Relative expansion of extracellular fluid in obese vs. nonobese women

Waki, Masako; Kral, John G.; Mazariegos, Manolo; Wang, J.; Pierson, Richard N.; Heymsfield, Steven B.

doi:10.1152/ajpendo.1991.261.2.e199

Cited by 141 publications

(150 citation statements)

References 9 publications

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“…It would also draw attention on the effects of treatment (diuretics, etc) on metabolism. In obese patients where a extracellular expansion is demonstrated (Battistini et al, 1995;Waki et al, 1991), metabolic data would be useful to challenge the theory.…”

Section: Discussionmentioning

confidence: 99%

Effects of changes in water compartments on physiology and metabolism

et al. 2003

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There is paramount evidence to suggest the importance of cell volume changes for the regulation of cell function, including protein metabolism. Among many other effects, cell swelling inhibits proteolysis and stimulates protein synthesis. However, most of the data pertinent to this theory relate to in vitro experiments. This paper reviews the evidence about the relevance of cell swelling and changes in water compartments to regulation of metabolism at the whole body level in animals and humans. Protein metabolism is most likely regulated by cellular hydration in health and disease. Cellular hydration appears to bear no effect on energy metabolism. The relationship between cellular hydration and lipolysis deserves to be verified. There appears to be a possible weak effect on glucose metabolism. Further studies are therefore necessary to challenge the cell swelling theory. If confirmed, strategies to modify cellular hydration could be used to improve metabolic orientations especially in the critically ill.

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Section: Discussionmentioning

confidence: 99%

Effects of changes in water compartments on physiology and metabolism

et al. 2003

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“…This suggests that the physiological relationship between Wt and TBW may be altered in obese children and that factors other than Wt may be involved in the control of body water in obese subjects. This may be of pathophysiological importance since the altered water homeostasis of obese subjects is likely to play a role in the development of oedema and hypertension (Waki et al, 1991). In obese subjects, ZI is a better predictor of TBW than Wt.…”

Section: Discussionmentioning

confidence: 99%

“…Whether obese subjects have an altered body water distribution has been the subject of some controversy until the recent work of Waki et al (1991). These Authors have convincingly shown that obese women have a reduced body hydration and an expanded ECW:ICW ratio in comparison to control women.…”

Section: Introductionmentioning

confidence: 99%

The prediction of total body water and extracellular water from bioelectric impedance in obese children

et al. 1997

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Objectives: To assess the reliability of bioelectric impedance analysis (BIA) for predicting total body water (TBW) and extracellular water (ECW) in obese children. Design: Comparison of ®ve prediction models based on: (i) body weight (Wt), (ii) the impedance (Z) index (ZI height 2 /Z), (iii) the association of Wt and ZI, (iv) the body surface area (SA) to impedance ratio (SA:Z) and, (v) the body volume (V) to impedance ratio (V:Z). Subjects: Thirty obese and 25 control children of 11.2 AE 1.8 y of age. Measurements: TBW and ECW were assessed by deuterium and bromide dilution; Z was measured at frequencies of 5, 50 and 100 kHz. Results: In controls, Wt explained 11% more variance of TBW than ZI (r 2 0.977, SEE 0.9 I, CV 3.8%) and the association of Wt and ZI improved the prediction of TBW only slightly (r 2 0.982, SEE 0.8 I, CV 3.5%). The SA:Z and V:Z indexes explained 6 and 33% less variance of TBW respectively as compared to Wt alone. In obese subjects, ZI explained 4% more variance of TBW than Wt (r 2 0.914, SEE 1.8 I, CV 6.4%) and the SA:Z ratio was the most accurate predictor of TBW (r 2 0.959, SEE 1.2 l, CV 4.4%). However, the increase in the explained variance of TBW associated to the use of the SA:Z ratio was of only 1% as compared to the association of ZI and Wt. The V:Z ratio explained 9% less of variance of TBW as compared to ZI. In both control and obese subjects, the association of Wt and ZI offered the best prediction of ECW (r 2 0.807, SEE 1.564 I and r 2 0.826, SEE 1.035 I, respectively). However, the values of CV were much higher in controls than in obese children (17.5% vs 8.4%) owing to their lower ECW and greater variability in ECW%. ZI was the most accurate predictor of TBW on the pooled sample (n 55; r 2 0.910, SEE 1.932 I, CV 7.4%). However, it was a poor predictor of ECW on the same sample owing to its high CV (n 55; r 2 0.866, SEE 1.806 I, CV 17.0%). Conclusions: The body surface area to impedance ratio is the most accurate predictor of TBW in obese children but the association of ZI and Wt may be of more interest when BIA is used to estimate both TBW and ECW. The impedance index offers a good prediction of TBW but not of ECW in children with different levels of fatness.

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“…As compared to normal-weight women, obese women have a lower total body water (TBW) per unit of weight (Wt) and a higher extracellular water (ECW) per unit of TBW (Waki et al, 1991). This ECW : TBW expansion persists after weight loss and may be an intrinsic feature of obesity (Mazariegos et al, 1992;Van Marken Lichtenbelt & Fogelholm, 1999).…”

Section: Introductionmentioning

confidence: 99%

Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis

et al. 2004

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Objective: To measure body water distribution and to evaluate the accuracy of eight-polar bioelectrical impedance analysis (BIA) for the assessment of total body water (TBW) and extracellular water (ECW) in severe obesity. Design: Cross-sectional study. Setting: Obesity clinic. Subjects: In all, 75 women aged 18-66 y, 25 with body mass index (BMI) between 19.1 and 29.9 kg/m 2 (ie not obese), 25 with BMI between 30.0 and 39.9 kg/m 2 (ie class I and II obese), and 25 with BMI between 40.0 and 48.2 kg/m 2 (ie class III obese). Methods: TBW and ECW were measured by 2 H 2 O and Br dilution. Body resistance (R) was obtained by summing the resistances of arms, trunk and legs as measured by eight-polar BIA (InBody 3.0, Biospace, Seoul, Korea). The resistance index at a frequency of x kHz (RI x ) was calculated as height 2 /R x . Results: ECW : TBW was similar in women with class III (4673%, mean7s.d.) and class I-II obesity (4573%) but higher than in nonobese women (3973%, Po0.05). In a random subsample of 37 subjects, RI 500 explained 82% of TBW variance (Po0.0001) and cross-validation of the obtained algorithm in the remaining 38 subjects gave a percent root mean square error (RMSE%) of 5% and a pure error (PE) of 2.1 l. In the same subjects, RI 5 explained 87% of ECW variance (Po0.0001) and cross-validation of the obtained algorithm gave a RMSE% of 8% and a PE of 1.4 l. The contribution of weight and BMI to the prediction of TBW and ECW was nil or negligible on practical grounds. Conclusions: ECW : TBW is similar in women with class I-II and class III obesity up to BMI values of 48.2 kg/m 2 . Eight-polar BIA offers accurate estimates of TBW and ECW in women with a wide range of BMI (19.1-48.2 kg/m 2 ) without the need of population-specific formulae. Sponsorship: Progetti di Ricerca Corrente, Istituto Auxologico Italiano.

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Relative expansion of extracellular fluid in obese vs. nonobese women

Cited by 141 publications

References 9 publications

Effects of changes in water compartments on physiology and metabolism

Effects of changes in water compartments on physiology and metabolism

The prediction of total body water and extracellular water from bioelectric impedance in obese children

Body water distribution in severe obesity and its assessment from eight-polar bioelectrical impedance analysis

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