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Effect of carbohydrate-electrolyte consumption on insulin, cortisol hormones and blood glucose after high-intensity exercise.
Mor, A, Kayacan, Y, Ipekoglu, G, Arslanoglu, E
Archives of physiology and biochemistry. 2019;(4):344-350
Abstract
Objective: This study aimed to examine the effect of CHO-E consumption after high-intensity exercise on insulin, cortisol hormones and blood glucose responses, which is important for performance and recovery in athletes. Methods: Sixteen volunteers, male athletes, participated into this study. Athletes were divided into two groups as experiment (CHO-E) and placebo (PLA). Blood was taken from the athletes three times as basal, post-exercise (PE) and 2 h after ingestion of supplement (PS). Results: When inter-group comparisons, insulin was significantly higher in the CHO-E group than the PLA group at the PS phase (p < .05). Cortisol significantly decreased in the CHO-E group at the PS compared to the PE (p < .05). Conclusions: Carbohydrate-electrolyte consumption after high-intensity exercise, accelerates the recovery process by providing optimal recovery, and enable the metabolism to remain in the anabolic state by preventing it from entering in the catabolic process as well as provides hormonal balance in metabolism.
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Ion shift index as a promising prognostic indicator in adult patients resuscitated from cardiac arrest.
Lee, HY, Jung, YH, Jeung, KW, Lee, BK, Youn, CS, Mamadjonov, N, Kim, JW, Heo, T, Min, YI
Resuscitation. 2019;:116-123
Abstract
BACKGROUND Several studies reported that disturbances in cellular ion homeostasis occur following ischaemia, the magnitude of which was proportional to illness severity. The changes in serum electrolyte levels following ischaemia were minor compared with the changes in ion concentrations in the extracellular fluid. To amplify the serum electrolyte changes, we devised a new index (ion shift index), which could be calculated using commonly measured serum electrolyte levels, and explored its prognostic value in adult cardiac arrest patients. METHODS This retrospective observational study included adult cardiac arrest survivors treated at a tertiary university hospital between January 2014 and December 2017. Using the first available serum electrolyte levels, the ion shift index was calculated as follows: ion shift index = (potassium + phosphate + magnesium) / calcium. The primary outcome was poor outcome at hospital discharge (cerebral performance categories 3-5). RESULTS The area under the receiver operating characteristic curve (AUC) of ion shift index for predicting poor outcome was 0.878 (95% confidence interval [CI], 0.849-0.907). The AUC of ion shift index was greater than those of individual electrolytes (all p < 0.001). In multivariate analysis, higher ion shift index levels were independently associated with poor outcome (odds ratio, 2.916; 95% CI, 1.798-4.730; p < 0.001). The AUC of multivariate model including ion shift index was greater than that of multivariate model after excluding ion shift index (p = 0.007). CONCLUSIONS Our results suggest that the ion shift index can be helpful in the early prognostication of adult cardiac arrest patients.
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Electrolyte minerals intake and cardiovascular health.
Mohammadifard, N, Gotay, C, Humphries, KH, Ignaszewski, A, Esmaillzadeh, A, Sarrafzadegan, N
Critical reviews in food science and nutrition. 2019;(15):2375-2385
Abstract
Appropriate intake of micronutrient, such as electrolyte minerals is critical for the well-being of the cardiovascular health system. However, there are some debates regarding the impacts of dietary and/or supplemental intake of these minerals, on the risk of cardiovascular events and associated risk factors. High sodium intake is adversely associated with the risk of hypertension. Although many reports refered to the positive association of Na intake and cardiovascular events and all-cause mortality, however, other studies indicated that low Na intake is related to higher risk of all-cause mortality and HF-related events. By contrast, dietary potassium, magnesium and calcium have an inverse correlation with cardiovascular events and risk factors, especially with blood pressure. There are some controversies about cardiovascular effects and all-cause mortality of high Ca intake, including no effect, preventive or adverse effect with or without vitamin D. Calcium supplementation might be beneficial for prevention of cardiovascular events and all-cause mortality only in individuals with low intake. Moreover, calcium intake showed a J- or U-shaped association with the risk of cardiovascular diseases. Due to the controversies of the effect of electrolyte minerals especially sodium and calcium intake on cardiovascular events, large scale, well-designed long-term randomized clinical trials are required to evaluate the effect of minerals intake on cardiovascular events and all-cause mortality. In this review, we discuss the role of dietary and or supplemental sodium, potassium, magnesium, calcium, in cardiovascular health, as well as their clinical applications, benefits, and risks for the primary prevention of cardiovascular disease, in general population.
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Challenges in management of diabetic ketoacidosis in hemodialysis patients, case presentation and review of literature.
Seddik, AA, Bashier, A, Alhadari, AK, AlAlawi, F, Alnour, HH, Bin Hussain, AA, Frankel, A, Railey, MJ
Diabetes & metabolic syndrome. 2019;(4):2481-2487
Abstract
Chronic kidney disease is associated with accumulation of uremic toxins that increases insulin resistance which will lead to blunted ability to suppress hepatic gluconeogenesis and reduce peripheral utilization of insulin. CKD patients fail to increase insulin secretion in response to insulin resistance because of acidosis, 1,25 vitamin D deficiency, and secondary hyperparathyroidism. Hemodialysis causes further fluctuations in glycemic control due to alterations in insulin secretion, clearance and resistance. DKA is uncommon in hemodialysis patients because of the absence of glycosuria and osmotic diuresis which accounts for most of the fluid and electrolyte losses seen in DKA, anuric patients may be somewhat protected from dehydration and shock, although still subject to hyperkalemia and metabolic acidosis. However, substantial volume loss can still occur due to a prolonged decrease in oral intake or increased insensible water losses related to tachypnoea and fever. There is no current guidelines for the management of diabetic ketoacidosis in anuric hemodialysis patients considering their differences than general population. In this review article we reviewed the literature and came with specific recommendations for management of Ketoacidosis in patients with CKD treated by hemodialysis.
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Electrolyte beverage consumption alters electrically induced cramping threshold.
Earp, JE, Stearns, RL, Stranieri, A, Agostinucci, J, Lepley, AS, Matson, T, Ward-Ritacco, CL
Muscle & nerve. 2019;(5):598-603
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Abstract
BACKGROUND Recent investigations have questioned the role of hydration and electrolytes in cramp susceptibility and thus the efficacy of consuming electrolyte-rich carbohydrate beverages (EB) to control/prevent cramping. METHODS Nine euhydrated, cramp-prone participants had their cramp susceptibility assessed by measuring the nerve stimulation threshold frequency at which cramping occurs (TF) before and after consumption of an EB (kCal: 120, Na: 840 mg, K: 320 mg, Mg: 5 mg) and placebo beverage (PB: kCal: 5, Na: 35 mg). Cramp intensity was assessed using a verbal pain scale and poststimulation electromyography (EMG). RESULTS TF was greater in EB (14.86 ± 7.47 Hz) than PB (14.00 ± 5.03 Hz; P = .038) and reported pain was lower in EB (2.0 ± 0.6) than PB (2.7 ± 0.8; P = .025) while EMG was similar (P = .646). DISCUSSION EB consumption decreased cramp susceptibility and pain but did not prevent cramping in any participants. These results suggest that electrolyte consumption independent of hydration can influence cramp susceptibility in young people.
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The Effect of Hypo-Hydration on Mood and Cognition Is Influenced by Electrolyte in a Drink and Its Colour: A Randomised Trial.
Cousins, AL, Young, HA, Thomas, AG, Benton, D
Nutrients. 2019;(9)
Abstract
Traditionally, it has been thought necessary to lose 2% of body mass due to dehydration to disrupt functioning, although recently, adverse effects have been reported, with a loss of 0.5%-0.7%. It is, however, unclear whether the response to small reductions in mass reflects dehydration as homeostatic mechanisms are thought to be effective. As psychological responses are most commonly reported, it is strange that the possibility of a placebo response has not been considered. Individuals were therefore subject to a temperature of 30 °C for three hours, and mood and cognition were monitored. To consider changes in hydration status, drinks were compared, differing in their ability to rehydrate due to the presence or absence of electrolytes. The possibility of a placebo response was considered by comparing the response to plain or coloured water. Not drinking was disruptive, although a combination of plain water and electrolyte tended to be the most effective means of preventing a decline in mood, indicating a role for rehydration after a loss of 0.66% body mass. There was, however, also evidence of a placebo response: a combination of plain water and electrolyte tended to be better able to prevent a decline in mood than coloured water and electrolyte.
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Effects of dual plasma molecular adsorption system on liver function, electrolytes, inflammation, and immunity in patients with chronic severe hepatitis.
Chen, G, Wu, M, Wu, B, Liu, F, Liu, J, Liu, L
Journal of clinical laboratory analysis. 2019;(7):e22926
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Abstract
BACKGROUND To investigate the effects of dual plasma molecular adsorption system (DPMAS) on the liver function, electrolytes, inflammation, and immunity in patients with chronic severe hepatitis (CSH). METHODS Total of 162 patients with CSH treated in our hospital from March 2016 to December 2018 were enrolled and equally randomly divided into control group (n = 81) and observation group (n = 81). The patients in control group were treated with plasma exchange, while those in observation group were additionally treated with DPMAS based on the treatment in control group. The liver function, electrolytes, inflammation, and immunity were evaluated and compared between the two groups. RESULTS After treatment, the liver function indexes in observation group were significantly favorable compared with those in control group, with the reduction in TBIL, DBIL, ALT, and rise of CHE levels (P < 0.05). The levels of K+ , Na+ , Cl- , and Ca2+ in both groups were significantly improved after treatment (P < 0.05), although there were no significant differences between the two groups (P > 0.05). The levels of C-reactive protein (CRP), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) in both groups declined after treatment compared with those before treatment, and those levels in observation group were higher than that in control group (P < 0.05). After treatment, the levels of cluster of differentiation 3+ (CD3+ ), CD4+ , and CD4+ /CD8+ were higher in observation group than those in control group, with decreasing level of CD8+ (P < 0.05). CONCLUSION Dual plasma molecular adsorption system can effectively improve the liver function, effectively correct the electrolyte disorders, reduce the inflammatory response, and adjust the immunity in patients with CSH.
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Multicentre endoscopist-blinded randomised clinical trial to compare two bowel preparations after a colonoscopy with inadequate cleansing: a study protocol.
Sey, MSL, von Renteln, D, Sultanian, R, McDonald, C, Martel, M, Barkun, A
BMJ open. 2019;(7):e029573
Abstract
INTRODUCTION Inadequate bowel preparation is common and negatively impacts colonoscopy quality. The objective of this study is to compare two bowel preparation regimens in cleansing the colon after an index colonoscopy with failed bowel preparation. METHODS AND ANALYSIS This is a phase III, multicentre, randomised clinical trial comparing two bowel preparation regimens after failure to adequately cleanse at the index colonoscopy. Regimen A consists of 4 L split-dose polyethylene glycol electrolyte solution (PEG-ELS) and Regimen B consists of 6 L split-dose PEG-ELS, both preceded by 15 mg of bisacodyl the day before the procedure along with a low-fibre diet 3 and 2 days before the procedure followed by a clear fluid diet starting the day before the procedure. The primary outcome is adequate bowel preparation, defined as a Boston Bowel Preparation Scale (BBPS) score of ≥6 with each segment score ≥2. Secondary outcomes include mean BBPS score, bowel preparation adequacy using the US Multi-Society Task Force on Colorectal Cancer definition, detection rate by polyp subtype, caecal intubation rate, mean Validated Patient Tolerability Questionnaire for Bowel Preparation score, subject willingness to repeat the preparation and faecal incontinence rate. ETHICS AND DISSEMINATION The study will be conducted in accordance with Good Clinical Practice guidelines and local institutional standards. Study findings will be disseminated at an international gastroenterology conference and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER NCT02976805; Pre-results.
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Ingesting a 12% Carbohydrate-Electrolyte Beverage Before Each Half of a Soccer Match Simulation Facilitates Retention of Passing Performance and Improves High-Intensity Running Capacity in Academy Players.
Rodriguez-Giustiniani, P, Rollo, I, Witard, OC, Galloway, SDR
International journal of sport nutrition and exercise metabolism. 2019;(4):397–405
Abstract
This study investigated the influence of ingesting a 12% carbohydrate plus electrolyte (CHO-E) solution providing 60 g of carbohydrate before each half of a 90-min soccer match simulation (SMS) protocol on skill performance, sprint speed, and high-intensity running capacity. Eighteen elite academy (age: 18 ± 2 years) soccer players ingested two 250-ml doses (pre-exercise and at halftime) of a 12% CHO-E solution or electrolyte placebo administered in a double-blind randomized cross-over design. During an indoor (artificial grass pitch) SMS, dribbling, passing, and sprint performance were assessed, and blood was drawn for glucose and lactate analysis. High-intensity running capacity was assessed following the SMS. Dribbling speed/accuracy and sprint speed remained unchanged throughout the SMS. Conversely, passing accuracy for both dominant (mean percentage difference [95% confidence interval, CI]: 9 [3, 15]) and nondominant (mean percentage difference [95% CI]: 13 [6, 20]) feet was better maintained during the SMS on CHO-E (p < .05), with passing speed better maintained in the nondominant foot (mean percentage difference [95% CI]: 5.3 [0.7, 9.9], p = .032). High-intensity running capacity was greater in CHO-E versus placebo (mean percentage difference [95% CI]: 13 [6, 20], p = .010). Capillary blood glucose concentration was higher in CHO-E than placebo at halftime (CHO-E: 5.8 ± 0.5 mM vs. placebo: 4.1 ± 0.4 mM, p = .001) and following the high-intensity running capacity test (CHO-E: 4.9 ± 0.4 mM vs. placebo: 4.3 ± 0.4 mM, p = .001). Ingesting a 12% CHO-E solution before each half of a match can aid in the maintenance of soccer-specific skill performance, particularly on the nondominant foot, and improves subsequent high-intensity running capacity.
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Proteinuria-associated renal magnesium wasting leads to hypomagnesemia: a common electrolyte abnormality in chronic kidney disease.
Oka, T, Hamano, T, Sakaguchi, Y, Yamaguchi, S, Kubota, K, Senda, M, Yonemoto, S, Shimada, K, Matsumoto, A, Hashimoto, N, et al
Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association. 2019;(7):1154-1162
Abstract
BACKGROUND Hypomagnesemia (Hypo-Mg) predicts mortality and chronic kidney disease (CKD) progression. However, in CKD, its prevalence, kidney-intrinsic risk factors, and the effectiveness of oral magnesium (Mg) therapy on serum Mg levels is uncertain. METHODS In a cross-sectional study enrolling pre-dialysis outpatients with CKD, the prevalence of electrolyte abnormalities (Mg, sodium, potassium, calcium and phosphorus) was compared. In an open-label randomized controlled trial (RCT), we randomly assigned CKD patients to either the magnesium oxide (MgO) or control arm. The outcome was serum Mg levels at 1 year. RESULTS In 5126 patients, Hypo-Mg was the most common electrolyte abnormality (14.7%) with similar prevalence across stages of CKD. Positive proteinuria was a risk factor of Hypo-Mg (odds ratio 2.2; 95% confidence interval 1.2-4.0). However, stratifying the analyses by diabetes mellitus (DM), it was not significant in DM (Pinteraction = 0.04). We enrolled 114 patients in the RCT. Baseline analyses showed that higher proteinuria was associated with higher fractional excretion of Mg. This relationship between proteinuria and renal Mg wasting was mediated by urinary tubular markers in mediation analyses. In the MgO arm, higher proteinuria or tubular markers predicted a significantly lower 1-year increase in serum Mg. In patients with a urinary protein-to-creatinine ratio (uPCR) <0.3 g/gCre, serum Mg at 1 year was 2.4 and 2.0 mg/dL in the MgO and control arms, respectively (P < 0.001), with no significant between-group difference in patients whose uPCR was ≥0.3 g/gCre (Pinteraction=0.001). CONCLUSIONS Proteinuria leads to renal Mg wasting through tubular injuries, which explains the high prevalence of Hypo-Mg in CKD.