Nanchang,330000,China [4]Department of Endocrinology,The Affiliated Hospital of Southwest Medical University,Luzhou,646000,China [5]Department of Endocrinology,The First Affiliated Hospital of Guangxi Medical University,Nanning,530000,China [6]Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou,310000,China [7]Department of Endocrinology,Affiliated Hospital of Guiyang Medical University,Guiyang,550000,China [8]Xinhua Hospital,Affiliated to Shanghai Jiao Tong University School of Medicine,Shanghai,200000,China [9]Tongji Hospital,Tongji Medical College,Huazhong University of Science and Technology,Wuhan,430000,China [10]Sun Yat-sen Memorial Hospital,Sun Yat-sen University,Guangzhou,510000,China [11]Department of Endocrinology,The First Affiliated Hospital of Zhengzhou University,Zhengzhou,450000,China [12]Department of Endocrinology,The First Hospital of Lanzhou University,Lanzhou,730000,China [13]Fujian Provincial Hospital,Fujian Medical University,Fuzhou,350000,China [14]Dalian Municipal Central Hospital,Affiliated of Dalian Medical University,Dalian,116000,China [15]Department of Endocrinology,The First Hospital of Jilin University,Changchun,130000,China [16]Department of Endocrinology,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou,325000,China [17]Qilu Hospital of Shandong University,Jinan,250000,China [18]Department of Endocrinology,The Second Affiliated Hospital of Harbin Medic

出　　处：《Frontiers of Medicine》2024年第2期303-314,共12页医学前沿（英文版）

基　　金：supported by the grants from the National Natural Science Foundation of China(Nos.82088102,91857205,82022011,81970728,and 81930021);the Shanghai Rising-Star Program(No.21QA1408100);Shanghai Outstanding Academic Leaders Plan(No.20XD1422800);the National Top Young Scholar Program(Yu Xu),the Innovative Research Team of High-Level Local Universities in Shanghai,the Shanghai Clinical Research Center for Metabolic Diseases(No.19MC1910100);the Shanghai Shen Kang Hospital Development Center(Nos.SHDC2020CR1001A and SHDC2020CR3064B).

摘　　要：Studies have found a U-shaped relationship between sleep duration and chronic kidney disease(CKD)risk,but limited research evaluated the association of reallocating excessive sleep to other behavior with CKD.We included 104538 participants from the nationwide cohort of the Risk Evaluation of Cancers in Chinese Diabetic Individuals:A Longitudinal Study,with self-reported time of daily-life behavior.Using isotemporal substitution models,we found that substituting 1 h of sleeping with sitting,walking,or moderate-to-vigorous physical activity was associated with a lower CKD prevalence.Leisure-time physical activity displacement was associated with a greater prevalence reduction than occupational physical activity in working population.In stratified analysis,a lower CKD prevalence related to substitution toward physical activity was found in long sleepers.More pronounced correlations were observed in long sleepers with diabetes than in those with prediabetes,and they benefited from other behavior substitutions toward a more active way.The U-shaped association between sleep duration and CKD prevalence implied the potential effects of insufficient and excessive sleep on the kidneys,in which the pernicious link with oversleep could be reversed by time reallocation to physical activity.The divergence in the predicted effect on CKD following time reallocation to behavior of different domains and intensities and in subpopulations with diverse metabolic statuses underlined the importance of optimizing sleeping patterns and adjusting integral behavioral composition.

关 键 词：SLEEP physical activity chronic kidney disease isotemporal substitution behavioral pattern 

分 类 号：R692[医药卫生—泌尿科学]