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Showing papers on "Body water published in 2012"


Journal ArticleDOI
TL;DR: Dapagliflozin reduces TBW, predominantly by reducing FM, VAT and SAT in T2DM inadequately controlled with metformin and establishes through body composition measurements whether weight loss is accounted for by changes in fat or fluid components.
Abstract: Context: Dapagliflozin, a selective sodium-glucose cotransporter 2 (SGLT2) inhibitor, reduces hyperglycemia in patients with type 2 diabetes mellitus (T2DM) by increasing urinary glucose excretion, and weight loss is a consistent associated finding. Objectives: Our objectives were to confirm weight loss with dapagliflozin and establish through body composition measurements whether weight loss is accounted for by changes in fat or fluid components. Design and Setting: This was a 24-wk, international, multicenter, randomized, parallel-group, double-blind, placebo-controlled study with ongoing 78-wk site- and patient-blinded extension period at 40 sites in five countries. Patients: Included were 182 patients with T2DM (mean values: women 63.3 and men 58.6 yr of age; hemoglobin A1c 7.17%, body mass index 31.9 kg/m2, and body weight 91.5 kg) inadequately controlled on metformin. Intervention: Dapagliflozin 10 mg/d or placebo was added to open-label metformin for 24 wk. Main Outcome Measures: Primary endpoint w...

667 citations


Journal ArticleDOI
TL;DR: There is a need to determine whether improved nutritional management can enhance lean tissue acquisition, which indicates a need for measures of body composition in addition to routine anthropometry.
Abstract: BACKGROUND AND OBJECTIVE: Infants born preterm are significantly lighter and shorter on reaching term equivalent age (TEA) than are those born at term, but the relation with body composition is less clear. We conducted a systematic review to assess the body composition at TEA of infants born preterm. METHODS: The databases MEDLINE, Embase, CINAHL, HMIC, “Web of Science,” and “CSA Conference Papers Index” were searched between 1947 and June 2011, with selective citation and reference searching. Included studies had to have directly compared measures of body composition at TEA in preterm infants and infants born full-term. Data on body composition, anthropometry, and birth details were extracted from each article. RESULTS: Eight studies (733 infants) fulfilled the inclusion criteria. Mean gestational age and weight at birth were 30.0 weeks and 1.18 kg in the preterm group and 39.6 weeks and 3.41 kg in the term group, respectively. Meta-analysis showed that the preterm infants had a greater percentage total body fat at TEA than those born full-term (mean difference, 3%; P = .03), less fat mass (mean difference, 50 g; P = .03), and much less fat-free mass (mean difference, 460 g; P < .0001). CONCLUSIONS: The body composition at TEA of infants born preterm is different than that of infants born at term. Preterm infants have less lean tissue but more similar fat mass. There is a need to determine whether improved nutritional management can enhance lean tissue acquisition, which indicates a need for measures of body composition in addition to routine anthropometry. * Abbreviations: ADP — : air-displacement plethysmography ATV — : adipose tissue volume CI — : confidence interval DXA — : dual energy x-ray absorptiometry FFM — : fat-free mass FM — : fat mass SD — : Standard Deviation %TBF — : total body fat as a percentage of body weight TBW — : total body water TEA — : term equivalent age

248 citations


Journal ArticleDOI
TL;DR: This review revises relevant physiology of body water distribution and capillary-tissue flow dynamics, outlines the rationale behind the fluid regimens mentioned above, and summarizes the current clinical evidence base for them, particularly the increasing use of individualized goal-directed fluid therapy facilitated by oesophageal Doppler monitoring.
Abstract: There is increasing evidence that intraoperative fluid therapy decisions may influence postoperative outcomes. In the past, patients undergoing major surgery were often administered large volumes of crystalloid, based on a presumption of preoperative dehydration and nebulous intraoperative 'third space' fluid loss. However, positive perioperative fluid balance, with postoperative fluid-based weight gain, is associated with increased major morbidity. The concept of 'third space' fluid loss has been emphatically refuted, and preoperative dehydration has been almost eliminated by reduced fasting times and use of oral fluids up to 2 h before operation. A 'restrictive' intraoperative fluid regimen, avoiding hypovolaemia but limiting infusion to the minimum necessary, initially reduced major complications after complex surgery, but inconsistencies in defining restrictive vs liberal fluid regimens, the type of fluid infused, and in definitions of adverse outcomes have produced conflicting results in clinical trials. The advent of individualized goal-directed fluid therapy, facilitated by minimally invasive, flow-based cardiovascular monitoring, for example, oesophageal Doppler monitoring, has improved outcomes in colorectal surgery in particular, and this monitor has been approved by clinical guidance authorities. In the contrasting clinical context of relatively low-risk patients undergoing ambulatory surgery, high-volume crystalloid infusion (20-30 ml kg(-1)) reduces postoperative nausea and vomiting, dizziness, and pain. This review revises relevant physiology of body water distribution and capillary-tissue flow dynamics, outlines the rationale behind the fluid regimens mentioned above, and summarizes the current clinical evidence base for them, particularly the increasing use of individualized goal-directed fluid therapy facilitated by oesophageal Doppler monitoring.

231 citations


Journal ArticleDOI
TL;DR: Objective normative values for hyperhydration, euhydration, and dehydration that can be used by registered dietitians and clinicians to counsel women about their hydration status are provided.

72 citations


01 Jan 2012
TL;DR: In this paper, the authors describe representative volumes and types of fluid consumed by healthy young women who undertook normal daily activities, and discover normative values for 24-hour fluid intake, and hydration biomarkers in urine (osmolality, specific gravity, colour, and volume) and blood (serum osmolality).
Abstract: Adults require simple but valid ways to assess hydration status. However, hydration status is difficult to measure because the distribution of total body water is a dynamic fluid matrix. All hydration assessment techniques are therefore best viewed as singular measures of this complex distribution. Normative values for hydration biomarkers have recently been published for men (Armstrong et al. 2010); but corresponding norms and hydration categories do not exist for women. Furthermore, the volume and types of fluid consumed by healthy young women are not well described. This study, which took place over two consecutive days, had two aims. The first was to discover normative values for 24-hour fluid intake, and hydration biomarkers in urine (osmolality, specific gravity, colour, and volume) and blood (serum osmolality). The second aim was to describe representative volumes and types of fluid consumed by young women who undertook normal daily activities.

67 citations


Journal ArticleDOI
TL;DR: The kinetic parameters of absorption and distribution of ingested water in the body water pool (BWP) and of its disappearance from this pool were estimated in 36 subjects from changes in plasma or urine deuterium to protium ratio (D/H) over 10 days using one- and two-compartments and a non-compartmental pharmacokinetic models.
Abstract: The kinetic parameters of absorption and distribution of ingested water (300 ml labeled with D2O; osmolality <20 mOsm kg−1) in the body water pool (BWP) and of its disappearance from this pool were estimated in 36 subjects from changes in plasma or urine deuterium to protium ratio (D/H) over 10 days using one- and two-compartment and a non-compartmental pharmacokinetic models (1-CM, 2-CM and N-CM which applied well to 58, 42 and 100% of the subjects, respectively). Compared with the volume and turnover of the BWP computed with the slope-intercept method (60.7 ± 4.1% body mass or 72.7 ± 3.2% lean body mass; turnover 4.58 ± 0.80 l day−1: i.e., complete renewal in ~50 days; n = 36), the values were accurately estimated with the N-CM and 1-CM and were slightly overestimated and underestimated, respectively, with the 2-CM (~7–8% difference, significant for water clearance only). Ingested water appeared in plasma and blood cells within 5 min and the half-life of absorption (~11–13 min) indicates a complete absorption within ~75–120 min. The 2-CM showed that in 42% of the subjects, ingested water quickly distributed within a central compartment before diffusing with a very short half-life (12.5 ± 4.3 min) to a peripheral compartment (18.5 ± 4.3 and 31.6 ± 6.4 L, respectively), which were in complete equilibrium within ~90 min. Pharmacokinetic analyses of water labeled with D2O can help describe water absorption and distribution, for which there is no well defined reference method and value; depending on the characteristics of the subjects and the drinks, and of environmental conditions.

64 citations



Journal ArticleDOI
TL;DR: It is concluded that young, native tropical soccer players started the match hypohydrated and replaced about 50% of the sweat lost and effective strategies to improve fluid replacement are needed for players competing in the heat.
Abstract: In this study, we assessed the pre-game hydration status and fluid balance of elite young soccer players competing in a match played in the heat (temperature 31.0 ± 2.0 ° C, relative humidity 48.0 ± 5.0%) for an official Brazilian soccer competition. Fluid intake was measured during the match, as were urine specific gravity and body mass before and after the game to estimate hydration status. Data were obtained from 15 male players (age 17.0 ± 0.6 years, height 1.78 ± 0.06 m, mass 65.3 ± 3.8 kg); however, data are only analysed for 10 players who completed the full game. The mean (± s) sweat loss of players amounted to 2.24 ± 0.63 L, and mean fluid intake was 1.12 ± 0.39 L. Pre-game urine specific gravity was 1.021 ± 0.004, ranging from 1.010 to 1.025. There was no significant correlation between sweat loss and fluid intake (r = 0.504, P = 0.137) or between urine specific gravity and fluid intake (r = -0.276, P = 0.440). We conclude that young, native tropical soccer players started the match hypohydrated and replaced about 50% of the sweat lost. Thus, effective strategies to improve fluid replacement are needed for players competing in the heat.

58 citations


Journal ArticleDOI
TL;DR: Patients with ankylosing spondylitis are at risk for accelerated muscle loss and reduced physical activity, and accurate data are needed on body composition and physical activity.
Abstract: Objective Patients with ankylosing spondylitis (AS) are at risk for accelerated muscle loss and reduced physical activity. Accurate data are needed on body composition and physical activity in this patient group. The purpose of this study was to investigate body composition and objectively assessed physical activity in patients with AS. Methods Twenty-five AS patients (15 men, mean ± SD age 48 ± 11 years) were compared with 25 healthy adults matched for age, sex, and body mass index. Body composition was measured using a 3-compartment model based on air-displacement plethysmography to assess body volume and deuterium dilution to assess total body water. The fat-free mass index (FFMI; fat-free mass divided by height squared) and the percent fat mass (%FM) were calculated. Daily physical activity was assessed for 7 days using a triaxial accelerometer and physical fitness with an incremental test until exertion on a bicycle ergometer. Blood samples were taken to determine C-reactive protein (CRP) level and tumor necrosis factor α. Results Accelerometer output (kilocounts/day) showed the same physical activity level for patients and controls (mean ± SD 319 ± 105 versus 326 ± 66). There was no difference in the FFMI or %FM between the patients and controls. Physical activity was positively related to the FFMI (partial R = 0.38, P = 0.01) and inversely related to CRP level (R = −0.39, P < 0.01), independent of group. CRP level was inversely related to the FFMI, but the effect was less strong than with physical activity (partial R = −0.31, P = 0.03). Conclusion Daily physical activity may help preserve fat-free mass in patients with AS.

56 citations


Journal ArticleDOI
TL;DR: Although NTproBNP was associated with residual renal function, cardiac hypertrophy, volume overload and inflammation on simple univariate analysis, on further examination NTproPNP was predominantly affected by factors associated with volume overload, and these results require confirmation in a prospective study.
Abstract: Background Brain natriuretic peptide (BNP) has been reported to be a powerful predictor of peritoneal dialysis patient survival. However, it is unclear as to whether this is related to cardiac dysfunction or chronic volume overload. Methods To investigate the relationship between BNP, cardiac function and fluid volume overload, we reviewed multifrequency bioimpedance, transthoracic echocardiography and serum N-terminal probrain-type natriuretic peptide (NTproBNP) in 115 stable peritoneal dialysis outpatients attending for assessment of peritoneal dialysis and transport status. Results In this cross-sectional study, the median NTproBNP was 251 (118-605) pmol/L. On simple univariate analysis, NTproBNP was associated with markers of residual renal function, volume overload, hypertension and hypertensive cardiac disease and inflammation [reduced serum albumin and raised C-reactive protein]. However, on multivariate logistical regression analysis, the strongest association for log NTproBNP was with the estimated right ventricular end-systolic pressure (β = 0.02, F = 11.5, P = 0.001), followed by log 24-h urine volume (β = -0.19, F = 10.7, P = 0.002), extracellular/total body water ratio (β = 13.5, F = 6.1, P = 0.017) and the number of different antihypertensive medications prescribed (β = 0.15, F = 8.7, P = 0.005). Conclusion In this cross-sectional study, although NTproBNP was associated with residual renal function, cardiac hypertrophy, volume overload and inflammation on simple univariate analysis, on further examination NTproBNP was predominantly affected by factors associated with volume overload, and these results require confirmation in a prospective study.

50 citations


Journal ArticleDOI
TL;DR: A novel method to calculate TBV with the use of a clinical DXA system was developed, compared against ADP as proof of principle, and used in Lohman's 4C body composition model.

Journal ArticleDOI
TL;DR: The body mass index and body fat were decreased in the CC and GO groups compared with the WS group, but there were no significant differences between the two weight-losing groups.

Journal ArticleDOI
TL;DR: It is concluded that faster runners lost more body mass, runners lost less body mass when they drank less fluid, and faster runners drank more fluid than slower runners.
Abstract: In 219 recreational male runners, we investigated changes in body mass, total body water, haematocrit, plasma sodium concentration ([Na+]), and urine specific gravity as well as fluid intake during a 100-km ultra-marathon. The athletes lost 1.9 kg (s = 1.4) of body mass, equal to 2.5% (s = 1.8) of body mass (P < 0.001), 0.7 kg (s = 1.0) of predicted skeletal muscle mass (P < 0.001), 0.2 kg (s = 1.3) of predicted fat mass (P < 0.05), and 0.9 L (s = 1.6) of predicted total body water (P < 0.001). Haematocrit decreased (P < 0.001), urine specific gravity (P < 0.001), plasma volume (P < 0.05), and plasma [Na+] (P < 0.05) all increased. Change in body mass was related to running speed (r = −0.16, P < 0.05), change in plasma volume was associated with change in plasma [Na+] (r = −0.28, P < 0.0001), and change in body mass was related to both change in plasma [Na+] (r = −0.36) and change in plasma volume (r = 0.31) (P < 0.0001). The athletes consumed 0.65 L (s = 0.27) fluid per hour. Fluid intake was re...

Journal ArticleDOI
TL;DR: In the absence of any food or fluid intake during the hours of daylight during the month of Ramadan, a progressive loss of body water will occur over the course of each day, though these losses can be completely replaced each night.
Abstract: In the absence of any food or fluid intake during the hours of daylight during the month of Ramadan, a progressive loss of body water will occur over the course of each day, though these losses can be completely replaced each night. Large body water deficits will impair both physical and cognitive performance. The point at which water loss will begin to affect performance is not well defined, but it may be as little as 1–2% of body mass. For resting individuals in a temperate environment, the water loss that occurs during a day without food or fluid will typically amount to about 1% of body mass by the time of sunset. This small loss of body water is unlikely to have a major adverse effect on any aspect of physical or cognitive performance. Larger body water losses will occur, however, in hot weather or if exercise is undertaken. Performance in events lasting about 1 hour or longer may be impaired in the absence of fluid intake during the event. In weight-category sports, there may be difficultie...

Journal ArticleDOI
TL;DR: A gender analysis revealed that Ad-SoS and BUA parameters increased significantly with age and that both positively correlated with age, weight, height, BMI, FFM and TBWater.
Abstract: The purpose of this study was to: (a) determine the relationship between quantitative ultrasound (QUS) results and anthropometric, dietary and body composition factors and establish reference ranges for amplitude-dependent speed of sound (Ad-SoS) in the phalanges and broadband ultrasound attenuation (BUA) in the calcaneus of children from Extremadura, Spain, and (b) to present reference curves for this population. Healthy children (n = 245), aged 4–16 years, were included (124 girls and 121 boys). Phalangeal and calcaneal QUS measurements were performed using DBM Sonic Bone Profiler and McCue CUBA Clinical ultrasound devices, respectively. Weight, height and body mass index (BMI) were evaluated by anthropometric methods. Fat percentage, fat mass, lean mass (FFM) and total body water (TBWater) were evaluated by bioelectrical impedance measurements using a Holtain body composition analyzer. Food intake was evaluated by a 7-day food record. A gender analysis revealed that Ad-SoS and BUA parameters increased significantly with age and that both positively correlated with age, weight, height, BMI, FFM and TBWater. For both genders, Ad-SoS showed significant and positive correlations with age, weight, height, BMI, FFM, BUA and TBWater.

Journal ArticleDOI
TL;DR: The results indicated that the changes in weighted segmental impedance at the frequencies evaluated (5, 20, 50, 100, and 500 kHz) are sensitive to acute changes in dehydration but lag behind changes in the standard physiological markers of hydration status after a 2-hour rehydration period.
Abstract: The objective of this study was to examine the validity of multifrequency direct segmental bioelectrical impedance analysis (DSM-BIA) measures to detect changes in the hydration status of wrestlers after they underwent 3% acute dehydration and a 2-hour rehydration period. Fifty-six National Collegiate Athletic Association wrestlers: (mean ± SEM); age 19.5 ± 0.2 years, height 1.73 ± 0.01 m, and body mass (BM) 82.5 ± 2.3 kg were tested in euhydrated, dehydrated (-3.5%), and 2-hour rehydration conditions using DSM-BIA to detect the changes in hydration status. The hydration status was quantified by measuring the changes in plasma osmolality (P(osm)), urine osmolality (Uosm), urine specific gravity (U(sg)), BM, and weighted segmental impedance at frequencies of 5, 20, 50, 100, and 500 kHz. Weighted segmental impedance significantly increased after a 3.5% reduction in the body weight for all the 5 frequencies evaluated, but it did not return to baseline at 2-hour rehydration. P(osm) (303 ± 0.6 mOsm·L(-1)), Uosm (617 ± 47 mOsm·L(-1)), and U(sg) (1.017 ± 0.001) all significantly increased at postdehydration and returned to baseline at 2-hour rehydration. Estimations of extracellular water were significantly different throughout the trial, but there were no significant changes in the estimations of the total body water or intracellular water. The results of this study demonstrate the potential use of DSM-BIA as a field measure to assess the hydration status of wrestlers for the purpose of minimal weight certification before the competitive season. When employing DSM-BIA to assess the hydration status, the results indicated that the changes in weighted segmental impedance at the frequencies evaluated (5, 20, 50, 100, and 500 kHz) are sensitive to acute changes in dehydration but lag behind changes in the standard physiological (plasma and urinary) markers of hydration status after a 2-hour rehydration period.

Journal ArticleDOI
TL;DR: The prevalence of exercise-associated hyponatremia (EAH) was higher in these Triple Iron ultra-triathletes compared to existing reports on Ironman triathletes and body fluid homeostasis remained stable in these ultra-Triathletes.
Abstract: In a recent study of male and female ultra-marathoners in a 161-km ultra-marathon, the prevalence of exercise-associated hyponatremia (EAH) was higher than reported for marathoners. Regarding triathletes, the prevalence of EAH has been investigated in Ironman triathletes, but not in Triple Iron ultra-triathletes. The aim of this study was to investigate the prevalence of EAH in male ultra-triathletes competing in a Triple Iron ultra-triathlon over 11.4 km swimming, 540 km cycling, and 126.6 km running. Changes in body mass, fat mass, skeletal muscle mass, total body water, haematocrit, plasma volume, plasma sodium concentration ([Na(superscript +)]) and urine specific gravity were determined in 31 male athletes with (means ±standard deviation) 42.1 ±8.1 years of age, 77.0 ±7.0 kg body mass, 1.78 ±0.06 m body height and a BMI of 24.3 ±1.7 kg/m^2 in the 'Triple Iron Triathlon Germany'. Of the 31 finishers, eight athletes (26%) developed asymptomatic EAH. Body mass, fat mass, skeletal muscle mass, and haematocrit decreased, plasma volume increased (P < 0.05), plasma [Na(superscript +)], total body water and urine specific gravity remained stable. The decrease in body mass was related to both the decrease in fat mass and skeletal muscle mass (P < 0.05), but was not related to overall race time, the change in plasma [Na(superscript +)], post-race plasma [Na(superscript +)], or urine specific gravity. The prevalence of EAH was higher in these Triple Iron ultra-triathletes compared to existing reports on Ironman triathletes. Body fluid homeostasis remained stable in these ultra-triathletes although body mass decreased.

Journal ArticleDOI
TL;DR: Women with low BMI and height in early pregnancy have lower ECW and TBW in early, mid, and late pregnancy and lower late pregnancy plasma volume expansion, potentially increasing risk of fetal growth restriction.
Abstract: Plasma volume expansion has been associated with fetal growth. Our objective was to examine the associations between maternal nutritional status in early pregnancy and extracellular water (ECW), total body water (TBW), and percentage plasma volume change across pregnancy. In a subsample of 377 pregnant women participating in a cluster-randomized trial of micronutrient supplementation, hemoglobin, hematocrit, and multi-frequency bioelectrical impedance were measured at ~10, 20, and 32 wk of gestation. In early pregnancy, women were short (mean ± SD, 148.9 ± 5.3 cm) and thin (19.5 ± 2.5 kg/m(2)). In mixed-effects multiple regression models, a 1-unit higher BMI at ~10 wk was associated with higher ECW and TBW (0.27 and 0.66 kg per kg/m(2), respectively; P < 0.01) at ~10, ~20, and ~32 wk. Height was also positively associated with ECW and TBW at each time point. Early pregnancy BMI was negatively associated with gains in ECW and TBW (-0.06 and -0.14 kg per kg/m(2), respectively; P < 0.01) from 10 to 20 wk, but not with 20- to 32-wk gains after accounting for weight gain. BMI was positively associated with percentage changes in plasma volume from 20 to 32 wk (0.57% per kg/m(2); P < 0.05). Height was not associated with changes in body water or plasma volume. Women with low BMI and height in early pregnancy have lower ECW and TBW in early, mid, and late pregnancy and lower late pregnancy plasma volume expansion, potentially increasing risk of fetal growth restriction.

Journal ArticleDOI
TL;DR: Exercise, in combination with an amino acid-rich diet, in particular, leucine, had effects beyond reducing tumoral weight such as improving protein turnover and carcass nitrogen content in the tumor-bearing host.
Abstract: Nutritional supplementation with some amino acids may influence host's responses and also certain mechanism involved in tumor progression. It is known that exercise influences body weight and muscle composition. Previous findings from our group have shown that leucine has beneficial effects on protein composition in cachectic rat model as the Walker 256 tumor. The main purpose of this study was to analyze the effects of light exercise and leucine and/or glutamine-rich diet in body composition and skeletal muscle protein synthesis and degradation in young tumor-bearing rats. Walker tumor-bearing rats were subjected to light aerobic exercise (swimming 30 min/day) and fed a leucine-rich (3%) and/or glutamine-rich (4%) diet for 10 days and compared to healthy young rats. The carcasses were analyzed as total water and fat body content and lean body mass. The gastrocnemious muscles were isolated and used for determination of total protein synthesis and degradation. The chemical body composition changed with tumor growth, increasing body water and reducing body fat content and total body nitrogen. After tumor growth, the muscle protein metabolism was impaired, showing that the muscle protein synthesis was also reduced and the protein degradation process was increased in the gastrocnemius muscle of exercised rats. Although short-term exercise (10 days) alone did not produce beneficial effects that would reduce tumor damage, host protein metabolism was improved when exercise was combined with a leucine-rich diet. Only total carcass nitrogen and protein were recovered by a glutamine-rich diet. Exercise, in combination with an amino acid-rich diet, in particular, leucine, had effects beyond reducing tumoral weight such as improving protein turnover and carcass nitrogen content in the tumor-bearing host.

Journal ArticleDOI
01 Apr 2012
TL;DR: Care must be taken even after successful KT to avoid dyslipidemia, which is a risk factor for cardiovascular disease, and well programmed dietary and/or exercise protocols to prevent muscle atrophy and fat gain should be considered even after successfully KT.
Abstract: Background Successful kidney transplantation (KT) can theoretically reconstitute body composition of a patient with chronic kidney disease (CKD). However, the practical changes have not been well documented. We evaluated changes in body composition among candidates before and 1 year after KT. Methods We enrolled 37 male and 18 female kidney recipients eligible for comparison of their body mass index (BMI), body composition, and lipid metabolism before and 1 year after KT. Twenty-one patients had been induced with a calcineurin inhibitor, mycophenolate mofetil, steroid, and basiliximab, and 34 others underwent steroid withdrawal on postoperative day 3. The body composition was analyzed using bioelectrical impedance. We also analyzed changes in BMI and lipid profiles. Results There was no significant change in BMI (21.4 ± 3.1 vs 21.7 ± 3.5 kg/m2). Regarding body composition, the water level decreased significantly (61.2 ± 4.9% vs 58.3 ± 5.3%; P Conclusions Care must be taken even after successful KT to avoid dyslipidemia, which is a risk factor for cardiovascular disease. Well programmed dietary and/or exercise protocols to prevent muscle atrophy and fat gain should be considered even after successful KT.

Journal ArticleDOI
TL;DR: To determine the precision of multi‐frequency bioimpedance analysis (MFBIA) in quantifying acute changes in volume and nutritional status during haemodialysis, in patients with end‐stage renal disease (ESRD).
Abstract: : Aim: To determine the precision of multi-frequency bioimpedance analysis (MFBIA) in quantifying acute changes in volume and nutritional status during haemodialysis, in patients with end-stage renal disease (ESRD). Methods: Using whole-body MFBIA, we prospectively studied changes in total body water (TBW), extracellular volume (ECV), intracellular volume (ICV), lean body mass (LBM), body cell mass (BCM) and fat mass (FM), pre- and post-haemodialysis and tested the agreement of volume changes with corresponding acute weight change and ultrafiltration volume (UF) using Bland-Altman analysis. Results: Forty-four prevalent and 17 incident haemodialysis patients were studied (median age 55 years, 56% males). MFBIA-derived TBW, ECV, ICV, LBM and BCM were significantly reduced after haemodialysis (P < 0.001), but FM remained constant. TBW change estimated weight change with mean bias of −0.52 L, with 56/61 (91.8%) data points within limits of agreement (−2.74 L, 1.69 L). TBW change estimated UF with mean bias of −0.62 L, with 55/61 (90.2%) data points within limits of agreement (−2.68 L, 1.43 L). ECV change underestimated weight change and UF with mean bias of −1.17 L and −1.27 L respectively. Similarly, ICV change underestimated both clinical measures with corresponding mean bias of −1.34 L and −1.44 L. Comparing incidents versus prevalent haemodialysis patients, TBW change estimated weight change with smaller mean bias (−0.10 L vs−0.69 L, respectively) and narrower limits of agreement. Conclusion: Multi-frequency bioimpedance analysis-derived TBW change has the best agreement with acute clinical volume change during haemodialysis compared to ECV or ICV change alone, but overall degree of precision remains poor. Nutritional assessment using LBM and BCM measurements is significantly confounded by hydration status.

Journal ArticleDOI
TL;DR: The current studies support using BIS as a means of sensitively and reliably performing repeated measurements of BFC in rats of a) differing sizes, b) in response to therapeutic agents known to influence renal sodium handling and c) in Response to osmotic challenge.

Journal ArticleDOI
TL;DR: The body fatness heritability estimate of 60% indicates a smaller contribution of genetic variance to total variance than many previous studies using less powerful research designs have indicated, and highlights the importance of environmental factors and possibly genotype by environmental interactions in the etiology of weight gain and the obesity epidemic.
Abstract: Heritability estimates of human body fatness vary widely and the contribution of body composition methodology to this variability is unknown. The effect of body composition methodology on estimations of genetic and environmental contributions to body fatness variation was examined in 78 adult male and female monozygotic twin pairs reared apart or together. Body composition was assessed by six methods - body mass index (BMI), dual energy x-ray absorptiometry (DXA), underwater weighing (UWW), total body water (TBW), bioelectric impedance (BIA), and skinfold thickness. Body fatness was expressed as percent body fat, fat mass, and fat mass/height2 to assess the effect of body fatness expression on heritability estimates. Model-fitting multivariate analyses were used to assess the genetic and environmental components of variance. Mean BMI was 24.5 kg/m2 (range of 17.8-43.4 kg/m2). There was a significant effect of body composition methodology (p<0.001) on heritability estimates, with UWW giving the highest estimate (69%) and BIA giving the lowest estimate (47%) for fat mass/height2. Expression of body fatness as percent body fat resulted in significantly higher heritability estimates (on average 10.3% higher) compared to expression as fat mass/height2 (p=0.015). DXA and TBW methods expressing body fatness as fat mass/height2 gave the least biased heritability assessments, based on the small contribution of specific genetic factors to their genetic variance. A model combining DXA and TBW methods resulted in a relatively low FM/ht2 heritability estimate of 60%, and significant contributions of common and unique environmental factors (22% and 18%, respectively). The body fatness heritability estimate of 60% indicates a smaller contribution of genetic variance to total variance than many previous studies using less powerful research designs have indicated. The results also highlight the importance of environmental factors and possibly genotype by environmental interactions in the etiology of weight gain and the obesity epidemic.

Journal Article
TL;DR: Type 2 DM patients have significantly higher resistin levels that are positively correlated with body fat mass supporting the evidence that resistin plays an important role in the pathogenesis of obesity and insulin resistance.
Abstract: OBJECTIVES To assess the relationships of resistin concentrations with body mass index (BMI), body fat mass, lean body mass, and body protein mass in patients with type 2 diabetes mellitus (DM). METHODS This cross-sectional study was conducted in the Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia from April 2008 to March 2011. A total of 229 subjects were selected for the study. Body composition was assessed by bioelectrical impedance analyzer. Parameters recorded included BMI, waist hip ratio (WHR), total body water, fat, protein, and lean body masses. Blood samples were analyzed for glucose, glycosylated hemoglobin (HbA1c), and resistin levels. RESULTS We found that BMI, WHR, fasting blood glucose, HbA1c, and resistin levels were significantly higher in diabetics compared to non-diabetic healthy individuals. Fat mass was significantly higher in diabetic patients compared with controls, while the difference for muscle mass and lean body mass was non-significant. A significant positive correlation was observed between plasma levels of resistin and fat mass in patients with DM (r=0.2824, p=0.0030). CONCLUSIONS Type 2 DM patients have significantly higher resistin levels that are positively correlated with body fat mass supporting the evidence that resistin plays an important role in the pathogenesis of obesity and insulin resistance.

Book ChapterDOI
TL;DR: Clinical evaluation, strict control of body weight, diuresis, sodium and fluids intakes, bioimpedance monitoring and serum levels of natriuretic peptides may all together help to maintain the PD patient euvolemic.
Abstract: Assessment of ideal body weight in peritoneal dialysis (PD) patients is important for clinical practice. Fluid overload may produce hypertension, reduced arterial distensibility, left ventricular hypertrophy. All these are risk factors for mortality in PD patients: cardio- and cerebrovascular events are the main causes of morbidity and mortality in PD population. Nowadays, a clear and widely accepted definition of ideal body weight in PD patients does not exist. Probably the ideal body weight is the weight at which the extra cellular volume is normal. Many different tools have been used to assess the hydration status in dialysis patients. Ultrasonic evaluation of inferior vena cava diameter only assesses intravascular volume, and is also influenced by diastolic dysfunction and is thus a reflection of preload and not of tissue hydration. Direct measurement of extra cellular and total body water by dilution methods is considered as the golden standard, but these techniques are laborious and expensive. Parameters, such as brain natriuretic peptide (BNP) or NT-proBNP can reflect changes in hydration status and may help the nephrologist to estimate it. Natriuretic peptides are influenced both by preload and ventricular abnormalities and in patients with renal failure accumulation can occur. Bioimpedance is an accurate, reproducible, not expensive and not invasive technique that permits a good evaluation of hydration status in PD and can drive the nephrologist in his clinical choices. Clinical evaluation, strict control of body weight, diuresis, sodium and fluids intakes, bioimpedance monitoring and serum levels of natriuretic peptides may all together help us to maintain the PD patient euvolemic.

Journal ArticleDOI
TL;DR: Bioelectrical impedance analysis did not prove to be sensitive for detecting changes in body composition, but body mass index, Lee index and abdominal circumference can be used for estimating the body composition of rats.
Abstract: OBJECTIVE: The aim of the present study was to determine the impedance of Wistar rats treated with high-fat and high-sucrose diets and correlate their biochemical and anthropometric parameters with chemical analysis of the carcass. METHODS: Twenty-four male Wistar rats were fed a standard (AIN-93), high-fat (50% fat) or high-sucrose (59% of sucrose) diet for 4 weeks. Abdominal and thoracic circumference and body length were measured. Bioelectrical impedance analysis was used to determine resistance and reactance. Final body composition was determined by chemical analysis. RESULTS: Higher fat intake led to a high percentage of liver fat and cholesterol and low total body water in the High-Fat group, but these changes in the biochemical profile were not reflected by the anthropometric measurements or bioelectrical impedance analysis variables. Anthropometric and bioelectrical impedance analysis changes were not observed in the High-Sucrose group. However, a positive association was found between body fat and three anthropometric variables: body mass index, Lee index and abdominal circumference. CONCLUSION: Bioelectrical impedance analysis did not prove to be sensitive for detecting changes in body composition, but body mass index, Lee index and abdominal circumference can be used for estimating the body composition of rats.

Journal ArticleDOI
TL;DR: It was hypothesized that kyokushin karate training and additional physical activity practiced by advanced athletes will result in alternation of their body composition, which allows to control changes in body weight while preparing for competitions and also defines the content of fat, lean tissue and water in the body thus allowing to controlChanges in the training process.
Abstract: The physical requirements put before contemporary athletes are rigorous and strictly defined and only an elite few possess the physical capacity and preparation to succeed. These requirements are mostly related to the construction of the physical body, the athletes motor, tactical and psychological skills; all of which determine the level of sports achievement obtained or the desired sport result [1,2]. Significant impact on the athlete’s potential capacity has his physique, whereas the body composition (for example fat free mass FFM, adipose tissue – fat mass FM, total amount of body water TBW) determines the level of achievements in many sports. Training regimes used in sport, including martial arts like kyokushin karate, affect the parameters of individuals’ cardio-respiratory and musculoskeletal system, body weight and especially body composition. Body composition assessments are widely used in sports and recreation centers as well as in fitness facilities, gyms, clinics, hospitals, medical and dietary research centers and help to determine the level of body fat and lean tissue in the body. There are many methods of determining body composition, including: bioelectrical impedance analysis (BIA), X-ray absorptiometry (DEXA), computed tomography (CT), magnetic resonance imaging (MRI), ultrasounds and isotopic methods [3,4,5]. The usefulness of these methods in sport diagnosis is unquestionable, however, for economic reasons using them on daily basis is severely limited. Due to this limitation, methods of body composition examination such as bioelectrical impedance (BIA), which is fast, noninvasive, reproducible and reliable while requiring little financial commitment, have become very popular [4]. Analysis of the body composition allows to control changes in body weight while preparing for competitions and also defines the content of fat, lean tissue and water in the body thus allowing to control changes in the training process. It gives the opportunity to monitor the resting metabolism, which in turn helps to specify daily energy expenditure. It was hypothesized that kyokushin karate training and additional physical activity practiced by advanced athletes will result in alternation of their body composition.

Journal ArticleDOI
TL;DR: Assessing total body water with single-frequency bioelectrical impedance analysis against the reference technique deuterium dilution found that individual variability of waist circumference in men and arm length in women significantly contributed to DiffBIA–D2O.
Abstract: Comparing single-frequency bioelectrical impedance analysis against deuterium dilution to assess total body water

Book ChapterDOI
18 Jun 2012
TL;DR: This chapter reviews the physiology, needs, and assessment of human water and electrolyte balance and considers the extent to which water and Electrolyte imbalances affect temperature regulation and exercise performance.
Abstract: : Humans demonstrate a remarkable ability to regulate daily body water and electrolyte balance so long as food and fluid are readily available. The imposition of exercise and environmental stress can, however, challenge this ability. Most circumstances involving physical exercise require the formation and vaporization of sweat as the principle means of heat removal in man. Sweat losses, if not replaced, reduce body water volume and electrolyte content. Excessive body water or electrolyte losses can disrupt physiological homeostasis and threaten both health and performance. Persons often dehydrate during physical activity or exposure to hot weather because of fluid non-availability or a mismatch between thirst and body water losses. In these instances, the person begins the task with normal total body water and dehydrates over a prolonged period. This scenario is common for most athletic and occupational settings, however, in some situations the person might begin exercise with a body water deficit. For example, in several sports (e.g., boxing, power lifting, wrestling) athletes frequently dehydrate to compete in lower weight classes. Also, persons medicated with diuretics may be dehydrated prior to initiating exercise. If sodium chloride deficits occur then the extracellular fluid volume will contract and cause "salt depletion dehydration." A sodium chloride deficit usually occurs due to sweat sodium losses combined with excessive water consumption, but a sodium deficit can also occur without excessive water intake owing to high sweat sodium losses. Both of these scenarios produce sodium dilution more commonly known as hyponatremia or "water intoxication". This chapter reviews the physiology, needs, and assessment of human water and electrolyte balance. The extent to which water and electrolyte imbalances affect temperature regulation and exercise performance are also considered.

Journal ArticleDOI
TL;DR: Results of forearm elasticity experiments can be used as a model for other body sites at risk for the development of pressure ulcers.
Abstract: Background: Skin aging is a risk factor for a decubitus and biophysical skin properties could help to identify persons at risk. Whether such biophysical properties of aged human skin differ between areas is undetermined. Objective: To investigate whether viscoelasticity, hydration or friction differ between important areas for decubitus risk. Methods: Pilot study in 32 (18 female, 14 male) acute and subacute old patients aged 81.9 ± 5.9 years (±SD), without active skin disease after an average of 10 days of stay. Assessment of skin resilience/viscoelasticity (E) and hydration (H) at the volar forearm (VF), trochanter (TR) and the sacrum (SA), nutrition by a Mini Nutritional Assessment (MNA), total body water (TBW), lean body mass (LBM), % body fat (%F) by bioimpedance and routine laboratory parameters (hemoglobin, hematocrit, leukocytes, C-reactive protein, serum proteins and creatinine). Results: Mean body mass index (27 ± 4.2), MNA (22.5 ± 2.9), Braden score (20 ± 2.5), E (68.5 ± 6.0%) and H (38.3 ± 6.7) at any site and laboratory parameters did not differ by sex. Men had more TBW (+12 ± 1.5 liters), LBM (+9 ± 2 kg), less %F (–8.8 ± 2.1%), increased H-TR (+7.11 ± 2.8) and H-SA (+5.68 ± 2.5). Overall E-VF correlated significantly with E-TR (r2 = 0.40, p 2 = 0.40, p Conclusion: Results of forearm elasticity experiments can be used as a model for other body sites at risk for the development of pressure ulcers.