Body Water and Sodium in Patients With Acromegaly 1

Abstract

The acromegalic state often is accompanied by an enlargement of the soft tissues of the body. The purpose of the present work was to determine whether these tissue changes are accompanied by changes in the content and distribution of water and electrolytes in the body. In this connection the administration of growth hormone was shown to induce an increase in the total body water of normal (1-4) and hypophysectomized (5) rats, and of normal dogs and cats (3). Similarly, growth hormone caused a retention of sodium and potassium in normal (6) and diabetic (7) rats, and a retention of sodium, potassium, and chloride in adrenalectomized rats (8). The thiocyanate space in normal and hypophysectomized rats (9) and the plasma volume in dogs (10) increased after injection of growth hormone.The present paper gives the results of measurements of the total body water, the extracellular water and the exchangeable sodium in 18 acromegalic patients. MATERIAL AND METHODSTotal body water was calculated from the volume of distribution of antipyrine (11). Total exchangeable sodium was calculated from the apparent volume of distribution of the radioactive sodium isotope Na' (12). The extracellular water was calculated from the volumes of distribution of inulin (13) Radioactive sodium, Nan, was injected intravenously, immediately after the determination of the extracellular water was completed. Urine was collected for the following 18 hours, and blood samples were taken at the end of the urine collection period.Antipyrine in plasma was analyzed according to Brodie, Axelrod, Soberman, and Levy (15). In our hands the time necessary for the completion of the reaction between antipyrine and sodium nitrite was different from day to day. Repeated readings, therefore, were taken every five to ten minutes after the addition of sodium nitrite. The maximal extinctions obtained were plotted on a semilogarithmic paper, and the extinction at zero time was obtained by extrapolation. The volume of distribution of antipyrine was calculated by dividing the given amount of antipyrine by its zero time plasma concentration.The inulin in plasma was analyzed by Roe's resorcinol method, as modified by Schreiner (16). The inulin space was obtained by dividing the total amount of inulin excreted after discontinuation of the infusion by the inulin concentration in plasma at equilibrium. The thiosulfate in plasma was analyzed by the indirect iodometricmacromethod of Newman, Gilman, and Philips (17). The thiosulfate concentration at zero time was obtained by extrapolation, and the volume of distribution calculated from this value and the amount of thiosulfate given.The concentration of'sodium in plasma was measured by a Beckman flame photometer.The conversion of the antipyrine, inulin, and thiosulfate spaces to total body water and extracellular water, respectively, was made by multiplying the values obtained by 0.93. The concentration of sodium in plasma water was calculated from the corresponding value in plasma, using the same figure, 0.93. The plasma wate...

Mild pituitary phenotype in 3- and 12-month-old Aip-deficient male mice

“…We found that Aip +/− mice exhibit a slightly enhanced total body weight at 3 and 7 months but not at 12 months of age. The increased lean mass of Aip +/− mice could be related to body fluid retention (Ikkos et al 1954, O'Sullivan et al 1994, Kamenický et al 2014), but we did not determine total body water. Fat mass increased with age in both Aip +/− and WT mice but to a lesser extent in the mutants, possibly explaining the similar total body weights of 12-month-old mutant and WT mice.…”

“…GH plays an important role in the regulation of body composition, promoting a lean phenotype by increasing lipolysis in WAT and enhancing protein synthesis in muscle (Møller & Jørgensen 2009). In humans, acromegaly leads to an increase in body water and lean body mass (Ikkos et al 1954, O'Sullivan et al 1994, Kamenický et al 2014, associated with a reduction in body fat (Freda et al 2008, Katznelson 2009. Similarly, giant bovine-GH transgenic mice (bGH) exhibit a lower body fat percentage, smaller WAT deposits and lower serum leptin levels (Berryman et al 2004, Benencia et al 2014.…”

Clinical evidence of growth hormone for patients undergoing abdominal surgery: Meta-analysis of randomized controlled trials

“…The sodium and fluid retaining impact of GH was demonstrated in humans almost 50 years ago by Ikkos et al [49] . Underlying mechanisms of GH-induced fluid retention are as follows.…”

GH Secretion in Open-Angle Glaucoma

“…This second hypothesis seems to us more plausible considering that in acromegaly a progressive overgrowth of connective tissue occurs throughout the body [13]. Nevertheless, the hypothesis that an increase in ocular pressure may be facilitated by excessive production of aque ous humor or by the accumulation of intra ocular fluid cannot be dismissed since ex perimentally HGH has been shown to be apt to increase total body water [18], Like wise, in acromegaly an increase in total body water and extracellular water has been ob served as well as an increase in exchange able sodium [14].…”