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Valenzuela LO, O'Grady SP, Ehleringer JR. Variations in human body water isotope composition across the United States. Forensic Sci Int 2021; 327:110990. [PMID: 34500129 DOI: 10.1016/j.forsciint.2021.110990] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 08/19/2021] [Accepted: 08/29/2021] [Indexed: 10/20/2022]
Abstract
Accurate human provenancing using stable isotopes depends directly on solid understandings of the geographic and individual factors affecting isotope variability and incorporation into human tissues. Transfer of isotopic, and therefore spatial, information between environmental water and biological tissues is mediated by the isotopic composition of body water. Thus, there is a need to study body water isotope ratios at a population level and over a large isotopic and geographic range. We evaluated oxygen (δ18Obw) and hydrogen (δ2Hbw) isotope values of body water from 72 volunteers in 10 different cities across the US, and over a 5-10-day period. We analyzed covariates (e.g., water intake, physical activity, biometrics, gender) that might explain individual stable isotope ratio variations and tested a predictive model that incorporates the δ-values of drinking water, food, and O2 as well as individual variables to predict the δ-values of body water. The individual variability in body water isotope values overtime (mean 0.3‰ for δ18Obw and 2.3‰ for δ2Hbw) was lower than the intra-city variability (mean 0.9‰ for δ18Obw and 6.9‰ for δ2Hbw). Body water isotope values differed among cities (ANOVA: δ18ObwF = 97.2, p < 0.001; δ2HbwF = 176.2, p < 0.001). However, significant overlap among some cities with different drinking water was discovered. We detected significant covariation of measured drinking water and human body water isotope values (both isotope systems R2 ≥ 0.89, p < 0.001) and small but significant effects of the average daily exercise and amount of fluid intake. The differences between measured and model-predicted body water values (mean 0.12 ± 1.2‰ for Δδ18O and -1.2 ± 8.2‰ for Δδ2H) were statistically indistinguishable from zero (Δδ18O t = -0.751, p = 0.45; Δδ2H t = 1.133, p = 0.26). Here we show that community level variation exists in the δ18Obw and δ2Hbw values and the primary drivers are the regional differences in drinking water isotopes. Consistency of the body water isotope composition over the study period suggests that tissues would incorporate a stable isotope signal over time. The amount of drinking water and physical activity influence body water values, while the variation in the isotopic values of food may contribute to regional level variability, but that still remains to be assessed further. The human body water model provides accurate estimates for measured values, capturing and reproducing the main features of the body water isotope variation across space.
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Affiliation(s)
- Luciano O Valenzuela
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Laboratorio de Ecología Evolutiva Humana (LEEH), Unidad de Enseñanza Universitaria Quequén, Facultad de Ciencias Sociales, Universidad Nacional del Centro de la Provincia de Buenos Aires (UNCPBA), Argentina; School of Biological Sciences, University of Utah, USA.
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Tian N, Yang X, Guo Q, Zhou Q, Yi C, Lin J, Cao P, Ye H, Chen M, Yu X. Bioimpedance Guided Fluid Management in Peritoneal Dialysis: A Randomized Controlled Trial. Clin J Am Soc Nephrol 2021; 15:685-694. [PMID: 32349977 PMCID: PMC7269207 DOI: 10.2215/cjn.06480619] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2019] [Accepted: 03/26/2020] [Indexed: 01/20/2023]
Abstract
BACKGROUND AND OBJECTIVES Bioelectrical impedance analysis (BIA) devices can help assess volume overload in patients receiving maintenance peritoneal dialysis. However, the effects of BIA on the short-term hard end points of peritoneal dialysis lack consistency. This study aimed to test whether BIA-guided fluid management could improve short-term outcomes in patients on peritoneal dialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS A single-center, open-labeled, randomized, controlled trial was conducted. Patients on prevalent peritoneal dialysis with volume overload were recruited from July 1, 2013 to March 30, 2014 and followed for 1 year in the initial protocol. All participants with volume overload were 1:1 randomized to the BIA-guided arm (BIA and traditional clinical methods) and control arm (only traditional clinical methods). The primary end point was all-cause mortality and secondary end points were cardiovascular disease mortality and technique survival. RESULTS A total of 240 patients (mean age, 49 years; men, 51%; diabetic, 21%, 120 per group) were enrolled. After 1-year follow-up, 11(5%) patients died (three in BIA versus eight in control) and 21 patients were permanently transferred to hemodialysis (eight in BIA versus 13 in control). The rate of extracellular water/total body water decline in the BIA group was significantly higher than that in the control group. The 1-year patient survival rates were 96% and 92% in BIA and control groups, respectively. No significant statistical differences were found between patients randomized to the BIA-guided or control arm in terms of patient survival, cardiovascular disease mortality, and technique survival (P>0.05). CONCLUSIONS Although BIA-guided fluid management improved the fluid overload status better than the traditional clinical method, no significant effect was found on 1-year patient survival and technique survival in patients on peritoneal dialysis.
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Affiliation(s)
- Na Tian
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China.,Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Xiao Yang
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
| | - Qunying Guo
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
| | - Qian Zhou
- Department of Medical Statistics, Clinical Trials Unit, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Chunyan Yi
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
| | - Jianxiong Lin
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
| | - Peiyi Cao
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
| | - Hongjian Ye
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China.,Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China
| | - Menghua Chen
- Department of Nephrology, General Hospital of Ningxia Medical University, Yinchuan, Ningxia, China
| | - Xueqing Yu
- Department of Nephrology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, China .,Key Laboratory of Nephrology, National Health Commission and Guangdong Province, Guangzhou, Guangdong, China.,Department of Nephrology, Guangdong Provincial People's Hospital, Guangzhou, Guangdong, China
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