Vasopressin and disorders of water balance: the physiology and pathophysiology of vasopressin

Ball, Stephen G.

doi:10.1258/000456307781646030

Cited by 90 publications

(75 citation statements)

References 96 publications

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“…Although we have not measured arginine vasopressin levels, previous studies demonstrated that an increased serum osmolality or a decreased plasma volume stimulate the secretion of arginine vasopressin. 39,40 Therefore, the decreased urinary output in obese subjects in our study might be the consequence of their higher sodium levels and decreased plasma volume (that is, more dehydrated status) compared with lean counterparts.…”

Section: Discussionmentioning

confidence: 80%

The impact of obesity on physiological responses during prolonged exercise

et al. 2011

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Background: Prolonged, moderate-intensity exercise training is routinely prescribed to subjects with obesity. In the general population, this type of exercise can lead to fluid and sodium imbalance. However, little is known whether obesity alters the risk of fluid and sodium imbalances. Objective: This study examined physiological responses, such as core body temperature, fluid and sodium balance, in lean (BMIo25), overweight (25oBMIo30) and obese (BMI430) subjects during prolonged moderate-intensity exercise. Subjects: A total of 93 volunteers (24-80 years), stratified for BMI, participated in the Nijmegen Marches and walked 30-50 km at a self-selected pace. Heart rate and core body temperature were recorded every 5 km. Subjects reported fluid intake, while urine output was measured and sweat rate was calculated. Baseline and post-exercise plasma sodium levels were determined, and urinary specific gravity levels were assessed before and after exercise. Results: BMI groups did not differ in training status preceding the experiment. Exercise duration (8 h 41 ± 1 h 36 min) and intensity (72 ± 9% HR max ) were comparable across groups, whereas obese subjects tended to have a higher maximum core body temperature than lean controls (P ¼ 0.06). Obese subjects demonstrated a significantly higher fluid intake (Po0.001) and sweat rate (Po0.001), but lower urine output (Po0.05) compared with lean subjects. In addition, higher urine specific gravity levels were observed in obese versus lean subjects after exercise (Po0.05). Furthermore, plasma-sodium concentration did not change in lean subjects after exercise, whereas plasma-sodium levels increased significantly (Po0.001) in overweight and obese subjects. Also, overweight and obese subjects demonstrated a significantly larger decrease in body mass after exercise than lean controls (Po0.05).Conclusion: Obese subjects demonstrate a larger deviation in markers of fluid and sodium balance than their lean counterparts during prolonged moderate-intensity exercise. These findings suggest that overweight and obese subjects, especially under strenuous environmental conditions, have an increased risk to develop fluid and sodium imbalances.

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Section: Discussionmentioning

confidence: 80%

The impact of obesity on physiological responses during prolonged exercise

et al. 2011

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“…The relationship between sodium and vasopressin in the SIADH has been categorised into four main groups (A-D) (4). Type A represents a picture with seemingly random AVP secretion, type B represents a picture where there is a 'reset osmostat', type C indicates AVP secretion that appears to be fixed at inappropriately high levels under hypotonic conditions, but then increases normally when the osmolality exceeds the usual threshold values, and finally type D SIADH represents antidiuresis in the absence of AVP.…”

Section: Discussionmentioning

confidence: 99%

“…Free water excretion was assessed by water load test according to a standard protocol (4). In brief, an oral water load (20 ml/kg) was administered over 15 minutes.…”

Section: Assessment Of Free Water Excretion: Water Load Testmentioning

confidence: 99%

“…Thirst and AVP response to graded hypertonic stimulation were assessed in the mother by standard methods (4). In brief, hypertonic 5% saline (850 mmol/l) was infused over a period of 2 h at a rate of 0.06 ml/kg per min.…”

Section: Assessment Of Osmoregulated Thirst and Avp Production By Gramentioning

confidence: 99%

“…Plasma osmolality and AVP were assessed at baseline and at 30 min intervals during the infusion. Thirst was assessed in parallel using a validated visual analogue scale (4). Plasma AVP and thirst were related to standardised normal reference ranges determined in normal volunteers.…”

Section: Assessment Of Osmoregulated Thirst and Avp Production By Gramentioning

confidence: 99%

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Thirst perception and arginine vasopressin production in a kindred with an activating mutation of the type 2 vasopressin receptor: the pathophysiology of nephrogenic syndrome of inappropriate antidiuresis

Gupta

Cheetham

Lambert³

et al. 2009

European Journal of Endocrinology

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Background: Activating mutations of the vasopressin receptor gene on the X chromosome cause the nephrogenic syndrome of inappropriate antidiuresis (NSIAD). We describe a male child who presented with persistent hyponatraemia and whose mother was also found to be hyponatraemic. She had learnt to avoid excess fluid consumption because of associated malaise. Both individuals had a subnormal ability to excrete a water load with mother also demonstrating a heightened sense of thirst at low serum osmolalities. Results: Mother and child were found to have the previously characterised activating mutation (p.Arg137Cys) of the arginine vasopressin receptor type 2 gene (AVPR2), but had measurable levels of AVP when hyponatraemic. Conclusions: We conclude that female carriers of activating mutations of the vasopressin receptor are susceptible to hyponatraemia and therefore need to be provided with advice regarding fluid intake. An altered thirst perception may increase susceptibility to hyponatraemia. We confirm that the presence of measurable amounts of AVP in patients with hyponatraemia does not exclude the diagnosis of NSIAD.

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Pituitary

Seejore¹,

Murray²

2020

Encyclopedia of Life Sciences

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The pituitary gland is central to the regulation and functional integrity of many peripheral hormone systems. Based at the base of the brain, the pituitary integrates signals from the hypothalamus with feedback from the peripheral endocrine glands, and in turn, releases the requisite amount of hormone or trophic factor for the ambient metabolic and physiological conditions. The past decades have seen key milestones in recombinant production of all known pituitary and hypothalamic hormones, characterisation of their receptors and discovery of additional hypothalamic peptides regulating the pituitary. These have enabled an in‐depth understanding of hypothalamic–pituitary physiology and pathophysiology. Key Concepts The pituitary gland is centrally regulated by the hypothalamus. The anterior pituitary (adenohypophysis) contains five distinct glandular cell types that secrete growth hormone (GH), prolactin, gonadotrophins (luteinizing hormone, LH; follicle‐stimulating hormone, FSH), adrenocorticotropic hormone (ACTH) and thyroid‐stimulating hormone (TSH). Anterior pituitary hormones are secreted in pulses under control of hypothalamic trophic factors released in the hypophyseal portal circulation. The ultradian pulsed patterns of GH, prolactin, ACTH and TSH secretion follow endogenous circadian rhythms. Peripheral hormones released from target endocrine organs regulate secretion of anterior pituitary hormones in negative feedback loops, with the exception of prolactin. Prolactin is produced by pituitary lactotrophs and is tonically inhibited by the hypothalamic neurotransmitter, dopamine. The neurohypophysis (posterior pituitary) is constituted of axonal projections extending from the hypothalamic supraoptic and paraventricular nuclei that secrete arginine vasopressin (AVP) and oxytocin. Posterior pituitary hormones are secreted and regulated via neural pathways to coordinate water balance and reproductive function.

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Vasopressin and disorders of water balance: the physiology and pathophysiology of vasopressin

Cited by 90 publications

References 96 publications

The impact of obesity on physiological responses during prolonged exercise

The impact of obesity on physiological responses during prolonged exercise

Thirst perception and arginine vasopressin production in a kindred with an activating mutation of the type 2 vasopressin receptor: the pathophysiology of nephrogenic syndrome of inappropriate antidiuresis

Pituitary

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