Body Water Research Articles

Reliability, biological variability, and accuracy of multi-frequency bioelectrical impedance analysis for measuring body composition components

IntroductionBioelectrical impedance analysis (BIA) systems are gaining popularity for use in research and fitness assessments as the technology improves and becomes more affordable and easier to use. Multifrequency BIA (MF-BIA) may improve accuracy and precision using octopolar contacts for segmental analyses.PurposeEvaluate reliability, biological variability, and accuracy of component measures (total body water, mass, and composition) of commercially available MF-BIA system (InBody 770, Cerritos, California, USA).MethodsFourteen healthy military-age adults were assessed by MF-BIA in duplicate on five laboratory visits across 3 weeks (10 measures each). Participants were evaluated at the same time of day after refraining from strenuous exercise (> 48 h), alcohol consumption (> 24 h), and caffeine, nicotine, and food (> 10 h). Systematic error (test–retest reliability) and biological variability (day-to-day reliability) were summarized by intraclass correlation coefficient (ICC) values determined for body mass (fat, fat-free, total) and body water (extracellular, intracellular, total). Body composition measurements derived from BIA on the second visit were also tested for accuracy compared to dual-energy x-ray absorptiometry (DXA).ResultsTest–retest reliability was very high for all measurements of whole-body water and mass (ICC ≥ 0.999) and high for regional body water and mass (ICC 0.973–1.000). Biological variability was observable with very minor differences between tests (same day) for total and regional body water (0.0–0.2 L) and total and regional body mass measurements (0.0–0.2 kg); while between day differences were slightly higher (0.0–0.5 L and 0.1–0.7 kg). Compared to DXA, the MF-BIA whole-body measures showed an offset in %BF (Bias −4.0 ± 2.8%; Standard error of the estimate (SEE), 2.6%), an overprediction for total body fat-free mass (Bias 2.8 ± 2.1 kg; SEE 2.2 kg) and an underprediction of total body fat mass (Bias −2.9 ± 2.0 kg; SEE 1.9 kg).ConclusionUnder controlled conditions with fit and healthy men and women, this MF-BIA system has high methodological reliability and demonstrates stable day-to-day measurements of major body composition components. Previously reported ~3% body fat offset compared to criterion methods was again confirmed. Precision of the InBody 770 shows consistency and supports further testing of this specific device as a new military standards method and suitability across a wider range of %BF.

Intra-abdominal pressure, renal resistive index, sublingual microcirculation and total body water for guidance of volume resuscitation to avoid acute kidney injury during shock therapy

Background/objectivesShock and accompanying acute kidney injury (AKI) as a frequent complication is a well-known cause of morbidity and mortality worldwide. The current standard parameters to guide fluid resuscitation therapy (i.e., cardiac output, heart rate, blood pressure, central venous pressure) to avoid AKI and renal replacement therapy remain imprecise, and fluid overload with consequent organ oedema and high intestinal pressures result in further complications. The VoluKid study investigated additional non-invasive fluid volume parameters including assessment of total body water (TBW), renal vascular resistance [renal resistive index (RRI)], intra-abdominal pressure (IAP) and microcirculatory blood flow (MBF) to predict AKI during the first 72 h of intensive care therapy.Methods, design and analysisThis mono-centre observational cohort study included patients with shock who presented to the intensive care unit (ICU). Routine volume resuscitation parameters (i.e., cardiac output, heart rate, blood pressure, central venous pressure) were used to guide fluid therapy. In addition, four parameters, including MBF using sublingual incident dark-field microscopy, IAP, RRI assessed by duplex-sonography, and TBW using bioimpedance analysis (BIA), were measured daily and evaluated for predicting the primary outcome of acute kidney injury (AKI) and need for renal replacement therapy within the first 72 h of admission. Baseline and post-ICU admission values of these parameters were compared between patients with and without AKI.ResultsA total of 45 patients were enrolled in this study. Of those 45 patients, 37 could be followed for the entire study period of 72 h and 14 patients developed AKI (31.1%). Twelve patients (26.7%) had pre-existing renal impairment, one of whom died during the observation period. Nineteen patients (42.2%) had no renal impairment. RRI and IAP did not differ between patients with AKI and without AKI and did not predict AKI. TBW measured by BIA predicted AKI (p = 0.029). After adjustment for covariates (age, body mass index,and gender) this prediction was not significant [adjusted odds rato (OR) 0.99, p = 0.258, 95% confidence interval (CI) [0.97,1.01]]. MBF could not be estimated due a high number of missing values.ConclusionsBased on our limited data, none of the non-invasive parameters (TBA, IAP, RRI,) serve as predictors for AKI when assessed during the first 72 h after ICU admission, either when analysed separately or in combination.RegistrationClinicalTrials.gov Identifier: NCT02666404, registered 28/01/2016; URL: https://classic.clinicaltrials.gov/ct2/show/NCT02666404.

Short-term impact of kampo goreisan in patients with congestive heart failure refractory to tolvaptan-incorporated medical therapy.

We often encounter patients with congestive heart failure refractory to conventional diuretics therapy. Kampo goreisan (Tsumura &Co. Tokyo, Japan) is receiving great concern in mediating body water balance, particularly for such a cohort. However, its detailed biological mechanism remains uncertain. Patients who received goreisan to treat congestive heart failure refractory to tolvaptan-incorporated medical therapy were prospectively included and observed for one week during the therapeutic period. The change in urine biomarkers during the first 24h was assessed as a primary concern. Baseline factors associated with an increase in urine volume during the first 24h were investigated as a secondary concern. A total of 18 patients were included. Median age was 81 (77, 86) and 12 (67%) were men. During the first 24h after the initiation of goreisan, urine cyclic AMP tended to decrease, urine aquaporin-2 decreased significantly, urine osmolality decreased significantly, and urine volume tended to increase. Baseline higher common logarithm of plasma B-type natriuretic peptide was associated with any increases in urine volume during the first 24h with an odds ratio of 73.2 (95% confidence interval 1.04-5149, p = 0.048). Baseline plasma B-type natriuretic peptide level had a positive correlation with a change in urine volume between baseline and day 1 (r = 0.533, p = 0.026). Goreisan may increase urine volume even in patients with congestive heart failure refractory to tolvaptan-incorporated medical therapy by modulating aquaporin-2 systems in the collecting duct, particularly in individuals with advanced heart failure accompanying significant congestion. Goreisan may have a regulatory effect on body fluid, rather than just forcing aquaresis.

Exploring Biomarkers for Excess Extracellular Fluid in the Context of Physical Function in Chronic Kidney Disease Patients

Background/Objectives: Fluid overload is an important risk factor for protein-energy wasting, which could lead to poor outcomes, such as higher morbidity and mortality, in patients with chronic kidney disease (CKD). This study aimed to validate the possible myokine as a biomarker of volume status in patients with non-dialysis CKD. Methods: In total, 151 patients with CKD were enrolled from a single medical center. Demographic data were collected via medical record review. Bioimpedance analysis was performed to measure body composition, and physical performance was assessed by measuring hand grip strength. Results: The physical performance of hand grip strength (21.9 ± 8.7 vs. 19.0 ± 10.1 kg, p = 0.233) and walking speed (1.05 ± 0.29 vs. 0.86 ± 0.52 m/s, p = 0.192) was higher in the low extracellular water/total body water (ECW/TBW) ratio group. Although higher, the median value of the brain-derived neurotrophic factor (BDNF) was not significant in the low ECW/TBW ratio group. Despite that, it had significant negative correlations with the ECW/TBW ratio in Pearson’s correlation analyses (r = −0.329, p < 0.001; r = −0.287, p < 0.001; and r = −0.238, p = 0.003). Linear regression analysis showed that the BDNF level had a significant negative relationship with the ECW/TBW ratio and significant associations even after multivariate analysis. Conclusions: Among myokines, BDNF had a significant negative relationship with the ECW/TBW ratio, suggesting that BDNF could be a possible biomarker for volume status in patients with non-dialysis CKD.

Phase angle as a predictor of mortality in elderly patients with multimorbidity: a matched case-control study.

We aimed to investigate the value of phase angle (PhA) as a prognostic marker for mortality in elderly patients with multimorbidity using a matched case-control study. This study was conducted with patients 70 years of age or older with multimorbidity at Beijing Geriatric Hospital. The body composition parameters including PhA were determined using bioelectrical impedance analysis. Common hematological indices were determined using blood tests. The outcome was mortality 1 year after admission. A multivariate logistic regression analysis was employed to identify independent risk factors for death. A receiver-operating characteristic (ROC) curve analysis was used to evaluate the performance of risk factors in predicting death. A total of 30 deceased patients were included in the death group. The living patients were matched 1:1 with the deceased patients in age, gender, and Cumulative Illness Rating Scale-Geriatric score to generate a survival group of 30. The death group exhibited higher levels of blood urea nitrogen and extracellular water to total body water ratio and lower levels of PhA and prealbumin than the survival group. The multivariate logistic regression analysis identified PhA as the only independent risk factor for mortality (OR = 3.296, 95% CI [1.201-9.044], P < 0.05). For the ROC curve analysis, PhA had an area of 0.854 (95% CI [0.755-0.955], P = 000). The Youden index was 0.700, and the optimal cutoff value associated with the Youden index was 2.45°. PhA serves as a good prognostic marker for mortality in elderly patients with multimorbidity.

Design and Development of Portable Body Composition Analyzer for Children

Objectives: The aim of this study was (i) to design and develop a portable BCA device for measuring body composition parameters such as body weight, body fat (BF) %, total body water (TBW), fat-free mass (FFM), muscle mass (MM), and bone mass (BM); (ii) to validate the developed portable BCA with the Tanita MC 980 MA BCA device. Methods: For this current study, two hundred healthy and obese subjects, whose ages ranged from 8 to 12 years (8.4 ± 1.7), were considered. Results: The highest percentage difference between the two study groups was found to be in BFat (50.39%), followed by body mass index (BMI) (41.73 kg), FFM (38.32 kg), and MM (37.89 kg), and this was found to be statistically significant. The results obtained from the designed prototype of the body composition analyzer were validated using Tanita MC 980MA BCA. The overall error% was calculated as ±3% for measuring the different body composition parameters. Conclusions: Due to its low standard error and high overall accuracy, the BCA prototype demonstrates the potential to be a dependable instrument for evaluating and tracking the body composition of children.

Disruption of mitochondrial electron transport impairs urinary concentration via AMPK-dependent suppression of aquaporin 2.

Urinary concentration is an energy-dependent process that minimizes body water loss by increasing aquaporin 2 (AQP2) expression in collecting duct (CD) principal cells. To investigate the role of mitochondrial (mt) ATP production in renal water clearance, we disrupted mt electron transport in CD cells by targeting ubiquinone (Q) binding protein QPC (UQCRQ), a subunit of mt complex III essential for oxidative phosphorylation. QPC-deficient mice produced less concentrated urine than controls, both at baseline and after type 2 vasopressin receptor stimulation with desmopressin. Impaired urinary concentration in QPC-deficient mice was associated with reduced total AQP2 protein levels in CD tubules, while AQP2 phosphorylation and membrane trafficking remained unaffected. In cultured inner medullary CD cells treated with mt complex III inhibitor antimycin A, the reduction in AQP2 abundance was associated with activation of 5' adenosine monophosphate-activated protein kinase (AMPK) and was reversed by treatment with AMPK inhibitor SBI-0206965. In summary, our studies demonstrated that the physiological regulation of AQP2 abundance in principal CD cells was dependent on mt electron transport. Furthermore, our data suggested that oxidative phosphorylation in CD cells was dispensable for maintaining water homeostasis under baseline conditions, but necessary for maximal stimulation of AQP2 expression and urinary concentration.

Exploring the association of dietary inflammatory index, disease progression and cellular integrity in chronic kidney disease: A cross-sectional study.

While the anti-inflammatory effects of specific nutrients are well established, there is limited research on the relationship between overall dietary patterns and chronic kidney disease (CKD). Therefore, we aimed to assess the association between dietary inflammatory index (DII) scores and biochemical and body composition parameters in pre-dialysis CKD patients. The DII scores of 143 pre-dialysis CKD subjects were calculated using 24-h recalls. Body composition was measured using bioelectric impedance-based InBody 770. Oxidative stress and total antioxidant capacity were measured using thiobarbituric acid reactive substances (TBARS), ferric-reducing antioxidant power (FRAP), and uric acid-independent FRAP (FRAP_UA) assays respectively. C-reactive protein (CRP) was selected as an inflammatory marker while other biochemical parameters were analysed using diagnostic kits. Subjects were categorized into early-stage CKD (ES; eGFR: 30 to 59 ml/min/1.73 m2) and late-stage CKD (LS; eGFR: < 30 ml/min/1.73 m2). The ES group had a lower extracellular to total body water ratio (p < 0.01) and higher levels of whole-body phase angle (p < 0.01) compared to the LS group. However, FRAP_UA was higher in the LS group (p < 0.05). For each increase in DII score by 1, eGFR decreased by 2.31 ml/min/1.73 m2 (p < 0.01) and phase angle by 0.11 degrees (p < 0.05). Consuming cereals and millets, other vegetables, roots and tubers, spices, poultry, oils and fats significantly contributed to the anti-inflammatory potential of the diet (p < 0.01). A pro-inflammatory diet was associated with disease progression and decreased cell integrity, underscoring the importance of its consideration in CKD management.

Effect of a Hydration Game-Based Learning Program in Improving Fluid Intake and Hydration Status in Institutional Residents.

Approximately 50% of residents living in institutions have insufficient fluid intake, and 20%-30% experience dehydration. Implementing strategies that effectively increase fluid intake is crucial to preventing dehydration-related complications and reducing complications and comorbidities in this population. This study was designed to explore the effects on fluid intake and hydration status of a hydration game-based learning program in institutional residents. A single-blind, cluster, randomized controlled trial was conducted. Sixty-four subjects from five long-term care facilities in northern Taiwan were randomly assigned to either an experimental or control group. The experimental group received a 40-minute game-based hydration care program intervention twice weekly for 8 weeks. The control group received routine care. The data obtained were analyzed using generalized estimating equation analysis to verify changes in observed variables in the two groups at 4 and 8 weeks (during and immediately after the intervention). The results showed a significant improvement in fluid intake in the experimental group at 4 and 8 weeks (p = .002 and p < .001, respectively). In terms of dehydration-related indicators, although total body water was significantly improved at 8 weeks in the experimental group (p = .009), no significant improvement was found in urine-specific gravity. In terms of signs of possible urinary tract infection, the experimental group showed significant improvement in urine leukocytes (p = .029) and nitrites (p = .004) at 8 weeks. The findings of this study support the positive effects of applying the concept of uncertain rewards and game-based learning in institutional group activities. Specifically, the interventions increased social interaction and enhanced enjoyment of drinking. The findings call for nursing professionals at institutions to offer similar hydration game-based learning programs as part of residents' daily activities to improve fluid intake.

Phase Angle (PhA) Is an Easy and Complementary Tool for Assessing Nutritional Status in Ulcerative Colitis (UC) Patients: A Cross-Sectional Study.

Accumulating evidence has proposed phase angle (PhA) as a marker for assessing cellular integrity and nutritional status in ulcerative colitis (UC) patients; the aim of the study was to evaluate the efficacy of PhA in assessing nutritional status in patients with UC, investigating its potential as a biomarker of disease activity. We conducted a cross-sectional study in patients with UC and healthy controls. We determined PhA by electrical bioimpedance and categorized participants through bioelectrical impedance analysis. They were classified as normal PhA > 6.1° and low PhA < 6.1° in men and normal PhA > 5.6° and low PhA < 5.6° in women. PhA was significantly lower in UC patients than in controls (5.8 ± 0.8 vs. 6.6 ± 0.7°; p < 0.001). Among UC patients, participants with low PhA showed a decrease in lean, dry mass (LDM) (p < 0.001), total body water (p = 0.008), and intracellular water (p = 0.005), accompanied by an increase in extracellular water (p = 0.001) compared to UC patients with normal PhA. PhA significantly decreases in UC patients compared to healthy controls and is even more reduced when UC is active. A cut-off point of <6.1 for men and <5.6 for women could be suitable for nutritional diagnosis in patients with UC, but it still needs to be validated.

Influence of Bladder Filling on Parameters of Body Composition by Bioimpedance Electrical Analysis: Observational Study.

Bioelectrical impedance analysis (BIA) is a widely used method for estimating body composition, and its accuracy may be influenced by various factors, including bladder filling. This study aims to investigate the impact of bladder filling on the accuracy of BIA measurements. An experimental crossover study was conducted with sedentary young adults. The influence of bladder filling on total body water (TBW), fat mass (FM), fat-free mass (FFM), and basal metabolic rate (BMR) was assessed. Participant in underwear followed an overnight fast. They were instructed to abstain from vigorous physical activity and alcohol for at least 24 h prior to the session. The results obtained from single-frequency and multi-frequency BIA devices were compared. The findings suggest that bladder filling does not affect measured impedance; however, changes in weight following bladder voiding influenced derived BIA results. Specifically, TBW, FM, and BMR values significantly reduced after voiding (p < 0.05). Furthermore, the study found poor agreement between single-frequency and multi-frequency BIA devices, indicating that they are not interchangeable. Bladder filling does affect BIA measurements, not clinically meaningful. Further research is needed to explore the implications of these findings for clinical practice and research protocols.

The mRNA N6-Methyladenosine Response to Dehydration in Xenopus laevis.

The African clawed frog, Xenopus laevis, exhibits remarkable adaptations to survive in its arid habitat, including behavioral and metabolic changes during periods of drought. During extreme dehydration, X. laevis undergoes estivation, a state characterized by increased urea and ammonia levels, depression of the metabolic rate, and tissue hypoxia. To understand the molecular mechanisms underlying these adaptations, we investigated the potential role of N6-methyladenosine (m6A), a widespread mRNA modification, in X. laevis during extreme dehydration. We analyzed the protein levels of key components in the m6A pathway, including writers (METTL3, METTL14, and WTAP), erasers (ALKBH5 and FTO), and readers (SRSF3, YTHDF1, YTHDF2, YTHDF3, and eIF3a), in the liver and kidneys of control frogs and frogs that had lost 35 ± 0.93% of their total body water. The relative protein levels generally decreased or remained unchanged, with the exception of YTHDF3, which depicted a protein level increase in the liver. Notable changes included eIF3a, which was downregulated by 26 ± 8% and 80 ± 8% in the dehydrated liver and kidney tissues, respectively. Additionally, the total m6A increased by 353 ± 30% and 177 ± 17% in dehydrated liver and kidney RNA samples, respectively. This study highlights the importance of epigenetic mechanisms in stress tolerance and provides a foundation for further exploration of the role of epigenetics in dehydration tolerance.

Evaluation of ethanolic extract of Piper methysticum leaves on anxiolytic activity of mice

The ethanol extract of Piper methysticum, commonly known as kava, has shown promising results in reducing anxiety. Studies suggest it may have anxiolytic effects, potentially offering a natural alternative to conventional anxiety treatments. The ethanolic extract of Piper methysticum can increase the duration of action. It can also increase the time spent in open arm, entry in open arm (in elevated plus model) as well as increase the time spent in light field (in Light Dark field) thus we can conclude that it can also possesses Anxiolytic action. The ethanolic extract of Piper methysticum possesses an anxiolytic like activity without sedative side effect. The corticosterone level in mice is increased when they got anxiety. So when the plasma corticosterone level of mice is checked in control group its turn out to be 10.28±0.52. It gets decreased with increase in doses. When treated with low dose of Aqueous extract is 7.28±1.44 is less effective than low dose of Ethanolic extract that is 6.22±1.28. Same as that high dose of extract shows the corticosterone level was 6.24±2.28 which was also less effective than high dose of ethanolic extract which was 5.52±0.32. Most effectively stress was decreased when treated with the Standard drug (Alprazolam) which shows plasma corticosterone level was 1.24±0.36. The mice of Piper methysticum extract (300 &amp;600 mg/kg/ p.o.) treated group showed significantly (p&lt;0.05) increased in body water intake as compared to the control group. Results showed that synthesized extract is very effective for the treatment of anxiety. Keywords: Piper methysticum; anxiolytic activity; Anthraquinones; Light Dark model

Abstract 4116486: Association of assessment of clinical congestion in patients with heart failure compared with assessment using bioimpedance and microwave spectroscopy

Background: Physicians have to find a balance between decongestion therapy and the risk of dehydration so non-invasive methods assessing congestion are of great importance. Purpose: The study aimed to compare the clinical assessment of congestion to bioimpedance and microwave spectroscopy. Methods: 27 hospitalized HF patients with congestion (40% females) (Congestion Group) and 59 HF patients without fluid overload (66% females) (NON-Congestion Group) were included. Clinical examination, chest x-ray, laboratory results, echocardiography, non-invasive body mass analysis (Tanita Pro), NT-poBNP, and selected modern biomarkers concentrations [GDF-15, galectin-3, FABP, copeptin, VEGF were performed. Additionally, we assessed pulmonary congestion using a proprietary sensor with a microwave spectroscopy method based on analyzing the dielectric properties of an object (patent applications P.442466). Results: There were no differences in body mass index, blood pressure values, left ventricular ejection fraction (LVEF), and echocardiographic parameters of diastolic left ventricular function between groups. In the Congestion Group, we observed significantly more patients in NYHA Class 3 and 4 (p&lt;0.001), lower values of fT3 (median 2.4 vs 2.7; p=0.02), higher a FIB-4 index (p=0.04), lower GFR MDRD (median 52.7 vs 66.7;p=0.04), higher concentrations of: NT-proBNP (pg/ml) (median 545 vs 101; p&lt;0.001), galectin-3 (ng/ml) (median 15.01 vs 11.35; p=0.01), GDF-15 (pg/ml) (median 2069.27 vs 734.64; p=0.01), FABP (pg/ml) (median 293.6 vs 101; p=0.008) compared to NON-Congestion Group, and a larger number of detected congestion in chest x-ray (p&lt;0.01) and more patients with limb edema (p= 0.0037). The patients with congestion also needed longer hospitalizations (p=0.008). Patients with congestion had lower total body water content in kg and intracellular water (ICW) (kg) (p=0.02 and p=0.01, respectively), and the higher extracellular water/total body water index (ECW/TBW) (p=0.001) assessed in bioimpedance and significantly higher Absorption Loss evaluated with the use of microwave spectroscopy (p=0.02). In a multiple logistic regression model, the factor that was independently associated with clinically diagnosed congestion was NT-proBNP &gt;1095 pg/ml (OR 111.6, 95% CI: 2.6-50.6; p=0.001) (Figure 1). Conclusions: Absorption Loss and ECW/TBW are valuable new diagnostic tools in diagnosing lung congestion in patients with heart failure.

Tofogliflozin reduces sleep apnea severity in patients with type 2 diabetes mellitus and heart failure: a prospective study.

Sleep apnea (SA) is prevalent among patients with heart failure (HF) and contributes to a poor prognosis. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have demonstrated efficacy in reducing the risk of serious clinical events in patients with HF. Additionally, SGLT2 inhibitors may reduce the risk of incident SA and mitigate its severity in patients with cardiovascular disease and T2DM. We aimed to investigate whether the SGLT2 inhibitor tofogliflozin reduced the severity of SA, as assessed using the apnea-hypopnea index (AHI), in patients with HF and T2DM and whether a decrease in AHI correlates with changes in body composition and cardiorenal function parameters. This is a single-arm, prospective pathophysiologic study involving patients with HF, T2DM, and SA, defined as having an AHI of 15 events/h and more. SA was assessed using polysomnography. Changes in AHI before and 6 months after starting oral administration of tofogliflozin (20 mg) were assessed. Additionally, body composition and cardiorenal functions were assessed before and 6 months after tofogliflozin administration. Ten patients with HF, T2DM, and SA were finally enrolled (60% men, 66.9 ± 13.4 years). Tofogliflozin reduced AHI from 43.2 [30.2] to 35.3 [13.1] events/h (p = 0.024) at 6 months. Hemoglobin A1c, body weight, and body water content decreased significantly. However, no significant changes were observed in the cardiorenal function parameters. A linear relationship was observed between the changes in body water content and AHI (r = 0.642, p = 0.045). Tofogliflozin reduced AHI, possibly associated with a reduction in body water content.

Can the Total Body Water and Total Fat Mass Predict Kidney Stone Recurrence in Overweight and Obese Patients?

Can the Total Body Water and Total Fat Mass Predict Kidney Stone Recurrence in Overweight and Obese Patients?

Assessment of the protective effect of vitamin E supplementation on oxidative damage of diabetic rat spleen induced by streptozotocin

AimsIncreased oxidative stress in diabetes mellitus may lead to splenic damage, contributing to decreased immunity. This study aims to evaluate the potential of vitamin E supplements as a protective agent against spleen injury by examining physiological, hematological, biochemical, and histological changes in diabetic rat model. MethodsDiabetes was induced in male wistar albino rats through an intraperitoneal injection of 50 mg/kg Streptozotocin, and the rats were randomly divided into five groups. The rats were then administered varying doses of vitamin E for 14 consecutive days. Assessments included renal function tests, blood glucose levels, complete blood counts, lipid profiles, tissue oxidative stress and spleen histology. An acute toxicity study was also conducted on normal rats. ResultsVitamin E supplementation did not result in any mortality up to 5000 mg/kg body weight. The treated diabetic group showed improved metabolic characteristics, such as normal body weight, food and water intake and a reduced spleen index compared to the untreated diabetic group. Significant improvements were observed in hematological parameters like packed cell volume (PCV), hemoglobin concentration, RBC (red blood cells) and WBC (white blood cells) counts. HCA (Hierarchical Cluster Analysis) of these parameters indicated that doses of 100 mg/kg and 150 mg/kg were most similar to normal condition. Catalase and MDA (Malondialdehyde) assays showed a substantial reduction in oxidative stress in spleen tissue and histopathological examination revealed significant regenerative effects. ConclusionThis study demonstrated that vitamin E supplementation significantly enhanced various metabolic, hematological, biochemical, and histological parameters in the diabetic group compared to those who did not receive the treatment. Among the doses tested, 100 mg/kg and 150 mg/kg body weight were found to yield the most favorable outcomes.

The Effect of Meal Frequency on Body Composition, Biochemical Parameters and Diet Quality in Overweight/Obese Individuals.

There is no consensus on the ideal frequency of meals for the prevention and treatment of obesity. While some studies have reported that increasing meal frequency might be beneficial in the treatment of obesity due to its positive effects on glycemic regulation, appetite and diet quality, other studies have reported negative effects. In this study, it was aimed to examine the effect of meal frequency on body composition, anthropometric measurements, some of the biochemical parameters and diet quality in overweight/obese adults. A total of 91 individuals, all overweight/obese, between the ages of 18-64, including 46 consuming 2 main meals (2MMG) and 45 consuming 3 main meals (3MMG) participated in the study. General characteristics and dietary habits of the individuals were obtained with a questionnaire. A 3-day food consumption record was taken to determine their daily energy and nutrient intake and to evaluate their diet quality with the "Healthy Eating Index 2015". Anthropometric measurements of the individuals were performed, body compositions were analyzed and some blood parameters were evaluated. The median values of body weight, lean body mass (kg), total body water, basal metabolic rate and hip circumference of men in the 3MMG were found to be higher than men in the 2MMG (p < 0.05). The anthropometric measurements and body composition components of women were similar between the two groups (p > 0.05). The renal urea nitrogen and total cholesterol values of women in 2MMG were higher than those of women in the 3MMG. In the regression analysis, a 1-unit increase in the number of main meals was determined to lead to a 9.3 points increase in the total score of HEI 2015. Regular consumption of main meals may have positive effects on diet quality, some of the biochemical parameters, basal metabolic rate and body composition in overweight/obese adults. In this group, which is known to have incorrect food preferences in general, it is important to plan the number of meals and the content of these meals correctly.

In-hospital bioimpedance-derived total body water predicts short-term cardiovascular mortality and re-hospitalizations in acute decompensated heart failure patients.

Hospital re-admissions in heart failure (HF) patients are mostly caused by an acute exacerbation of their chronic congestion. Bioimpedance analysis (BIA) has emerged as a promising non-invasive method to assess the volume status in HF. However, its correlation with clinically assessed volume status and its prognostic value in the acute intra-hospital setting remains uncertain. In this single-center observational study, patients (n = 49) admitted to the cardiology ward for acute decompensated HF (ADHF) underwent a daily BIA-derived volume status assessment. Median hospital stay was 7 (4-10) days. Twenty patients (40%) reached the composite endpoint of cardiovascular mortality or re-hospitalization for HF over 6months. Patients at discharge displayed improved NYHA class, lower body weight, plasma and blood volume, as well as lower NT-proBNP levels compared to the admission. Compared to patients with total body water (TBW) less than or equal to that predicted by body weight, those with higher relative TBW levels had elevated NT-proBNP and E/e´ (both p < 0.05) at discharge. In the Cox multivariate regression analysis, the BIA-derived delta TBW between admission and discharge showed a 23% risk reduction for each unit increase (HR = 0.776; CI 0.67-0.89; p = 0.0006). In line with this finding, TBW at admission had the highest prediction importance of the combined endpoint for a subgroup of high-risk HF patients (n = 35) in a neural network analysis. In ADHF patients, BIA-derived TBW is associated with the increased risk of HF hospitalization or cardiovascular death over 6months. The role of BIA for prognostic stratification merits further investigation.

Ultrasonographic Evaluation of Systemic Venous Congestion in Maintenance Hemodialysis Patients during Fluid Removal

Introduction: Fluid overload is a frequent and serious complication in hemodialysis patients. The combination of multiple point-of-care ultrasound (POCUS) measurements can identify significant venous congestion, but its usefulness to determine ultrafiltration (UF) requirements and dry weight is unknown. Therefore, we evaluated prospectively patients in maintenance hemodialysis to establish the correlations between changes in venous congestion parameters and fluid removal. Methods: This was a prospective, single-center, observational study. POCUS venous congestion measurements were performed in 22 patients during 32 online post-dilutional hemodiafiltration sessions, and findings were correlated with UF volume, central venous pressure, and body water composition determined by multifrequency bioelectric impedance analysis (BIA). Results: The pre-dialysis weight was on average 1.9 kg above the BIA estimated dry weight, the average initial inferior vena cava (IVC) diameter was <2 cm. An initial abnormal hepatic vein (HV) waveform was present in 26% (8) of the measurements. The average UF volume was 2,084 ± 655 mL and correlated with changes in IVC diameter (R = 0.34, 95% CI: [0.18, 0.56], p < 0.05) but not with any other POCUS venous congestion parameters. Normalization of the IVC diameter and HV waveform was observed during the first UF hour in all initially altered measurements. Diameter reduction in the IVC correlated with total body water volume reduction estimated with BIA when measured immediately after fluid removal (R = 0.34, 95% CI: [0.08, 0.56], p < 0.05). Conclusion: Reduction in IVC diameter had a modest but significant correlation with UF volume in our patients on maintenance hemodiafiltration. POCUS may be used to monitor patients during UF.