Association of Single Measurement of dipstick proteinuria with physical performance of military males: the CHIEF study

Abstract

Background: Proteinuria, a marker of kidney injury, may be related to skeletal muscle loss. Whether the severity of proteinuria is associated with physical performance is unclear. Methods: We examined the association of proteinuria severity with physical performance cross-sectionally in 3357 military young males, free of chronic kidney disease, from the cardiorespiratory fitness and hospitalization events in armed Forces (CHIEF) study in Taiwan. The grades of proteinuria were classified according to one dipstick urinalysis which were collected at morning after an 8-h fast as unremarkable (0, +/−, and 1+), moderate (2+) and severe (3+ and 4+). Aerobic physical performance was evaluated by time for a 3000-m run and anaerobic physical performance was evaluated by numbers of 2-min sit-ups and 2-min push-ups, separately. Multiple linear regressions were used to determine the relationship. Results: As compared with unremarkable proteinuria, moderate and severe proteinuria were dose-dependently correlated with 3000-m running time (β: 4.74 (95% confidence intervals (CI): − 0.55, 10.02) and 7.63 (95% CI: 3.21, 12.05), respectively), and inversely with numbers of 2-min push-ups (β = − 1.13 (− 1.97, − 0.29), and − 1.00 (− 1.71, − 0.28), respectively) with adjustments for age, service specialty, body mass index, blood pressure, alcohol intake, smoking, fasting plasma glucose, blood urea nitrogen, serum creatinine and physical activity. However, there was no association between proteinuria severity and 2-min sit-ups. Conclusions: Our findings show a relationship of dipstick proteinuria with aerobic physical performance and parts of anaerobic physical performance in military healthy males. This mechanism is not fully understood and requires further investigations.

Urinary Proteomics of Simulated Firefighting Tasks and Its Relation to Fitness Parameters

“…The main cause of exerciseinduced proteinuria is not clarified, but the reninangiotensin system and prostaglandins might play a significant role [28]. The plasma angiotensin II concentration increases at intense physical activity, possibly leading to filtration of proteins through the glomerular membrane [28]. Moreover, in this study, the proteomic analysis indicated that angiotensinogen and beta 2-microglobulin were also significantly increased in urine post-simulated exercise, which were related with glomerular leakage [39,40].…”

“…Papassotiriou [29] reported that, after a typical session of the preparatory phase, proteinuria, approximately 30 mg/L, was found in 60% of athletes applying the relevant assay for microprotein concentrations. The main cause of exerciseinduced proteinuria is not clarified, but the reninangiotensin system and prostaglandins might play a significant role [28]. The plasma angiotensin II concentration increases at intense physical activity, possibly leading to filtration of proteins through the glomerular membrane [28].…”

“…Most importantly, urinary proteins have been served as noninvasive biomarkers monitoring the body's stress under various physiological changes and identify the body's condition in different exercise situations [26,27]. Most previous studies applied standard dipstick proteinuria method and specific assay for microprotein concentrations to monitor training load, physical performance and exercise capacity [28,29]. However, these methods could not reflect the physiological changes induced by exercise comprehensively, and related relative mechanisms could not be fully understood.…”

Localized periodontitis and kidney function for the risk of proteinuria in young adults in the CHIEF oral health study

“…This study found an association between localized periodontitis and dipstick proteinuria in young adults, specifically in participants with reduced eGFR, highlighting the importance of early treatment of periodontitis in young patients with early CKD. In contrast, the association between periodontitis and proteinuria www.nature.com/scientificreports/ was null in participants with normal eGFR, probably due to the confounding of exercise-induced proteinuria, which could be considered a benign process in this relatively healthier population 21 .…”

“…Inc., Shiga, Japan) using an AX-4030 urinechemistry analyzer (ARKRAY Inc, Shiga, Japan). Urine protein concentrations of 30-99 mg/dL, 100-299 mg/ dL, 300-999 mg/dL, and ≥ 1000 mg/dL were labeled as "1 + , " "2 + , " "3 + " and "4 + , " respectively, based on the clinical classifications recommended by the National Kidney Foundation 21 . The intra-assay coefficient of variation for proteinuria grading was 6.08%.…”