Body Mass Index Modifies an Association between Self-Reported Regular Exercise and Proteinuria

A Nationwide Cross-Sectional Survey in Japan

抄録

Aim: Regular exercise habits are well-known to exert a favorable effect on the metabolic syndrome, which may cause proteinuria and chronic kidney disease (CKD). However, it remains unknown if exercise exerts a favorable effect on proteinuria and kidney dysfunction. The aim of this study was to reveal the association between exercise and the prevalence of proteinuria and kidney dysfunction and the attenuation by obesity.
Methods: This study was a cross-sectional cohort study that included 292,013 participants who underwent the Specific Health Check and Guidance in Japan. The exercise score (range 0-3) was based on the number of positive answers to three questions regarding exercise habits. The outcome was defined as urinary protein detected by a dipstick test and kidney dysfunction [estimated glomerular filtration rate (GFR) less than 45 ml/min/1.73 m²].
Results: The exercise score was significantly associated with the prevalence of proteinuria in both males [vs. exercise score 0; exercise score 1, multivariate-adjusted odds ratio 0.86 (95% confidence interval 0.81-0.92), P＜0.001; exercise score 2, 0.84 (0.79-0.90), P＜0.001; exercise score 3, 0.77 (0.72-0.82), P＜0.001] and females (same as in males). After the male subjects were divided into quintiles according to body mass index (BMI) in more than three groups (22.9＜BMI＜24.1), there was no significant association between the exercise score and the prevalence of proteinuria. In females, a higher exercise score was associated with a lower prevalence of proteinuria, regardless of BMI. The association between the exercise score and kidney dysfunction was as similar as that between the exercise score and proteinuria, except the attenuation of BMI.
Conclusion: Exercise may associate with a lower prevalence of proteinuria and kidney dysfunction, and a high BMI may attenuate this association between exercise and proteinuria in male subjects.