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Showing papers on "Body water published in 2007"


Journal ArticleDOI
TL;DR: No evidence incontrovertibly demonstrates that any concentration measurement, including plasma osmolality (Posm), accurately represents TBW gain and loss during daily activities, and one blood or urine sample cannot validly represent fluctuating TBW and fluid compartments.
Abstract: Acknowledging that total body water (TBW) turnover is complex, and that no measurement is valid for all situations, this review evaluates 13 hydration assessment techniques. Although validated laboratory methods exist for TBW and extracellular volume, no evidence incontrovertibly demonstrates that any concentration measurement, including plasma osmolality (Posm), accurately represents TBW gain and loss during daily activities. Further, one blood or urine sample cannot validly represent fluctuating TBW and fluid compartments. Future research should (a) evaluate novel techniques that assess hydration in real time and are precise, accurate, reliable, non-invasive, portable, inexpensive, safe, and simple; and (b) clarify the relationship between Posm and TBW oscillations in various scenarios. Key teaching points:  All hydration assessment techniques provide singular measures of a complex and dynamic fluid matrix, containing interconnected compartments.  A single gold standard, including plasma osmolality, is not possible for all hydration assessment requirements.  In the laboratory, measurement resolution and accuracy are essential.  Field assessment of hydration requires techniques that are easy-to-use, safe, portable, and inexpensive.  Total body water approximates “euhydration” when morning body weight is near the normal baseline, fluid intake is adequate, urine color is pale yellow, and urine volume is normal.  Body weight change provides the simplest and most accurate index of hydration status in real time, when serial measurements are made in close proximity.

570 citations


Journal ArticleDOI
TL;DR: A model to determine fixed hydration constants of primary body tissues enabling ExF to be calculated from whole-body measurements of weight, intracellular water (ICWWB), and extracellularWater (ECWWB) is developed.

453 citations


Journal ArticleDOI
TL;DR: The PEA POD system provided a reliable, accurate, and immediate assessment of %BF in infants and is highly suitable for monitoring changes in body composition during infant growth in both the research and clinical settings.

264 citations


Journal ArticleDOI
TL;DR: Hydration status is not easily measured, but acute changes in hydration status are often estimated from body mass change, and substantial loss of mass may occur without an effective net negative fluid balance.
Abstract: Hydration status is not easily measured, but acute changes in hydration status are often estimated from body mass change. Changes in body mass are also often used as a proxy measure for sweat losses. There are, however, several sources of error that may give rise to misleading results, and our aim in this paper is to quantify these potential errors. Respiratory water losses can be substantial during hard work in dry environments. Mass loss also results from substrate oxidation, but this generates water of oxidation which is added to the body water pool, thus dissociating changes in body mass and hydration status: fat oxidation actually results in a net gain in body mass as the mass of carbon dioxide generated is less than the mass of oxygen consumed. Water stored with muscle glycogen is presumed to be made available as endogenous carbohydrate stores are oxidized. Fluid ingestion and sweat loss complicate the picture by altering body water distribution. Loss of hypotonic sweat results in increased osmolality of body fluids. Urine and faecal losses can be measured easily, but changes in the water content of the bladder and the gastrointestinal tract cannot. Body mass change is not always a reliable measure of changes in hydration status and substantial loss of mass may occur without an effective net negative fluid balance.

263 citations


Journal ArticleDOI
TL;DR: Bioimpedance spectroscopy has been found to be more accurate for measuring changes in fluid volumes or BCM, particularly in post-surgical and human immunodeficiency virus (HIV)-infected individuals.
Abstract: Body composition assessment has been used to evaluate clinical interventions in research trials, and has the potential to improve patient care in the clinical setting. Body cell mass (BCM) is an important indicator of nutrition status; however, its measurement in the clinic has been limited. BCM can be estimated by the measurement of intracellular water (ICW). The assessment of extracellular water (ECW) is also important because many clinical populations undergo alterations in fluid distribution, particularly individuals with wasting, those receiving dialysis, and obese individuals. Bioimpedance spectroscopy (BIS) is a unique bioimpedance approach that differs in underlying basis from the more readily recognized single-frequency bioelectrical impedance analysis (SF-BIA) in that it does not require the use of statistically derived, population-specific prediction equations. It has the potential advantage of not only measuring total body water (TBW), as does SF-BIA, but also offering the unique capacity to differentiate between ECW and ICW and, thus, to provide an estimate of BCM. This literature review was conducted to compare available BIS devices to multiple dilution for measuring fluid compartments or BCM in a number of populations. Variable results regarding the ability of BIS to measure absolute volumes, as well as the observation of wide limits of variation, make BIS problematic for individual assessment in the clinic, particularly in populations with abnormal fluid distribution or body geometry. BIS has been found to be more accurate for measuring changes in fluid volumes or BCM, particularly in post-surgical and human immunodeficiency virus (HIV)-infected individuals. It is certainly possible that population-specific adjustments may improve the accuracy of BIS for assessing individuals in the clinical setting; however, additional research and development is needed before the method can be accepted for routine clinical use.

178 citations


Journal ArticleDOI
TL;DR: The observation that underlying mechanisms for alteration in blood volume with physical activity and inactivity are similar but respond directly opposite suggests that they are intricately related have implications as to a mechanism by whichPhysical activity and fitness may be protective against reduced blood volume and subsequent development of cardiovascular disease associated with aging.

135 citations


Journal ArticleDOI
01 Aug 2007-Placenta
TL;DR: The study of amniotic fluid volume regulation may yield important insights into the mechanisms used by the fetus to maintain water homeostasis, and may allow novel treatments for amniotics fluid volume abnormalities with resultant improvement in clinical outcome.

122 citations


Journal ArticleDOI
TL;DR: Changes in key hormones which control intermediary metabolism are programmed by maternal protein restriction during lactation, resulting in BW alterations in adult rats.
Abstract: Previously we have reported that maternal malnutrition during lactation programmes body weight and thyroid function in the adult offspring. In the present study we evaluated the effect of maternal protein restriction during lactation upon body composition and hormones related to glucose homeostasis in adult rats. During lactation, Wistar lactating rats and their pups were divided into two experimental groups: control (fed a normal diet; 23 % protein) and protein-restricted (PR; fed a diet containing 8 % protein). At weaning, offspring received a normal diet until they were 180 d old. Body weight (BW) and food intake were monitored. Serum, adrenal glands, visceral fat mass (VFM) and carcasses were collected. PR rats showed lower BW ( − 13 %; P < 0·05), VFM ( − 33 %; P < 0·05), total body fat ( − 33 %; P < 0·05), serum glucose ( − 7 %; P < 0·05), serum insulin ( − 26 %, P < 0·05), homeostasis model assessment index ( − 20 %), but higher total adrenal catecholamine content (+90 %; P < 0·05) and serum corticosterone concentration (+51 %; P < 0·05). No change was observed in food intake, protein mass or total body water. The lower BW of PR rats is due to a reduction of white fat tissue, probably caused by an increase in lipolysis or impairment of lipogenesis; both effects could be related to higher catecholaminergic status, as well as to hypoinsulinaemia. To conclude, changes in key hormones which control intermediary metabolism are programmed by maternal protein restriction during lactation, resulting in BW alterations in adult rats.

105 citations


Journal ArticleDOI
M. L. Keen1, F. A. Gotch
TL;DR: These data suggest that interdialytic weight gain in individual patients may be associated with the use of dialysate Na+ concentration in excess of the patient's desired Na+ “setpoint”.
Abstract: IntroductionHemodialysis patients lack the normal mechanisms to regulate body water volume and osmolality The dialysis treatment is expected to adequately regulate both body water volume and body N...

94 citations


Journal ArticleDOI
TL;DR: Weight loss and regain were associated with minimal changes in lean tissue as measured using multi-compartment models and the LTL system is a useful method to measure body composition changes during clinical weight management programmes.
Abstract: To investigate changes in body composition and the validity of the leg-to-leg bioimpedance (LTL) method to measure body fat during active weight loss (WL) and weight regain (WR). Longitudinal, 12-week weight loss intervention (3.3–3.8 MJ/day) and subsequent follow-up at 1 year. Fifty-eight adult women aged between 24 and 65 years (mean age: 46.8±8.9 years) and with a body mass index (BMI) ⩾25 kg/m2 (mean BMI: 31.6±2.5 kg/m2, range=26.0–48.2 kg/m2) participated in the study. Fat mass (FM) was measured at baseline, 12 weeks, 24 weeks and 52 weeks using three- and four-compartment (4-C) models, air displacement plethysmography (ADP), deuterium dilution – total body water (TBW), dual-energy X-ray absorptiometry (DXA), skinfold thickness (SFT), tetrapolar bioelectrical impedance analysis (T-BIA) and LTL. At the end of the weight loss programme, subjects lost 9.9±3.5 kg weight (P<0.001) and 7.6±0.5 kg fat (P<0.001) but after 1 year they had regained 4.9±3.7 kg of weight and 3.7±2.9 kg of fat. The 4-C model showed that FM and TBW accounted for 76.2 and 23.6% of the loss in body mass and 81.8 and 17.7% of the tissue accrued during weight regain, respectively. The estimate of body fat change by LTL relative to multi-compartment models (WLbias±2s.d.=0.51±3.26 kg; WRbias±2s.d.=−0.25±2.30 kg) was similar to ADP, DXA and TBW in both phases but it was better than T-BIA (WLbias±2s.d.=0.17±7.90 kg; WRbias±2s.d.=−0.29±7.59 kg) and skinfold thickness (WLbias±2s.d.=2.68±6.68 kg; WRbias±2s.d.=−0.84±3.80 kg). Weight loss and regain were associated with minimal changes in lean tissue as measured using multi-compartment models. The LTL system is a useful method to measure body composition changes during clinical weight management programmes.

82 citations


Journal ArticleDOI
TL;DR: Six months of pioglitazone treatment in patients with NASH is associated with weight gain that is attributable to an increase in adipose tissue mass and not to water retention.

Journal ArticleDOI
TL;DR: Athletes taking part in a multistage ultra-endurance triathlon over 10 Ironman triathlon distances in 10 consecutive days lost 3 kg of body fat; skeletal muscle mass, mineral mass and body water were unchanged.
Abstract: Objective: To investigate the effect of a multistage ultra-endurance triathlon on body composition in ultra-triathletes. Design: Descriptive field study. Setting: The “World Challenge Deca Iron Triathlon 2006” in Monterrey, Mexico, in which every day for 10 consecutive days athletes had to perform the distance of one Ironman triathlon. Subjects: Eight male ultra-endurance athletes (mean (SD) age 40.6 (10.7) years, weight 76.4 (8.4) kg, height 175 (4) cm and body mass index (BMI) 24.7 (2.2) kg/m2). Interventions: None. Main outcome measurements: Determination of body mass, protein mass, body fat, per cent body fat, mineral mass, total body water, intracellular water, extracellular water and lean body mass with a direct segmental multifrequency bioelectrical impedance method before the race and after each stage in order to show changes in body composition. Results: A statistically significant decrease of body mass (−2.4 kg, p = 0.014), body fat (−5 kg, p = 0.0078) and per cent body fat (−6.4%, p = 0.0078) occurred at the end of the first day compared to values taken in the pre-race period. In contrast, at the same time, a statistically significant increase of protein mass (+0.7 kg, p = 0.035), mineral mass (+0.2 kg, p = 0.04), total body water (+1.8 litres, p = 0.042), intracellular water (+1.6 litres, p = 0.034) and lean body mass (+2.6 kg, p = 0.023) was shown. After the first day until the end of the challenge, body fat (−3 kg, p>0.05) and per cent body fat (−3.9%, p>0.05) showed a statistically significant decrease, whereas the other parameters showed no changes. Conclusions: Athletes taking part in a multistage ultra-endurance triathlon over 10 Ironman triathlon distances in 10 consecutive days lost 3 kg of body fat; skeletal muscle mass, mineral mass and body water were unchanged.

Journal ArticleDOI
TL;DR: Elevated plasma solute concentrations are associated with obesity in free-living adults and Physicians and researchers should be alert to a possible link between hypertonicity and obesity.
Abstract: This study explored whether the increased extracellular relative to intracellular fluid (ECF/ICF) ratio in obesity might reflect osmotic effects of elevated plasma solute concentrations. Cross-sectional, epidemiological survey. The present analysis used nationally representative data from the Third National Health and Nutrition Examination Survey on community-dwelling adults (aged 40–59 years) in the US without evidence of glucose dysregulation or chronic disease (n=1285). Body mass index (BMI) was estimated from measured height and weight. Total body reactance, an index of body fluid distribution, was determined by bioelectrical impedance analysis. Plasma tonicity (the cumulative index of osmotically effective plasma solute) was estimated from plasma glucose, sodium and potassium. Sex-specific relative odds of lower reactance (⩽50 Ω/m for women, ⩽40 Ω/m for men) and plasma hypertonicity (tonicity ⩾295 mmol/l) associated with overweight (25⩽BMI <30) and obesity (BMI⩾30) were estimated using logistic regression models that controlled for sociodemographic variables, smoking, leisure-time physical activity, total energy intake, serum creatinine, plasma insulin and glucose. Multinomial logistic regression models tested for associations between weight status and specific serum solute. Independent of covariates, in men and women, overweight and obesity were associated with increased odds of lower reactance and hypertonicity. Overweight and obese individuals with lower reactance had significantly higher serum sodium than normal weight individuals. Elevated plasma solute concentrations are associated with obesity in free-living adults. Physicians and researchers should be alert to a possible link between hypertonicity and obesity. Hydration, body water, hypertonicity, obesity, ECF/ICF ratio, sodium. Grants from the NIH, Nestle Waters.

Journal ArticleDOI
TL;DR: Body compartments were evaluated in 50 obese subjects before and after a 7 kg weight loss obtained after 6 months of calorie restriction and orlistat, with the 3- or 4-compartment model being considered the reference method.

Journal ArticleDOI
TL;DR: Findings indicate that impedance vectors provide quantitative evidence of hydration status during pregnancy and that the impedance vector method is useful in monitoring hydrationstatus in pregnancy.

Journal ArticleDOI
TL;DR: The BOD POD technique is a valid and reliable method compared to the 4C model and it could be applied in subjects with similar physical and anthropometric characteristics to subjects of this study.
Abstract: The aims of this study were to validate BOD POD in a wide sample of healthy and independent Mexican elderly men and women subjects using the 4 compartment (4C) model as the reference method, and to evaluate the assumptions of the densitometric two-compartment (2C) model. Cross-sectional study designed to assess body composition and validation of a method based on 2C model (BOD POD). Urban and rural regions of Sonora, Mexico. Two hundred and two free-living subjects ⩾60 years old were completed in this study. Body density and body fat were measured by the BOD POD, total body water by deuterium dilution and total body bone ash by dual energy X-ray absorptiometry. Body composition was determined using Baumgartner's equation. Percent body fat by the 4C model was 31.2 and 42.5% in men and women, respectively (P<0.001). Group mean accuracy of body fat by BOD POD against that of the 4C model showed an effect of sex (P<0.001), but not the method (P=0.27). Results of individual accuracy showed no significant difference with the identity line and the slope was significantly different from zero or a slope similar to one. Precision assessed by model R2 was high for all subjects and for men and women by separate. The standard error of the estimate was low for all and for men and women by separate. Bland and Altman analysis showed no significant bias. The BOD POD technique is a valid and reliable method compared to the 4C model and it could be applied in subjects with similar physical and anthropometric characteristics to subjects of this study. The study was funded by CONACYT, Mexico (J37891-M) and IAEA (Research contract no. 12694/R0).

Journal ArticleDOI
TL;DR: Assessment of total energy expenditure (TEE) and body composition, i.e. total body water (TBW) and adipose tissue volume (ATV), at term age in 8 healthy preterm infants, born between gestational weeks 30 and 33, and in 9 healthy full‐term newborns found a significant correlation between ATV/kg body weight and body weight.
Abstract: During recent years much interest has been focused on the relationship between early nutrition and the future health of humans. Poor growth during early life has been associated with impaired glucose tolerance and coronary heart disease later in life, while rapid weight gain in infancy has been associated with an increased risk of obesity during childhood. Access to appropriate methods that can provide information about adipose tissue (AT), total body fat (TBF), and total energy expenditure (TEE) during infancy is important in order to conduct successful research in this area. The magnetic resonance imaging (MRI) technique based on the combination of a magnetic field and radiowaves can provide images of the body by which total adipose tissue volume (ATV) as well as its distribution between subcutaneous and non-subcutaneous ATV can be assessed. The doubly labelled water (DLW) method can assess total body water (TBW) and TEE. Estimates ofTBW can be used to calculate TBF. Measurements ofskinfold thickness (SFT) represent a traditional technique for assessing body fatness in humans, but even though it is simple in concept and easily applied, it has so far not been evaluated in infants under four months of age. The combination of the MRI and DLW methods represents a new possibility-to evaluate estimates of TBF based on measurements of SFT and to study various aspects of body composition during infancy. A method based on MRI which can assess total, subcutaneous and non-subcutaneous ATV was therefore developed, evaluated and applied in studies of infants.Total, subcutaneous and non-subcutaneous ATV was assessed in 46 fullterm infants between four and 131 days old (25 boys and 21 girls), and in eight moderately preterm infants (six boys and two girls) with a postnatal age of 44-75 days. The infants were also studied by means of the DLW method to assess TBW and TEE, while TBF and the degree of hydration in fat free weight (FFW) and AT fat content were calculated. TBF based on SFT measurements was also assessed in 43 of these infants.The MRI method can assess total ATV with good precision and with relative validity. During the first four months of life a considerable gain in ATV was found in both boys and girls. About 90% of the adipose tissue was located subcutaneously. Based on estimates of ATV and TBW, changes in body fat, FFW and in the degree of hydration in FFW were found to be similar to classical reference data for early infancy. During the first four months of life a significant increase in TEE (kJ/kg/24h) with age was found, probably an effect of a gradual increase in physical activity. In preterm infants at term postconceptional age and in fullterm newboms, the ATV (ml/kg body weight), TBW (%), the fat content in AT as well as the proportion of total ATV present as subcutaneous ATV were similar, while TEE (kJ/kg/24h) was 20% higher in the preterm infants than in the fullterm newboms. This difference could be explained by more rapid growth and also by higher physical activity in the preterm infants. Estimates of TBF based on SFT produces biased estimates of body fat in fullterm infants under four months of age. This bias can to a large extent be explained by a considerable variation in the fat content of AT. However, estimates of TBF obtained by means of the SFT method can be used to estimate body fatness in groups of infants with similar AT fat content.In conclusion, estimates of ATV obtained by means of MRI contributed to new knowledge regarding various aspects of body composition during infancy.

Journal Article
TL;DR: There is inadequate timely information on measured total and extra-cellular water volumes for the population, and available data indicate a coincident increase in body water with overweight and obesity, and a shifting in the proportion of ECW in TBW.
Abstract: Background Most investigations of TBW, ECW and body composition and reports of their intra-body relationships were published prior to 1980. Distributional TBW and ECW relationships within the body have been considered fixed, but there was evidence these relationships were affected by the level of fatness. Body composition models based on past findings and assumptions could produce inaccurate estimates when the majority of the population is overweight to obese. Methods TBW and ECW volumes, their proportions of body weight, FFM and percent body fat and associations with age are considered in U.S. children and adults. This review focuses on studies reporting measured body water volumes from large samples except for the national predicted values from NHANES III. Results Measured TBW volumes for children and adults are almost exclusively from whites with the exception of the estimated values from NHANES III for non-Hispanic black and Mexican-Americans. Mean adult TBW volumes are as much as 9 liters greater than those reported prior to 1980. Low mean percentages of TBW%WT reflect the greater level of adiposity in children and adults, and this level of adiposity affects the value of TBW% FFM. Mean ECW volumes for white adults are 10 to 12 liters larger than those reported previously. With greater fatness in adults, ECW%TBW has increased to near 60%, and this implies that a calculation of FFM based on 73% and an ECW%TBW of 25-45% could produce an overestimation but more important clinically an underestimation of body fatness. Conclusion There is inadequate timely information on measured total and extra-cellular water volumes for the population. Available data indicate a coincident increase in body water with overweight and obesity, and a shifting in the proportion of ECW in TBW. Clinical and pharmacological treatments based upon past assumptions of body water volumes, proportions and relationships could produce inaccurate estimates.

Journal ArticleDOI
TL;DR: The developed theoretical model revealed that the proportion of BCM to FFM is mainly determined by water distribution (i.e., E/I, the ratio of extracellular to intracellular water).
Abstract: The proportion of fat-free mass (FFM) as body cell mass (BCM) is highly related to whole body resting energy expenditure. However, the magnitude of BCM/FFM may have been underestimated in previous ...

29 Nov 2007
TL;DR: Bioelectrical Impedance Analysis is a reliable, non-invasive, safe and effective method of determining body composition in healthy individuals as well as in patients with diabetes, hypertension, obesity and other diseases.
Abstract: Bioelectrical Impedance Analysis (BIA) is a reliable, non-invasive, safe and effective method of determining body composition in healthy individuals as well as in patients with diabetes, hypertension, obesity and other diseases. BIA is about measuring the overall electrical resistance of the body, which is related to both passive and active resistance (reactance) using a set of surface electrodes connected to a computer analyser and by means of known intensity and frequency of electrical current. The parameters assessed are: total body water (TBW), intra-cellular body water (ICW), extra-cellular body water (ECW), body cell mass (BCM) and thus body fat mass (FM) and lean, fat-free body mass (FFM). BIA allows for following body composition changes during dietary programs and helps tune the diet adequately to them. BIA test results are influenced by variable factors dependent on correct usage of the measuring device and appropriate preparation of the individual to be examined.

Journal ArticleDOI
TL;DR: In healthy middle-aged adults homocysteine concentration independently relates to fat-free mass and to water components, both in simple correlations and in multivariate models including age, smoking habits and vitamin concentrations.
Abstract: Objective Homocysteine is a sex-related risk factor for cardiovascular disease but the reason for dimorphism is unclear. It has been hypothesized that fat-free mass is an independent determinant of the circulating homocysteine and methionine concentrations. Methods The relationship of homocysteine to body composition was investigated in 52 healthy middle-aged 40–60 year olds. Plasma total homocysteine, methionine, folates, vitamins B6 and B12 concentrations were measured with fat mass, bone mineral content, lean body mass, fat-free mass, body water compartments and resting energy expenditure by Anthropometry, Dual X-ray Absorptiometry, Bioimpedentiometry and Indirect Calorimetry. Results Men had higher homocysteine (+28%) and methionine (+18%) concentrations than women, but a similar ratio between the two concentrations. Men also had higher lean body mass and fat-free mass. Homocysteine and methionine concentrations were significantly related to fat-free mass, lean body mass, total, extracellular and intracellular water both in simple correlations and in multivariate models including age, smoking habits and vitamin concentrations. Fat-free mass related measures explained the sex effect on homocysteine and methionine concentrations but not the ratio of homocysteine to methionine concentrations. Conclusion In healthy middle-aged adults homocysteine concentration independently relates to fat-free mass and to water components. Homocysteine and methionine concentrations increase together in relation to the proportion of fat-free mass but their ratio is unrelated to fat-free mass.

Journal ArticleDOI
TL;DR: Evaluating body weight and composition during the menstrual cycle and during oral contraception with EE+DRSP maintains the same concentrations in TBW and ECW observed in the FP, likely due to the antimineralocorticoid activity of DRSP, which counteracts the water retention elicited by estrogen.

Journal ArticleDOI
TL;DR: These regression equations provide ECW quantile reference values based on a large multi-ethnic adult population that should not only prove useful in clinical settings and physiological research, but serve as a model approach for developing body composition normative ranges.
Abstract: Extracellular water (ECW) is a large and clinically important body compartment that varies widely in volume both in health and disease. Interpretation of ECW measurements in the clinical setting requires consideration of potential influencing factors such as age, race, sex and other variables that influence fluid status. An important gap in physiological research is a lack of normative ECW values against which to reference perturbations in fluid homeostasis. The current study's aim was to develop conditional quantile equations for ECW based on weight, height, age, sex and race using a large (n = 1538, 854 females and 684 males) healthy adult multi-ethnic (African American, Asian, European American, Hispanic) sample. ECW was derived from total body water and potassium measured by isotope dilution and whole-body 40K counting, respectively. Quantile regression methods were used to identify five percentile levels (10th, 25th, 50th, 75th, 90th). Weight and height were significant variables at each quantile in both males and females; age made a significant contribution in the male but not the female sample. These regression equations provide ECW quantile reference values based on a large multi-ethnic adult population that should not only prove useful in clinical settings and physiological research, but serve as a model approach for developing body composition normative ranges.

Journal ArticleDOI
TL;DR: It is concluded that hypoalbuminemia is also a marker of fluid excess and the SA is associated to the fluid index and the PA allows assessment of the dry weight and its variations in an individualized manner in dialysis patients.
Abstract: Hypoalbuminemia may be secondary to volume expansion conditions and an independent risk factor for cardiovascular disease. Bioelectrical impedance analysis (BIA) is an accurate, non-invasive method to measure body composition, especially the water compartments in humans. The aim of this cross-sectional study is to evaluate the relationship between serum albumin concentration (SA) and hydration state measured by whole BIA. The study investigated 108 non-selected patients (73 on hemodialysis, 35 on peritoneal dialysis) with a mean age of 61.4 +/- 15.6 years, 42.7% of whom were female. The patients were allotted to groups according to their SA: Group 1, 4.0 g/dL. The BIA parameters used included: total body water, intracellular water (ICW), extracellular water (ECW), phase angle (PA), body cell mass (BCM), ICW/ECW ratio and ICW/ECW ratio patients/controls (fluid index). Seventy-five healthy volunteers formed the control group. A strong positive correlation was found between the PA and fluid index (r (2) = 0.993, P < 0.001), as well as between the PA and SA (r = 0.386, P < 0.001), and the ICW/ECW ratio and SA (r = 0.227, P < 0.001). The ECW was negatively correlated with SA (r = -0.330, P < 0.001). Every 0.1 g/dL decrease in SA was associated with a 0.33 L increase in ECW. Group 1 patients had lower reactance (P = 0.006), PA (P < 0.001), BCM (P = 0.012), fluid index (P < 0.001) and ICW/ECW ratio (P = 0.015), and an increased ECW (NS) than groups 2 and 3. We conclude that hypoalbuminemia is also a marker of fluid excess. The SA is associated to the fluid index and the PA allows assessment of the dry weight and its variations in an individualized manner in dialysis patients.

Journal ArticleDOI
TL;DR: The predictions suggest that the baseline state of extracellular volume and the degree of hyperglycemia are major factors influencing the magnitude of abnormalities in the tonicity and extrace cellular volume resulting from DH, while transfers of solute between the intracellular compartment and the extracllular compartment have relatively smaller effects.
Abstract: Hyperglycemic syndromes cause disturbances in the tonicity of body fluids, the distribution of body water between major body fluid compartments, and the external balance of body solute and water. The unique feature of dialysis-associated hyperglycemia (DH) is that, during its development, it can cause changes exclusively in the internal balance of body solute (hypertonicity) and fluids (intracellular volume contraction and extracellular volume expansion) without affecting the external balance of water or solute. This makes DH the proper substrate for studying predictions of the changes in tonicity and extracellular volume caused by hyperglycemia because these predictions fail, by and large, to account for changes in the external balance of sodium, potassium, and water observed in hyperglycemic syndromes occurring in patients with preserved renal function. The predictions suggest that the baseline state of extracellular volume and the degree of hyperglycemia are major factors influencing the magnitude of abnormalities in the tonicity and extracellular volume resulting from DH, while transfers of solute between the intracellular compartment and the extracellular compartment have relatively smaller effects. Edematous patients are at risk for greater hypertonicity and larger increases in their extracellular volume than euvolemic -- or, even less, hypovolemic -- patients with the same degree of hyperglycemia. Studies reporting the treatment of DH with only insulin therapy can be used to test these theoretical predictions and to analyze the relationship between solute and fluid abnormalities and clinical manifestations.

Journal Article
TL;DR: These data suggest that 21 days of CS produced significant effects on gross and/or propelling efficiency during swimming in female athletes, however, CS did not influence performance, body weight and body composition.
Abstract: Aim Creatine supplementation (CS) has been reported to increase body weight and improve performance during high intensity, short duration, exercise tasks. However, none of the published studies has investigated the influence of CS on performance related hydrodynamic variables during swimming. To investigate the effect of oral CS on swimming velocity, body composition and hydrodynamic variables during the period of final preparation of competitive junior female swimmers. Methods In a double blind and randomized manner, 16 female swimmers, were supplemented with 20 g day(-1) of creatine monohydrate (CS group), or a maltodextrin placebo (PL group) for 21 days. Just pre- and post-21 days of supplementation, subjects performed 2x25 swimming bouts at maximum velocity with a 3 min recovery between bouts. The variables measured were 25 m swimming velocity (MSV(25)); active drag force (D(f)); hydrodynamic coefficient (C(x)); power output (P(o)). Body measures were also analysed: body weight (kg), fat-mass (% FAT), body water (% H(2)O), and fat free mass (FFM). Results Significant differences were observed in hydrodynamic values: the CS group showed a significant reduction (approximately =25%), in D(f), C(x) and P(o) values, when comparing pretest with post-test. No differences were found in variables related to body composition and performance between CS group and PL group, as well as for CS group during the experimental period. Conclusions These data suggest that 21 days of CS produced significant effects on gross and/or propelling efficiency during swimming in female athletes. However, CS did not influence performance, body weight and body composition.

Journal ArticleDOI
TL;DR: In women with PMS, 30EE+DRSP reduces the concentrations in TBW and ECW, likely due to the antimineralocorticoid activity of DRSP, which may account for the improvement of premenstrual fluid-related symptoms reported with this formulation.

Journal Article
TL;DR: In order to assess the compartmental water management of Marwari sheep various body water compartments were determined during the periods of control, dehydration and rehydration, where the maximum gain was observed in blood volume and the slowest gain in intracellular and red cell fluid compartments.
Abstract: In order to assess the compartmental water management of Marwari sheep various body water compartments were determined during the periods of control, dehydration and rehydration. The control mean values of total body water, extracellular, plasma volume, blood volume, red cell volume, intracellular fluid volume and interstitial fluid volume were 20.0 ± 0.8, 1.80 ± 0.1, 2.8 ± 0.20, 0.56 ± 0.02, 9.3 ± 0.4, 11.0 ± 0.4 and 7.5 ± 0.3 litre, respectively, thereby forming 64.26%, 5.78, 8.99, 1.79, 29.88, 35.34 and 24.10% of the body mass, respectively. Significant (P ≤0.05) decline was found with progression of dehydration in all the water compartments with a different pattern. Maximum loss was observed from the plasma volume (50%), whereas minimum loss was in the intracellular fluid compartment. Again upon rehydration, the pattern of water replenishment was different in various compartments. Immediately after rehydration the maximum gain was observed in blood volume and the slowest gain in intracellular and red cell fluid compartments. Decreased plasma volume was related with a significantly (P ≤0.05) higher serum aldosterone during dehydration period. Simultaneously, dehydration functioning as a stress increased the levels of serum cortisol accompanied by increase in serum creatinine, creatine kinase, γ-glutamyl transferase and alkaline phosphatase activities significantly (P ≤0.05).

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TL;DR: This study confirmed that fluid overload was closely associated with the development of hypertension in CAPD patients and showed that hypertensive patients were in general more fluid overloaded despite a higher fluid and sodium removal as compared with normotensive patients.
Abstract: Background. Although fluid overload contributes to hypertension in CAPD patients, less attention has been paid to the role of excess salt and fluid intake. Therefore, we investigated the role of salt and fluid intake in the development of hypertension in CAPD patients. Methods. A total of 165 stable CAPD patients were included into this study. Based on the blood pressure in three consecutive months, they were divided into three groups: persistent hypertensive (PH; n = 33), intercurrent hypertensive (IH; n = 58) and persistent normotensive (PN; n = 74). The IH group was further divided into two phases: normotensive and hypertensive. Fluid status was evaluated by clinical assessment and bioimpedance analysis (BIA). Results. There were no differences in age, gender, and duration of dialysis among groups. Patients were more fluid overloaded in the PH group. Extracellular water (ECW), total body water (TBW), and normalized extracellular water by height (NECW) were higher in the PH group than the PN group...

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TL;DR: Multi-frequency bioelectrical impedance analysis represents a practical and accurate means of assessing acute fluid changes during dehydration and expansion of ECFV using isotonic crystalloids with potential clinical applications in equine critical care.
Abstract: Background: Multi-frequency bioelectrical impedance analysis (MF-BIA) has been used to evaluate extracellular fluid volume (ECFV), but not fluid fluxes associated with fluid or furosemide administration in horses. If able to detect acute changes in ECFV, MF-BIA would be useful in monitoring fluid therapy in horses. Hypothesis: The purpose of this study was to evaluate the ability of MF-BIA to detect acute fluid compartment changes in horses. We hypothesized that MF-BIA would detect clinically relevant (10–20%) changes in ECFV. Animals: Six healthy mares were used in the study. Methods: This is an original experimental study. Mares were studied in 3 experiments: (1) crystalloid expansion of normally hydrated subjects, (2) furosemide-induced dehydration followed by crystalloid administration, and (3) acute blood loss followed by readministration of lost blood. MF-BIA measurements were made before, during, and after each fluid shift and compared to known changes in volume calculated based on the intravenous fluids that were administered in addition to urinary fluid losses. Mean errors between MF-BIA estimated change and known volume change were compared using nonparametric analysis of variance. Estimated ECFV pre- and post-fluid administration similarly were compared. The level of statistical significance was set at P < .05. Results: Results of the study revealed a statistically significant change in ECFV and total body water during crystalloid expansion and dehydration. Statistically significant changes were not observed during blood loss and administration. Mean errors between MF-BIA results and measured net changes were small. Conclusions and Clinical Importance: MF-BIA represents a practical and accurate means of assessing acute fluid changes during dehydration and expansion of ECFV using isotonic crystalloids with potential clinical applications in equine critical care.