A randomized trial of a pedometer-based intervention with weekly activity goals led to a modest increase in step count among dialysis patients. In a secondary analysis, we investigated the effect of this intervention on body composition. Sixty dialysis patients were randomized to standard care or a 6-month program consisting of 3 months of pedometers and weekly step count targets and 3 months of post-intervention follow-up. We obtained bioelectrical impedance spectroscopy (BIS) data on 54 of these patients (28 control, 26 intervention) and used linear mixed-modeling (adjusted for sex and dialysis modality) to estimate differences in change in total-body muscle mass (TBMM) adjusted for height2, fat mass (kg), and body mass index (BMI) (kg/m2) between control and intervention groups. The median age of participants was 57.5 years (53–66), and 76% were men. At baseline, there was no significant difference between groups in age, BMI, race, or body composition, but there were more men in the intervention group. After 3 months, patients in the intervention group increased their average daily steps by 2414 (95% CI 1047, 3782) more than controls (p < 0.001), but there were no significant differences in body composition. However, at 6 months, participants in the intervention had a significantly greater increase from baseline in TBMM of 0.7 kg/m2 (95% CI 0.3, 1.13), decrease in fat mass (− 4.3 kg [95% CI -7.1, − 1.5]) and decrease in BMI (− 1.0 kg/m2 [95% CI -1.8, − 0.2]) relative to controls. In post-hoc analysis, each increase of 1000 steps from 0 to 3 months was associated with a 0.3 kg decrease in fat mass (95% CI 0.05, 0.5) from 0 to 6 months, but there was no dose-response relationship with TBMM/ht2 or BMI. A pedometer-based intervention resulted in greater decreases in fat mass with relative preservation of muscle mass, leading to a greater decrease in BMI over time compared with patients not in the intervention. These differences were driven as much by worsening in the control group as by improvement in the intervention group. Step counts had a dose-response relationship with decrease in fat mass. ClinicalTrials.gov (NCT02623348). 02 December 2015.

中文翻译：

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基于计步器的步行干预对 ESRD 患者身体成分的影响：一项随机对照试验。

一项基于计步器的干预措施和每周活动目标的随机试验导致透析患者的步数略有增加。在二次分析中，我们研究了这种干预对身体成分的影响。60 名透析患者被随机分配接受标准护理或为期 6 个月的计划，其中包括 3 个月的计步器和每周步数目标以及 3 个月的干预后随访。我们获得了其中 54 名患者（28 名对照患者、26 名干预患者）的生物电阻抗谱 (BIS) 数据，并使用线性混合模型（根据性别和透析方式进行调整）来估计调整后的全身肌肉质量 (TBMM) 变化的差异对照组和干预组之间的身高2、脂肪量（kg）和体重指数（BMI）（kg/m2）。参与者的中位年龄为 57.5 岁（53-66 岁），其中 76% 为男性。基线时，各组之间的年龄、体重指数、种族或身体成分没有显着差异，但干预组中有更多男性。3 个月后，干预组患者的平均每日步数比对照组增加了 2414 步 (95% CI 1047, 3782) (p < 0.001)，但身体成分没有显着差异。然而，在 6 个月时，干预参与者的 TBMM 较基线显着增加 0.7 kg/m2 (95% CI 0.3, 1.13)，脂肪量减少 (− 4.3 kg [95% CI -7.1, − 1.5) ]），并且相对于对照组，BMI 降低（− 1.0 kg/m2 [95% CI -1.8，− 0.2]）。在事后分析中，0至3个月每增加1000步与0至6个月脂肪量减少0.3公斤相关（95% CI 0.05，0.5），但与TBMM不存在剂量反应关系/ht2 或体重指数。与未接受干预的患者相比，基于计步器的干预导致脂肪量更大程度地减少，同时肌肉质量相对保留，从而导致 BMI 随着时间的推移出现更大程度的下降。这些差异既是由对照组的恶化造成的，也是由干预组的改善造成的。步数与脂肪量的减少存在剂量反应关系。ClinicalTrials.gov (NCT02623348)。2015 年 12 月 2 日。