Associations of Prolonged Occupational Sitting with the Spectrum of Kidney Disease: Results from a Cohort of a Half-Million Asian Adults

Min-Kuang Tsai; Wayne Gao; Kuo-Liong Chien; Chin-Kun Baw; Chih-Cheng Hsu; Chi-Pang Wen

doi:10.1186/s40798-022-00542-8

Associations of Prolonged Occupational Sitting with the Spectrum of Kidney Disease: Results from a Cohort of a Half-Million Asian Adults

Sports Med Open. 2022 Dec 13;8(1):147. doi: 10.1186/s40798-022-00542-8.

Authors

Min-Kuang Tsai^{1

2}, Wayne Gao², Kuo-Liong Chien³, Chin-Kun Baw⁴, Chih-Cheng Hsu⁵, Chi-Pang Wen^{6

7}

Affiliations

¹ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei, 10055, Taiwan.
² PhD Program in Global Health and Health Security, College of Public Health, Taipei Medical University, Taipei, Taiwan.
³ Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, No. 17, Xu-Zhou Road, Taipei, 10055, Taiwan. klchien@ntu.edu.tw.
⁴ The Southeast Permanente Medical Group, Atlanta, Georgia, USA.
⁵ Institute of Population Health Sciences, National Health Research Institutes, No. 35, Keyan Road, Zhunan Town, Miaoli, 35053, Taiwan.
⁶ Institute of Population Health Sciences, National Health Research Institutes, No. 35, Keyan Road, Zhunan Town, Miaoli, 35053, Taiwan. cwengood@nhri.edu.tw.
⁷ China Medical University Hospital, Taichung, Taiwan. cwengood@nhri.edu.tw.

Abstract

Background: Kidney diseases are viewed as continuously progressing diseases from microalbuminuria and chronic kidney disease (CKD), to end-stage renal disease (ESRD) and its mortality including deaths. The report on the association between prolonged sitting and kidney diseases is limited.

Methods: We examined a cohort of 455,506 participants in a screening program in Taiwan conducted between 1996 and 2017. Data on occupational sedentary behavior and physical activity were collected with a standardized questionnaire. The outcomes of ESRD and death were identified by linking with the Catastrophic Illness Dataset and Cause of Death Data. The association between prolonged sitting and CKD, the incidence of ESRD, and death were assessed using logistic regression models to compute odds ratios (ORs) and Cox proportional hazards models for hazard ratios (HRs).

Results: More than half of the participants, i.e., 265,948 (58.4%), were categorized as "prolonged sitting" during their work. During a median of 13 years of follow-up, we identified 2227 individuals undergoing dialysis and 25,671 deaths. Prolonged occupational sitting was significantly associated with a higher risk of CKD (OR: 1.26, 95% confidence interval: 1.21, 1.31), ESRD (HR: 1.19, 95% CI 1.03, 1.38), and kidney-specific mortality (HR: 1.43, 95% CI 1.07, 1.91) compared to mostly standing participants after controlling for physical activity and other risk factors. Inactive prolonged sitting carries a significantly higher risk of ESRD than physically active mostly standing participants (HR: 1.34, 95% CI 1.04, 1.73). However, active prolonged sitting decreased the risk of ESRD (HR: 1.03, 95% CI 0.79, 1.34) compared to inactive prolonged sitting.

Conclusion: The results suggest that prolonged occupational sitting is associated with a greater risk of the spectrum of kidney disease, proteinuria, CKD, dialysis (ESRD), and mortality for all causes and kidney diseases. Physical activity, even at a minimal level of 15 min/day (90 min/week) of moderate-intensity exercise, was associated with a reduction in these risks.

Keywords: Chronic kidney disease; Cohort; End-stage renal disease; Physical activity; Prolonged occupational sitting.

Grants and funding

MOHW110-TDU-B-212-124004/Taiwan Ministry of Health and Welfare Clinical Trial Center