| 1. |
- Johannsson, Gudmundur, 1960, et al.
(författare)
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GH increases extracellular volume by stimulating sodium reabsorption in the distal nephron and preventing pressure natriuresis.
- 2002
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Ingår i: The Journal of clinical endocrinology and metabolism. - : The Endocrine Society. - 0021-972X .- 1945-7197. ; 87:4, s. 1743-9
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Tidskriftsartikel (refereegranskat)abstract
- Although sodium retention and volume expansion occur during GH administration, blood pressure is decreased or unchanged. The aim was to study the effect of short- and long-term GH replacement in adults on sodium balance, renal hemodynamics, and blood pressure. Ten adults with severe GH deficiency were included into a 7-d, randomized, placebo-controlled, cross-over trial followed by 12 months of open GH replacement. All measurements were performed under metabolic ward conditions. Extracellular water (ECW) was determined using multifrequency bioelectrical impedance analysis. Renal plasma flow and glomerular filtration rate were assessed using renal paraminohippurate and Cr(51) EDTA clearances, respectively. Renal tubular sodium reabsorption was assessed using lithium clearance. Plasma renin activity (PRA), plasma concentrations of angiotensin II, aldosterone, atrial natriuretic peptides and brain natriuretic peptides (BNP) and 24-h urinary norepinephrine excretion were measured. Seven days of GH treatment decreased urinary sodium excretion. Lithium clearance as a marker of proximal renal tubular sodium reabsorption was unaffected by GH treatment. ECW was increased after both short- and long-term treatment. This increase was inversely correlated to the decrease in diastolic blood pressure (r = -0.70, P = 0.02) between baseline and 12 months. Short-term treatment increased PRA and decreased BNP. The increase in PRA correlated with an increase in 24-h urinary norepinephrine excretion (r = 0.77, P < 0.01). Glomerular filtration rate and renal plasma flow did not change during treatment. The sodium- and water-retaining effect of GH takes place in the distal nephron. The sustained increase in ECW in response to GH is associated with an unchanged or decreased blood pressure. This together with unchanged or decreased atrial natriuretic peptides and BNP may prevent pressure-induced escape of sodium.
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| 2. |
- Buendia, Ruben, 1982, et al.
(författare)
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Estimation of body fluids with bioimpedance spectroscopy: state of the art methods and proposal of novel methods
- 2015
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Ingår i: Physiological Measurement. - : IOP Publishing. - 0967-3334 .- 1361-6579. ; 36:10
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Tidskriftsartikel (refereegranskat)abstract
- Determination of body fluids is a useful common practice in determination of disease mechanisms and treatments. Bioimpedance spectroscopy (BIS) methods are non-invasive, inexpensive and rapid alternatives to reference methods such as tracer dilution. However, they are indirect and their robustness and validity are unclear. In this article, state of the art methods are reviewed, their drawbacks identified and new methods are proposed. All methods were tested on a clinical database of patients receiving growth hormone replacement therapy. Results indicated that most BIS methods are similarly accurate (e.g. < 0.5 +/- 3.0% mean percentage difference for total body water) for estimation of body fluids. A new model for calculation is proposed that performs equally well for all fluid compartments (total body water, extra-and intracellular water). It is suggested that the main source of error in extracellular water estimation is due to anisotropy, in total body water estimation to the uncertainty associated with intracellular resistivity and in determination of intracellular water a combination of both.
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| 3. |
- Buendia, Rubén, et al.
(författare)
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Robustness study of the different immittance spectra and frequency ranges in bioimpedance spectroscopy analysis for assessment of total body composition.
- 2014
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Ingår i: Physiological measurement. - : IOP Publishing. - 1361-6579 .- 0967-3334. ; 35:7, s. 1373-95
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Tidskriftsartikel (refereegranskat)abstract
- The estimation of body fluids is a useful and common practice for assessment of disease status and therapy outcomes. Electrical bioimpedance spectroscopy (EBIS) methods are noninvasive, inexpensive and efficient alternatives for determination of body fluids. One of the main source of errors in EBIS measurements in the estimation of body fluids is capacitive coupling. In this paper an analysis of capacitive coupling in EBIS measurements was performed and the robustness of the different immittance spectra against it tested. On simulations the conductance (G) spectrum presented the smallest overall error, among all immittance spectra, in the estimation of the impedance parameters used to estimate body fluids. Afterwards the frequency range of 10-500kHz showed to be the most robust band of the G spectrum. The accuracy of body fluid estimations from the resulting parameters that utilized G spectrum and parameters provided by the measuring device were tested on EBIS clinical measurements from growth hormone replacement therapy patients against estimations performed with dilution methods. Regarding extracellular fluid, the correlation between each EBIS method and dilution was 0.93 with limits of agreement of 1.06 ± 2.95 l for the device, 1.10 ± 2.94 l for G [10-500kHz] and 1.04 ± 2.94 l for G [5-1000kHz]. Regarding intracellular fluid, the correlation between dilution and the device was 0.91, same as for G [10-500kHz] and 0.92 for G [5-1000kHz]. Limits of agreement were 0.12 ± 4.46 l for the device, 0.09 ± 4.45 for G [10-500kHz] and 0.04 ± 4.58 for G [5-1000kHz]. Such close results between the EBIS methods validate the proposed approach of using G spectrum for initial Cole characterization and posterior clinical estimation of body fluids status.
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| 4. |
- Seoane, Fernando, et al.
(författare)
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Mean Expected Error in Prediction of Total Body Water: A True Accuracy Comparison between Bioimpedance Spectroscopy and Single Frequency Regression Equations
- 2015
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Ingår i: Biomed Research International. - : Hindawi Limited. - 2314-6133 .- 2314-6141. ; 2015:Article ID 656323
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Tidskriftsartikel (refereegranskat)abstract
- For several decades electrical bioimpedance (EBI) has been used to assess body fluid distribution and body composition. Despite the development of several different approaches for assessing total body water (TBW), it remains uncertain whether bioimpedance spectroscopic (BIS) approaches are more accurate than single frequency regression equations. The main objective of this study was to answer this question by calculating the expected accuracy of a single measurement for different EBI methods. The results of this study showed that all methods produced similarly high correlation and concordance coefficients, indicating good accuracy as a method. Even the limits of agreement produced from the Bland-Altman analysis indicated that the performance of single frequency, Sun's prediction equations, at population level was close to the performance of both BIS methods; however, when comparing the Mean Absolute Percentage Error value between the single frequency prediction equations and the BIS methods, a significant difference was obtained, indicating slightly better accuracy for the BIS methods. Despite the higher accuracy of BIS methods over 50 kHz prediction equations at both population and individual level, the magnitude of the improvement was small. Such slight improvement in accuracy of BIS methods is suggested insufficient to warrant their clinical use where the most accurate predictions of TBW are required, for example, when assessing over-fluidic status on dialysis. To reach expected errors below 4-5%, novel and individualized approaches must be developed to improve the accuracy of bioimpedance-based methods for the advent of innovative personalized health monitoring applications.
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| 5. |
- Seoane, Fernando, et al.
(författare)
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Slightly superior performance of bioimpedance spectroscopy over single frequency regression equations for assessment of total body water.
- 2015
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Ingår i: Engineering in Medicine and Biology Society (EMBC), 2015 37th Annual International Conference of the IEEE. 25-29 Aug. 2015, Milan, Italy.. - : IEEE. - 1094-687X .- 1558-4615. - 9781424492718 - 9781424492701 ; 2015, s. 3707-10
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Konferensbidrag (refereegranskat)abstract
- Electrical bioimpedance has been used for several decades to assess body fluid distribution and body composition by using single frequency and bioimpedance spectroscopic (BIS) techniques. It remains uncertain whether BIS methods have better performance compare to single frequency regression equations. In this work the performance of two BIS methods and four different 50 kHz single frequency prediction equations was studied in a data set of wrist-to-ankle tetrapolar BIS measurements (5-1000 kHz) together with reference values of total body water obtained by tritium dilution in 92 patients. Data were compared using regression techniques and Bland-Altman plots. The results of this study showed that all methods produced similarly high correlation and concordance coefficients, indicating good accuracy as a method. Limits of agreement analysis indicated that the population level performance of Sun's prediction equations was very similar to the performance of both BIS methods. However, BIS methods in practice have slightly better predictive performance than the single-frequency equations as judged by higher correlation and the limits of agreement from the Bland-Altman analysis. In any case, the authors believe that an accurate evaluation of performance of the methods cannot be done as long as the evaluation is done using Bland-Altman analysis, the commonly accepted technique for this kind of performance comparisons.
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| 6. |
- Tengvall, Marja, 1982, et al.
(författare)
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Bioelectrical impedance spectroscopy in growth hormone-deficient adults.
- 2010
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Ingår i: Physiological measurement. - : IOP Publishing. - 1361-6579 .- 0967-3334. ; 31:1, s. 59-75
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Tidskriftsartikel (refereegranskat)abstract
- This study evaluated water compartment assessment by bioelectrical impedance spectroscopy (BIS) by Xitron 4000B in 164 growth hormone-deficient adults on growth hormone replacement therapy, examined the assumed constant body density and gender-specific resistivities in BIS methodology and evaluated a published BMI-adjusted BIS equation. Body composition was measured by BIS, total body potassium (TBK), tritium dilution and dual-energy x-ray absorptiometry (DXA). Tritium dilution and TBK were combined to a reference method for water compartments. Average difference for total body water (TBW) by tritium dilution and by BIS was 0.6 l in women (p > 0.05) and -0.2 l in men (p > 0.05). Average extracellular water (ECW) by the reference method and by BIS differed 1.5 l in women (p < 0.05) and 1.2 l in men (p < 0.05). Average intracellular water (ICW) by the reference method and by BIS differed -0.9 l in women (p < 0.05) and -1.3 l in men (p < 0.05). However, average ECW and ICW could be successfully estimated by BIS with use of unisex resistivity constants that were derived from this population, although with large individual variation. Average individual body density was lower than assumed. Application of individual body density did not improve agreement between methods. BMI-adjusted equations were not fully accurate in this population.
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