scholarly journals Nonthyroidal illness syndrome (NTIS) in severe COVID-19 patients: role of T3 on the Na/K pump gene expression and on hydroelectrolytic equilibrium

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Salvatore Sciacchitano ◽  
Carlo Capalbo ◽  
Christian Napoli ◽  
Andrea Negro ◽  
Luciano De Biase ◽  
...  
Keyword(s):  
Body Composition ◽  
Thyroid Function ◽  
Acute Phase ◽  
Total Body Water ◽  
Mononuclear Cells ◽  
Body Water ◽  
University Hospital ◽  
Dependent Manner ◽  
Nonthyroidal Illness ◽  
Total Body

Abstract Background Nonthyroidal Illness Syndrome (NTIS) can be detected in many critical illnesses. Recently, we demonstrated that this condition is frequently observed in COVID-19 patients too and it is correlated with the severity the disease. However, the exact mechanism through which thyroid hormones influence the course of COVID-19, as well as that of many other critical illnesses, is not clear yet and treatment with T4, T3 or a combination of both is still controversial. Aim of this study was to analyze body composition in COVID-19 patients in search of possible correlation with the thyroid function. Methods and findings We report here our experience performed in 74 critically ill COVID-19 patients hospitalized in the intensive care unit (ICU) of our University Hospital in Rome. In these patients, we evaluated the thyroid hormone function and body composition by Bioelectrical Impedance Analysis (BIA) during the acute phase of the disease at admission in the ICU. To examine the effects of thyroid function on BIA parameters we analyzed also 96 outpatients, affected by thyroid diseases in different functional conditions. We demonstrated that COVID-19 patients with low FT3 serum values exhibited increased values of the Total Body Water/Free Fat Mass (TBW/FFM) ratio. Patients with the lowest FT3 serum values had also the highest level of TBW/FFM ratio. This ratio is an indicator of the fraction of FFM as water and represents one of the best-known body-composition constants in mammals. We found an inverse correlation between FT3 serum values and this constant. Reduced FT3 serum values in COVID-19 patients were correlated with the increase in the total body water (TBW), the extracellular water (ECW) and the sodium/potassium exchangeable ratio (Nae:Ke), and with the reduction of the intracellular water (ICW). No specific correlation was observed in thyroid patients at different functional conditions between any BIA parameters and FT3 serum values, except for the patient with myxedema, that showed a picture similar to that seen in COVID-19 patients with NTIS. Since the Na+/K+ pump is a well-known T3 target, we measured the mRNA expression levels of the two genes coding for the two major isoforms of this pump. We demonstrated that COVID-19 patients with NTIS had lower levels of mRNA of both genes in the peripheral blood mononuclear cells (PBMC)s obtained from our patients during the acute phase of the disease. In addition, we retrieved data from transcriptome analysis, performed on human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM)s treated with T3 and we demonstrated that in these cells T3 is able to stimulate the expression of these two genes in a dose-dependent manner. Conclusions In conclusion, we demonstrated that measurement of BIA parameters is a useful method to analyze water and salt retention in COVID-19 patients hospitalized in ICU and, in particular, in those that develop NTIS. Our results indicate that NTIS has peculiar similarities with myxedema seen in severe hypothyroid patients, albeit it occurs more rapidly. The Na+/K+ pump is a possible target of T3 action, involved in the pathogenesis of the anasarcatic condition observed in our COVID-19 patients with NTIS. Finally, measurement of BIA parameters may represent good endpoints to evaluate the benefit of future clinical interventional trials, based on the administration of T3 in patients with NTIS.

BODY WATER COMPARTMENTS IN CHILDREN: CHANGES DURING GROWTH AND RELATED CHANGES IN BODY COMPOSITION

PEDIATRICS ◽  
1961 ◽  
Vol 28 (2) ◽  
pp. 169-181
Author(s):  
B. Friis-Hansen
Keyword(s):  
Body Composition ◽  
Total Body Water ◽  
Rapid Decrease ◽  
Body Water ◽  
The Other ◽  
First Year ◽  
Extracellular Water ◽  
Water Compartments ◽  
Total Body ◽  
First Year Of Life

During growth of infants and children, certain characteristic changes are found. A rapid decrease of the relative volumes of total body water and of extracellular water occurs during the first year of life, followed by a smaller decrease of volume of extracellular water later in childhood. At the same time an increased heterogeneity of the extracellular water takes place. On the other hand, the volume of intracellular water increases a little during the first months of life and remains more or less constant from then on. Formulas and nomograms from which these body water compartments can be predicted are presented. Finally, data on the corresponding changes in the total body water and in body specific gravity are discussed.

Effects of 1‐year Treatment with Canagliflozin on Body Composition and Total Body Water in Patients with Type 2 Diabetes

2021 ◽  
Author(s):  
Ikuro Matsuba ◽  
Masahiro Takihata ◽  
Masahiko Takai ◽  
Hajime Maeda ◽  
Akira Kubota ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Body Composition ◽  
Total Body Water ◽  
Body Water ◽  
Total Body

Body composition in vivo. VII. Relation between red cell volume and total body water in ewes

1965 ◽  
Vol 16 (4) ◽  
pp. 661 ◽  
Author(s):  
BA Panaretto ◽  
DA Little
Keyword(s):  
Body Composition ◽  
Cell Volume ◽  
Total Body Water ◽  
Mean Value ◽  
Body Water ◽  
Red Cell ◽  
Red Cell Volume ◽  
Total Body ◽  
Body Parameters

The relationship between total body water and red cell volume was determined in a group of non-pregnant crossbred ewes, in an endeavour to obtain a method which did not necessitate the use of radioisotopes for determining body composition. Total body water could be predicted from red cell volume. The 95% confidence interval for a mean value for total body water, predicted from the red cell volume, was ±18.8% of the mean. All other relations which can be derived between the red cell volume and other body parameters depended on this relation. The calculation of body composition from measurements of the red cell volume is discussed.

Change in Total Body Water as a Metric for Predicting Need for Outpatient Intravenous Fluids in Postoperative Bariatric Patients

2020 ◽  
Vol 86 (9) ◽  
pp. 1169-1174
Author(s):  
Lauren E. Matevish ◽  
Alexander T. Hawkins ◽  
Alva J. Bethurum ◽  
Chetan V. Aher ◽  
Wayne J. English ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Body Composition ◽  
Length Of Stay ◽  
Total Body Water ◽  
Hospital Length ◽  
Body Water ◽  
Hospital Length Of Stay ◽  
Diabetes Diagnosis ◽  
Bariatric Patients ◽  
Total Body

Background Dehydration drives a significant proportion of readmissions following bariatric surgery. Routinely performed body composition testing and total body water (TBW) calculations may present a novel method for diagnosing dehydration for outpatient intervention. We sought to determine if a change in TBW from preoperative baseline could help identify bariatric patients requiring outpatient intravenous fluid (IVF) administration for dehydration. Methods The VUMC Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was retroactively queried for all patients undergoing bariatric surgery at an accredited bariatric surgery center from January 1, 2017 to May 31, 2018. Body composition test results presurgery and postsurgery were extracted from the electronic health record. Change in TBW was compared between patients requiring outpatient IVF and those who did not use multivariable logistic regression. Results 583 patients underwent surgery over the study period (388 laparoscopic Roux-en-Y gastric bypass, 195 sleeve). 62 (10.6%) required outpatient fluid administration for dehydration. After multivariable analysis, patients with an increased hospital length of stay at index operation were more likely to require outpatient IVF (odds ratio [OR] 1.65, 95% CI 1.22-2.2). Preexisting diabetes diagnosis was protective (OR 0.35, 95% CI 0.16-0.74). Neither 1-week nor 1-month change in TBW from preoperative baseline was significantly different between patients receiving outpatient IVF and those who did not. Conclusion Increased hospital length of stay predicts patients at risk of postoperative dehydration requiring IVF administration. Body composition testing and TBW were not useful in distinguishing between populations. Further research is needed to examine the efficacy of outpatient IVF in preventing hospital readmissions for dehydration.

scholarly journals Can Bioimpedance Determine the Volume of Distribution of Antibiotics in Sepsis?

2005 ◽  
Vol 33 (3) ◽  
pp. 345-350 ◽  
Author(s):  
M. Balik ◽  
J. Sedivy ◽  
P. Waldauf ◽  
M. Kolar ◽  
V. Smejkalova ◽  
...  
Keyword(s):  
Fluid Balance ◽  
Total Body Water ◽  
Volume Of Distribution ◽  
Body Water ◽  
University Hospital ◽  
Pharmacokinetic Analysis ◽  
Extracellular Water ◽  
Serum Concentrations ◽  
Total Body ◽  
Volumes Of Distribution

The relationship between the volume of distribution, assessed according to the two-compartmental pharmacokinetic model, and extracellular water estimated by bioimpedance was studied in mechanically ventilated patients with sepsis and capillary leak. A prospective observational study was performed in a twenty-bed general intensive care unit in the university hospital. Patients received either vancomycin (n=16) or netilmicin (n=12) for more than 48 hours. Those with ascites, pleural effusion, on renal replacement therapy or with haemodynamic instability were excluded. Serum concentrations of drugs were taken for pharmacokinetic analysis before, 1 hour and 4 hours after the 30 minute infusion. Bioimpedance measurement was performed at the time of the third sampling. The protocol was repeated after 24 hours. Fluid balance during the 24 hour interval was recorded. Extracellular water was increased and represented 45.6 to 46.6% of total body water. Fluid balance correlated with the change of extracellular water (r=0.82, P<0.0001) and total body water (r=0.74, P<0.0001). Volumes of distribution of vancomycin (0.677±0.339 l/kg) and netilmicin (0.505±0.172 l/kg) were increased compared to normal values. A correlation was demonstrated between volume of distribution (Vdarea) of vancomycin and extra cellular water/total body ratio (r=0.70, P<0.0001). The central compartment distribution volume (V1) of netilmicin correlated with extracellular water/total body water ratio (r=0.60, P<0.003). Serum concentrations above the recommended therapeutic range were detected in 81.2% of patients on vancomycin and in 50% of patients on netilmicin. Increased volumes of distribution can be estimated by the bioimpedance measurements but are not associated with requirements for higher dosage of the glycopeptide or aminoglycoside antibiotics.

scholarly journals Measuring the body composition of elderly subjects: a comparison of methods

1994 ◽  
Vol 72 (1) ◽  
pp. 33-44 ◽  
Author(s):  
J. J. Reilly ◽  
L. A. Murray ◽  
J. Wilson ◽  
J. V. G. A. Durnin
Keyword(s):  
Body Composition ◽  
Total Body Water ◽  
Body Water ◽  
The Body ◽  
Practical Significance ◽  
Elderly Subjects ◽  
Younger Adults ◽  
Individual Level ◽  
Total Body ◽  
The Individual

There is a paucity of data on differences between methods for the assessment of body composition in elderly subjects. Studies on younger adults suggest that such differences are of some practical significance at the individual level. In the present study the following methods of estimating percentage body fatness (BF%) were compared in healthy elderly men and women (mean age 70 (SD 6) years: densitometry; skinfold thickness; total body water; bioelectrical impedance (BIA) using an age-specific predictive equation and the manufacturers' equation; body mass index (BMI). Though BF% estimates from the various methods tended to be highly correlated with those from densitometry and with each other, differences between methods at the individual level were marked. In particular, the age-specific equations based on BMI and BIA systematically overestimated BF% relative to the other methods. Biases between BF% estimates derived from densitometry, skinfolds, BIA (manufacturers' equation) and total body water were less marked, indicating little evidence of systematic differences between these methods in elderly subjects. Individual differences between methods were slightly greater than those reported in some studies of younger adults, but this may be of little practical significance, and may be considered inevitable in view of variability between and within subjects in the extent to which the underlying assumptions of these two-component methods are met in elderly subjects.

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