High water intake and low urine osmolality are associated with favorable metabolic profile at a population level: low vasopressin secretion as a possible explanation

Louise Brunkwall,Sofia Enhörning,Ulrika Ericson,Peter M Nilsson

doi:10.1007/s00394-020-02202-7

Louise Brunkwall, Sofia Enhörning + Show 2 more

Open Access

https://doi.org/10.1007/s00394-020-02202-7

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Abstract

PurposeElevated plasma concentration of the vasopressin marker copeptin and low water intake are associated with elevated blood glucose and diabetes risk at a population level. Moreover, in individuals with low urine volume and high urine osmolality (u-Osm), water supplementation reduced fasting plasma (fp) copeptin and fp-glucose. In this observational study, we investigated if low total water intake or high u-Osm correlated with high fp-copeptin and components of the metabolic syndrome at the population level.MethodsIn the population-based Malmö Offspring Study (MOS, n = 2599), fp-copeptin and u-Osm from morning urine samples were measured, and diet and total water intake (from beverages and food moisture) was assessed by a 4-day web-based record.ResultsIncreasing water intake by tertile was after adjustment for age and sex associated with low fp-triglycerides (p = 0.002) and high fp-HDL (p = 0.004), whereas there was no association with the other investigated metabolic traits (HbA1c, fp-glucose, BMI or waist circumference). Increasing u-Osm by tertile was, after adjustment for age and sex, associated with high fp-glucose (p = 0.007), and borderline significantly associated with high HbA1c (p = 0.053), but no association was observed with fp-HDL, fp-triglycerides, BMI or waist circumference. Fp-copeptin concentration correlated significantly with water intake (r = − 0.13, p < 0.001) and u-Osm (r = 0.27, p < 0.001). High copeptin was associated with all investigated metabolic traits (p < 0.001 for all).ConclusionLow concentrations of the vasopressin marker copeptin is linked to high water intake, low u-Osm, and a favorable metabolic profile, suggesting that vasopressin lowering lifestyle interventions, such as increased water intake, may promote metabolic health.

Highlights

Vasopressin (VP), called antidiuretic hormone, is released from the posterior pituitary gland mainly in conditions of increased plasma osmolality
We recently studied the effect of increased water intake on copeptin concentration and glucose metabolism, and found that individuals with high copeptin concentrations, high urine osmolality (u-Osm), and low urine volume expressed significantly decreased glucagon and copeptin concentrations after 1 week of increased drinking water intake (3 L/day) compared to control week [20]
U-Osm and copeptin were markedly lower in women than in men (Table 2b, c), and total water intake was slightly lower in women than in men (Table 2a)

Summary

Introduction

Vasopressin (VP), called antidiuretic hormone, is released from the posterior pituitary gland mainly in conditions of increased plasma osmolality. A reliable marker of VP secretion, has previously been associated with multiple components of the metabolic syndrome [2,3,4] and with increased. Previous experimental studies [8, 9] and a Mendelian randomization study [10] points at a causal association between elevated copeptin concentration and increased metabolic risk. It can be speculated that this relationship may be explained by effects mediated by VP receptors expressed in the liver, the pancreas and in the anterior pituitary gland, which potentially could affect glucose metabolism in many different ways by inducing gluconeogenesis, glycogenolysis, glucagon secretion, and increased cortisol release [11,12,13,14,15,16,17]

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