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1.
Effects of the Dual Endothelin Receptor Antagonist Aprocitentan on Body Weight and Fluid Homeostasis in Healthy Subjects on a High Sodium Diet.
Gueneau de Mussy, P, Sidharta, PN, Wuerzner, G, Maillard, MP, Guérard, N, Iglarz, M, Flamion, B, Dingemanse, J, Burnier, M
Clinical pharmacology and therapeutics. 2021;(3):746-753
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Abstract
Aprocitentan is a novel, oral, dual endothelin receptor antagonist (ERA) in development in difficult-to-control hypertension. As fluid retention and edema are concerns with ERAs, we investigated whether aprocitentan causes weight gain in healthy subjects on a high sodium diet and explored potential mechanisms if occurring. This double-blind, randomized, placebo-controlled, crossover study enrolled 28 subjects. Three doses of aprocitentan (10, 25, or 50 mg/day for 9 days) were compared with placebo. Increases in body weight were observed with aprocitentan (placebo-corrected mean weight gains [90% confidence interval]) of 0.43 [0.05-0.80], 0.77 [0.03-1.51], and 0.83 [0.33-1.32] kg at 10 mg, 25 mg, and 50 mg, respectively. Decreases in hemoglobin and uric acid were observed. Plasma volume increased at most by 5.5% without dose-response relationship. Urinary sodium excretion decreased at 10 mg and 25 mg but not at 50 mg. Therefore, aprocitentan produced moderate weight increases in healthy subjects on high sodium diet, without obvious sodium retention.
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Effects of a 14-Day Hydration Intervention on Individuals with Habitually Low Fluid Intake.
Caldwell, AR, Rosa-Caldwell, ME, Keeter, C, Johnson, EC, Péronnet, F, Ganio, MS
Annals of nutrition & metabolism. 2020;:67-68
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Abstract
BACKGROUND Debate continues over whether or not individuals with low total water intake (TWI) are in a chronic fluid deficit (i.e., low total body water) [1]. When women with habitually low TWI (1.6 ± 0.5 L/day) increased their fluid intake (3.5 ± 0.1 L/day) for 4 days 24-h urine osmolality decreased, but there was no change in body weight, a proxy for total body water (TBW) [2]. In a small (n = 5) study of adult men, there were no observable changes in TBW, as measured by bioelectrical impedance, after increasing TWI for 4 weeks [3]. However, body weight increased and salivary osmolality decreased indicating that the study may have been underpowered to detect changes in TBW. Further, no studies to date have measured changes in blood volume (BV) when TWI is increased. OBJECTIVES Therefore, the purpose of this study was to identify individuals with habitually low fluid intake and determine if increasing TWI, for 14 days, resulted in changes in TBW or BV. METHODS In order to identify individuals with low TWI, 889 healthy adults were screened. Participants with a self-reported TWI less than 1.8 L/day (men) or 1.2 L/day (women), and a 24-h urine osmolality greater than 800 mOsm were included in the intervention phase of the study. For the intervention phase, 15 participants were assigned to the experimental group and 8 participants were assigned to the control group. The intervention period lasted for 14 days and consisted of 2 visits to our laboratory: one before the intervention (baseline) and 14 days into the intervention (14-day follow-up). At these visits, BV was measured using a CO-rebreathe procedure and deuterium oxide (D2O) was administered to measure TBW. Urine samples were collected immediately prior, and 3-8 h after the D2O dose to allow for equilibration. Prior to each visit, participants collected 24-h urine to measure 24-h hydration status. After the baseline visit, the experimental group increased their TWI to 3.7 L for males and 2.7 L for females in order to meet the current Institute of Medicine recommendations for TWI. RESULTS Twenty-four-hour urine osmolality decreased (-438.7 ± 362.1 mOsm; p < 0.001) and urine volume increased (1,526 ± 869 mL; p < 0.001) in the experimental group from baseline, while there were no differences in osmolality (-74.7 ± 572 mOsm; p = 0.45), or urine volume (-32 ± 1,376 mL; p = 0.89) in the control group. However, there were no changes in BV (Fig. 1a) or changes in TBW (Fig. 1b) in either group. CONCLUSIONS Increasing fluid intake in individuals with habitually low TWI increases 24-h urine volume and decreases urine osmolality but does not result in changes in TBW or BV. These findings are in agreement with previous work indicating that TWI interventions lasting 3 days [2] to 4 weeks [3] do not result in changes in TBW. Current evidence would suggest that the benefits of increasing TWI are not related changes in TBW.
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Overhydration, Cardiac Function and Survival in Hemodialysis Patients.
Onofriescu, M, Siriopol, D, Voroneanu, L, Hogas, S, Nistor, I, Apetrii, M, Florea, L, Veisa, G, Mititiuc, I, Kanbay, M, et al
PloS one. 2015;(8):e0135691
Abstract
BACKGROUND AND OBJECTIVES Chronic subclinical volume overload occurs very frequently and may be ubiquitous in hemodialysis (HD) patients receiving the standard thrice-weekly treatment. It is directly associated with hypertension, increased arterial stiffness, left ventricular hipertrophy, heart failure, and eventually, higher mortality and morbidity. We aimed to assess for the first time if the relationship between bioimpedance assessed overhydration and survival is maintained when adjustments for echocardiographic parameters are considered. DESIGN, SETTING, PARTICIPANTS AND MEASUREMENTS A prospective cohort trial was conducted to investigate the impact of overhydration on all cause mortality and cardiovascular events (CVE), by using a previously reported cut-off value for overhydration and also investigating a new cut-off value derived from our analysis of this specific cohort. The body composition of 221 HD patients from a single center was assessed at baseline using bioimpedance. In 157 patients supplemental echocardiography was performed (echocardiography subgroup). Comparative survival analysis was performed using two cut-off points for relative fluid overload (RFO): 15% and 17.4% (a value determined by statistical analysis to have the best predictive value for mortality in our cohort). RESULTS In the entire study population, patients considered overhydrated (using both cut-offs) had a significant increased risk for all-cause mortality in both univariate (HR = 2.12, 95%CI = 1.30-3.47 for RFO>15% and HR = 2.86, 95%CI = 1.72-4.78 for RFO>17.4%, respectively) and multivariate (HR = 1.87, 95%CI = 1.12-3.13 for RFO>15% and HR = 2.72, 95%CI = 1.60-4.63 for RFO>17.4%, respectively) Cox survival analysis. In the echocardiography subgroup, only the 17.4% cut-off remained associated with the outcome after adjustment for different echocardiographic parameters in the multivariate survival analysis. The number of CVE was significantly higher in overhydrated patients in both univariate (HR = 2.46, 95%CI = 1.56-3.87 for RFO >15% and HR = 3.67, 95%CI = 2.29-5.89 for RFO >17.4%) and multivariate (HR = 2.31, 95%CI = 1.42-3.77 for RFO >15% and HR = 4.17, 95%CI = 2.48-7.02 for RFO >17.4%) Cox regression analysis. CONCLUSIONS The study shows that the hydration status is associated with the mortality risk in a HD population, independently of cardiac morphology and function. We also describe and propose a new cut-off for RFO, in order to better define the relationship between overhydration and mortality risk. Further studies are needed to properly validate this new cut-off in other HD populations.
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The use of high frequency ultrasound imaging in skin moisturization measurement.
Mlosek, RK, Malinowska, S, Sikora, M, Dębowska, R, Stępień, A, Czekaj, K, Dąbrowska, A
Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI). 2013;(2):169-75
Abstract
INTRODUCTION The appropriate skin hydration level enables its normal function and healthy appearance. PURPOSE The purpose of present research was to assess the applicability of high frequency ultrasound (HFU) to the monitoring of skin moisturization treatments. MATERIAL AND METHODS The study sample encompassed 27 women, aged 20-67 y.o. (mean age of 45.48 y.o.) with dry skin. All women applied a strong moisturizing cream on their facial skin for 14 days. The course of treatment was monitored using the HFU. The following parameters were subjected to the ultrasound evaluation: epidermal echo thickness, dermis thickness, and separately the thickness of the superior and inferior layer of dermis. The measurements were taken on the participants' chins and cheeks. In addition, skin hydration and transepidermal water loss (TEWL) were determined. RESULTS Statistically significant differences were obtained between the echogenicity of the superior layer of the dermis on the chin and cheek. After treatment, the statistically significant values of TEWL decrease and hydration increase were obtained on the cheek skin. No statistically significant differences between the TEWL or hydration levels were found on the chin. No statistically significant differences between the epidermal echo and dermis thickness values for the two measurement points were observed. CONCLUSION The HFU is a useful method for the monitoring of skin moisturization treatments.
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Influence of probe application pressure on in vitro and in vivo capacitance (Corneometer CM 825(®)) and conductance (Skicon 200 EX(®)) measurements.
Clarys, P, Clijsen, R, Barel, AO
Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI). 2011;(4):445-50
Abstract
BACKGROUND/PURPOSE The measuring probe of the electrical hydration instruments is equipped with a spring system to ensure a constant pressure of probe application on the skin surface. However, it is possible to trigger the measurement at, respectively, a low and a high force of probe application. It is the purpose of this paper to compare the in vitro and in vivo hydration values of the capacitance and conductance method at, respectively, low and high values of application pressure on the considered surface. METHODS In vitro capacitance and conductance hydration measurements were carried out at a low and a high pressure on a calibration filter pad impregnated with different alcohols and in vivo on different skin sites covering a wide range of hydration values. RESULTS The in vitro results were pressure dependent and higher hydration values were noticed when the probes were applied with a high pressure compared with a low pressure. In vivo, the pressure effect was a function of the skin type and it was more pronounced for dry skin (40%), lower for normal skin (20%) and the lowest for hydrated skin (5-8%). CONCLUSION This study confirms the influence of probe pressure application on the skin surface when carrying out capacitance and conductance hydration measurements.
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Deuterium equilibrium time in saliva of newborn infants.
Traver, LA, Martinez, FE, Ferriolli, E, Marchini, JS, Monteiro, JP, Pfrimer, K, Sanchez, AP, de Oliveira, T, Ducatti, C, Camelo, JS
Journal of pediatric gastroenterology and nutrition. 2009;(4):471-4
Abstract
UNLABELLED There is an increasing interest about the use of stable isotopes for body composition analysis in pediatrics. To ensure the success of total body water analysis by the deuterium dilution method, it is fundamental to determine the equilibrium time (plateau) of deuterium in the body fluid studied. OBJECTIVES We report here the equilibration time of deuterium oxide in the saliva of newborns after oral intake of the isotope. METHODS Twenty healthy term newborn infants, 10 males and 10 females, were analyzed. Saliva was collected from each newborn before the oral administration of a 100 mg/kg dose of deuterium oxide (baseline sample) and then at 1-hour intervals for 5 hours after administration. Deuterium enrichment of saliva was determined by isotope ratio mass spectrometry according to the recommendations of the International Atomic Energy Agency. RESULTS The plateau time of deuterium in saliva occurred 3 hours after oral administration of the stable isotope. CONCLUSION These data are essential for further studies on the body composition of newborn infants. To the best of our knowledge, this is the first study regarding the equilibration time of deuterium in the saliva of term newborns.
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Increasing sodium intake from a previous low or high intake affects water, electrolyte and acid-base balance differently.
Heer, M, Frings-Meuthen, P, Titze, J, Boschmann, M, Frisch, S, Baecker, N, Beck, L
The British journal of nutrition. 2009;(9):1286-94
Abstract
Contrasting data are published on the effects of high salt intake (between 300 and 660 mmol/d) on Na balance and fluid retention. In some studies high levels of NaCl intake (400, 440, 550 and 660 mmol/d) led to positive Na balances without fluid retention. To test the relevance of different baseline NaCl intake levels on changes in metabolic water, Na, K, chloride and acid-base balance, a 28 d clinical trial ('Salty Life 6') was carried out in a metabolic ward. Nine healthy male volunteers (aged 25.7 (SD 3.1) years; body mass (BM) 71.4 (SD 4.0) kg) participated in the present study. Four consecutive levels of NaCl intake: low (6 d, 0.7 mmol NaCl/kg BM per d), average normal (6 d, 2.8 mmol NaCl/kg BM per d), high (10 d, 7.7 mmol NaCl/kg BM per d), and low again (6 d, 0.7 mmol NaCl/kg BM per d) were tested. Urine osmolality, extracellular volume (ECV) and plasma volume (PV), cumulative metabolic Na, K, chloride and fluid balances, mRNA expression of two glycosaminoglycan (GAG) polymerisation genes, capillary blood pH, bicarbonate and base excess were measured. During average normal NaCl intake, 193 (SEM 19) mmol Na were retained and ECV (+2.02 (SEM 0.31) litres; P<0.001) and PV (+0.57 (SEM 0.13) litres; P<0.001) increased. During high NaCl intake, 244 (SEM 77) mmol Na were retained but ECV did not increase (ECV -0.54 (SEM 0.30) litres, P=0.+89; PV +0.27 (SEM 0.25) litres, P=0.283). mRNA expression of GAG polymerisation genes increased with rise in NaCl intake, while pH (P<0.01) and bicarbonate (P<0.001) levels decreased. We conclude that a high NaCl intake may increase GAG synthesis; this might play a role in osmotically inactive Na retention in humans.
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Millimeter wave reflectivity used for measurement of skin hydration with different moisturizers.
Alekseev, SI, Szabo, I, Ziskin, MC
Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI). 2008;(4):390-6
Abstract
BACKGROUND/AIMS: A new non-invasive method for determining the free water content in human skin has been developed. The method analyzes the reflection of millimeter (mm) wavelength electromagnetic waves. The amount of reflection of mm waves depends on an electrical property (namely, the permittivity) of the skin, and this depends upon the free water content of the various skin layers. The aim of the present study was to use the mm wave reflectometry method for determination of free water content in healthy skin treated with different hydrating substances. METHODS Skin lotion, pure water, glycerol, and petroleum jelly (an occlusive substance) were used for hydration of skin. The amount of free water was calculated using the permittivity values of skin layers found from fitting a three layer skin model to measured reflection data. The skin model consisted of (1) the stratum corneum (SC), (2) the viable epidermis plus the dermis, and (3) fat layers. RESULTS Mm wave reflection was significantly affected by the water content of the thick SC of the palm but not by the very thin SC of the forearm. Treatment of the forearm and palm skin with different hydrating substances produced notable changes of the free water content in the SC, but not in the viable epidermis or dermis. The greatest hydration was produced by pure water and skin lotion, and the lowest by petroleum jelly. However, petroleum jelly produced prolonged retention of water in the SC following its hydration by other moisturizers. The content of free water was found to return to its baseline value after removal of moisturizers in as short a time as 8.3 min. CONCLUSION The study shows that mm wave reflectometry can be used as a sensitive technique for the non-invasive determination of water content in living skin.
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The oral contraceptive containing 30 microg of ethinylestradiol plus 3 mg of drospirenone is able to antagonize the increase of extracellular water occurring in healthy young women during the luteal phase of the menstrual cycle: an observational study.
Fruzzetti, F, Lello, S, Lazzarini, V, Fratta, S, Orrù, M, Sorge, R, Minerba, L, Ricci, C, Genazzani, AR, Melis, GB, et al
Contraception. 2007;(3):199-203
Abstract
PURPOSE This nonrandomized study aimed to evaluate body weight and composition during the menstrual cycle and during oral contraception with 30 microg of ethinylestradiol plus 3 mg of drospirenone (EE+DRSP). DESIGN Multifrequency bioelectrical impedance analysis was carried out in 38 normally cycling women (mean age, 25.5 years) at baseline during the follicular phase (FP) and the luteal phase (LP) of the menstrual cycle and after three and six cycles of EE+DRSP to evaluate total body water (TBW), intracellular water (ICW), extracellular water (ECW), fat mass and fat-free mass. Body weight, waist-to-hip ratio, blood pressure and the plasma concentrations of electrolytes were also determined at each visit. RESULTS TBW and ECW increased in the LP. During EE+DRSP, TBW and ECW were significantly lower than in the LP but similar to the values measured in the FP. No significant variations in ICW or in the other parameters were observed. CONCLUSION EE+DRSP maintains the same concentrations in TBW and ECW observed in the FP. This effect is likely due to the antimineralocorticoid activity of DRSP, which counteracts the water retention elicited by estrogen.
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Moisturizing effect of cosmetic formulations containing Aloe vera extract in different concentrations assessed by skin bioengineering techniques.
Dal'Belo, SE, Gaspar, LR, Maia Campos, PM
Skin research and technology : official journal of International Society for Bioengineering and the Skin (ISBS) [and] International Society for Digital Imaging of Skin (ISDIS) [and] International Society for Skin Imaging (ISSI). 2006;(4):241-6
Abstract
BACKGROUND/PURPOSE The polysaccharide-rich composition of Aloe vera extracts (Aloe barbadensis Miller), often used in cosmetic formulations, may impart moisturizing properties to the product. The aim of this study was to evaluate the effect of cosmetic formulations containing different concentrations of freeze-dried Aloe vera extract on skin hydration, after a single and a 1- and 2-week period of application, by using skin bioengineering techniques. METHODS Stable formulations containing 5% (w/w) of a trilaureth-4 phosphate-based blend were supplemented with 0.10%, 0.25% or 0.50% (w/w) of freeze-dried Aloe vera extract and applied to the volar forearm of 20 female subjects. Skin conditions in terms of the water content of the stratum corneum and of transepidermal water loss (TEWL) (Corneometer CM 825 and Tewameter TM 210) were analysed before and after a single and 1- and 2-week period of daily application. RESULTS After a single application, only formulations supplemented with 0.25% and 0.50% (w/w) of Aloe vera extract increased the water content of the stratum corneum, while after the 2-week period application, all formulations containing the extract (0.10%, 0.25% and 0.50%) had the same effect, in both cases as compared with the vehicle. TEWL was not modified after a single and after 1- and 2-week period of application, when compared with the vehicle. CONCLUSION Our results show that freeze-dried Aloe vera extract is a natural effective ingredient for improving skin hydration, possibly through a humectant mechanism. Consequently, it may be used in moisturizing cosmetic formulations and also as a complement in the treatment of dry skin.