Background and aim: Diabetic nephropathy is one of the most important complications of diabetes mellitus. In recent years, aerobic exercise has been reported to be potentially effective in preventing nephropathy. However, the relationship with light physical activity (LPA), activities of daily living, is not clear. In this study, we researched the effect of LPA assessed by tri-axial acceleration sensors on the progression of nephropathy in patients with type 2 diabetes Materials and methods: We analyzed retrospectively the cohort study of type 2 diabetic patients (T2DM) with urinary albumin-to-creatinine ratio (UACR) under 300 mg/gCr who visited Ayabe City Hospital from April 2018 to March 2020 and were observed until May 2022. The progression of nephropathy was defined as an increase in the category of diabetic nephropathy. LPA time was measured using a tri-axial accelerometer ActiGraph GT3X-BT instructed to use the accelerometer for 7 days, except while bathing and sleeping. LPA was defined as 100-1,952 counts per min. Hazard ratio of LPA for the progression of nephropathy was calculated by Cox hazard model after adjusting by age, gender, BMI, hemoglobin A1c (HbA1c), smoking states, alcohol consumption, use of renin-angiotensin system inhibitor at baseline. Results: 167 patients (109 men) including 132 with stage1 and 35 with stage 2, mean age, body mass index, HbA1c, UACR, LPA and median observation period were 72.1 ± 12.3 years, 23.4 ± 3.4 kg/m2, 7.6 ± 0.9 %, 56.8 ± 137.4 mg/gCr, 305.6 ± 85.5 minutes/day and 1246 (406-1283) days. During follow-up, progression of nephropathy was observed in 39.5 % (66/167). The adjusted hazard ratio of LPA per 1 hour of progression of nephropathy was 0.81 (95% confidence interval 0.67-0.98, P = 0.031). Conclusion: Patients with T2DM with low LPA were shown to be at higher risk of developing diabetic nephropathy. This suggests that increasing activities of daily living in patients with T2DM is important in terms of preventing diabetic nephropathy. Disclosure T.Osaka: None. H.Okada: None. M.Fukui: None.
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