Abstract
Glucoregulatory diseases, such as type 2 diabetes are currently a key public health priority. Public health messages have started to include the addition of water in their dietary guidelines. Such guidelines however are not based on causal evidence pertaining to the health effects of increased water intake, but rather more heavily based upon non-causal or mechanistic data. One line of thinking linking fluid intake and health is that hypohydration induces elevated blood concentrations of arginine vasopressin (AVP). Research in the 1970s and 1980s implicated AVP in glucoregulation, supported by observational evidence. This important area of research subsequently appeared to stop until the 21st century during which interest in hypertonic saline infusion studies, animal AVP receptor knockout models, dietary and genetic associations, and human interventions manipulating hydration status have resurged. This narrative review briefly describes and critically evaluates the usefulness of the current AVP-glucoregulatory research. We offer suggestions on how to test the independent glucoregulatory effects of body water changes compared to elevated circulating AVP concentrations, such as investigating hydration manipulations using 3,4-Methylenedioxymethamphetamine. Whilst much research is still needed before making firm conclusions, the current evidence suggests that although AVP may be partially implicated in glucoregulation, more ecologically valid models using human participants suggests this effect might be independent of the hydration status. The key implication of this hypothesis if confirmed in future research is that manipulating the hydration status to reduce circulating AVP concentrations may not be an effective method to improve glucoregulatory health.
Highlights
Research in hydration focused on large deviations in hydration status
We propose two potential pathways that could help uncouple the independent effects of alterations in body water and circulating arginine vasopressin (AVP) concentrations: (i) Investigating 3,4-Methylenedioxymethamphetamine (MDMA), and (ii) investigating those with water balance conditions, namely the syndrome of inappropriate antidiuretic hormone secretion (SIADH) and diabetes insipidus
With regards to the first point (a), if we were able to find a simple measure of hydration that accurately describes those under the influence of MDMA as hyperhydrated, despite the overwhelming symptoms of hypohydration, we may more effectively be able to assess hydration status
Summary
Research in hydration focused on large deviations in hydration status. the ill-effects of severe hypohydration in soldiers under extreme conditions were investigated, resulting in guidelines for optimal sports performance [1]. One key mechanism linking hydration status to glucoregulatory health is arginine vasopressin (AVP) which is a hormone implicated in body water regulation This hormone is typically known for its impacts on blood pressure regulation, whereby hypohydration (as detected by a 1–2% increase in serum osmolality) is met by an increase in circulating AVP [3]. The result of this is V2 receptor binding in the collecting ducts of the kidney, signalling an increase in aquaporin expression and redistribution to the luminal membrane [4]. The aim of this narrative review is to briefly discuss early and current human research in hydration, AVP, and glucoregulatory health and provide a critical perspective as to how to advance the field, focusing on uncoupling the effects of hydration status and AVP
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Disclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.