Abstract
Obesity and impaired glucose homeostasis in older adults place these individuals at risk for diabetes. Dehydration, glucose homeostasis, and insulin resistance are related; while aging and dehydration are associated with decreased glucose tolerance, weight loss can improve glycemia. For older adults following hypocaloric diets, additional water consumption may lead to greater weight loss. Further more, research suggests an association between insulin resistance and the body water retention hormone, arginine vasopressin (AVP). Analysis of the association between plasma copeptin (an AVP derivative) and fasting glucose, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) may provide further insight into the relationship between dehydration and diabetes risk. Our objective was to investigate the possibility that increased water consumption among older adults (n = 29, BMI = 31 ± 1 kg/m2, age = 62 ± 1 years) could improve glucose homeostasis beyond that observed with weight loss, as well as associations between plasma copeptin and diabetes risk. This retrospective analysis utilized data from a previous investigation, in which obese/overweight older adults were assigned to one of two groups: 1) Water: consume 500 ml of water prior to three daily meals over a 12-week hypocaloric diet intervention, or 2) Non-water: hypocaloric diet alone. In the present analysis, fasting plasma glucose and insulin, HOMA-IR, and plasma copeptin were evaluated, and compared to urinary specific gravity (USG), drinking water consumption, and body weight. Analyses performed using group assignment, volume of drinking water consumed or among a subgroup pair-matched for weight loss and sex did not reveal significant differences between groups. However in the full sample, plasma insulin concentration was associated with USG (r = 0.512, P
Highlights
The prevalence of diabetes for Americans aged 65+ years is about 30%, and 50% of those in this age group are considered prediabetic [1,2]
No group differences were noted in pre-to-post changes in BMI, body weight, USG, fasting glucose or insulin concentration, HOMA-IR score, or plasma copeptin concentration (Table 1)
Body weight correlated with drinking water consumed (r = −0.512, P < 0.01); plasma copeptin correlated with USG (r = 0.424) and total grams of beverages consumed (r = −0.403) (P < 0.05); fasting insulin correlated with grams of drinking water consumed (r = −0.378, P < 0.05); and HOMA-IR score correlated with USG (r = 0.394, P < 0.05) and drinking water consumed (r = −0.373, P < 0.05)
Summary
The prevalence of diabetes for Americans aged 65+ years is about 30%, and 50% of those in this age group are considered prediabetic [1,2]. Diabetes and prediabetes are major risk factors for cardiovascular and kidney diseases, intervention strategies aimed at reducing diabetes risk factors in this population are critically needed. Weight loss and increasing water consumption are lifestyle strategies which improve fasting glucose concentration and insulin resistance [3,4,5,6,7]. Adequate fluid intake and hydration status become especially important as decreased renal function leads to impairments in renalconcentrating and sodium-conserving ability, conditions associated with volume depletion and hypernatremia [8]. Clark et al / Open Journal of Preventive Medicine 3 (2013) 363-367
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