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A proposed method for assessing plasma hypertonicity in vivo

Abstract

Indices of plasma hypertonicity, elevated plasma concentrations of solutes that draw fluid out of cells by osmosis, are needed to pursue hypertonicity as a possible risk factor for obesity and chronic disease. This paper proposes a new index that may be more sensitive to mild hypertonicity in vivo at a point in time than traditional measures. The index compares mean corpuscular volume (MCV) estimates from diluted (in solution by automated cell counter) and nondiluted blood (calculated from manual hematocrit, MCV=Hct/RBC*106). A larger Auto vs Manual MCV (>2 fl) in vitro indicates hypertonicity in vivo if the cell counter diluent is isotonic with the threshold for plasma vasopressin (PVP) release and PVP is detectable in plasma (>0.5 pg/ml). To evaluate this principle of concept, hypertonicity was induced by 24-h fluid restriction after a 20 ml/kg water load in four healthy men (20–46 years). Unlike serum and urine indices, the MCV difference-&-PVP index detected hypertonicity in all participants.

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Acknowledgements

Funding for this work was provided by Public Health Service National Research Service Award No. 5 T32 HL 07034 from the National Heart, Lung and Blood Institute, and a grant (M01 RR-00070) from the National Center for Research Resources, National Institutes of Health. We thank the Stanford University and San Francisco General Hospital General Clinical Research Centers and Dr Fahim Abbasi for their support.

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Correspondence to J D Stookey.

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Guarantor: JD Stookey.

Contributors: JDS was responsible for all aspects of the method development, study conception, design, implementation, analysis and manuscript preparation. DES, and JCK assisted with all aspects. MB, DES, and LVH contributed key ideas to the method development. JEG, AA, and CG provided essential expertise for the study design and implementation. All authors contributed to the manuscript preparation.

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Stookey, J., Burg, M., Sellmeyer, D. et al. A proposed method for assessing plasma hypertonicity in vivo. Eur J Clin Nutr 61, 143–146 (2007). https://doi.org/10.1038/sj.ejcn.1602481

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