Seasonal variation in hydration status among community‐dwelling elderly in Japan

Tanaka, Sho; Fujishiro, Midori; Watanabe, Kentaro; Imatake, Kazuhiro; Suzuki, Yasuyuki; Abe, Masanori; Ishihara, Hideharu; Tani, Shigemasa

doi:10.1111/ggi.14010

Cited by 10 publications

(6 citation statements)

References 22 publications

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“…Several cardiovascular risk factors, including blood pressure, lipids, and glucose [8,37], exhibit to a varying degree a seasonal pattern with a peak during winter. Given the physiological effects of VP, increased concentration during winter is concordant with previous observations of an increase in urine concentration [38], elevated plasma glucose and triglycerides [8,37], elevated blood pressure [8], increased hemostasis [9], and elevated cortisol [2] during winter. Lowered VP secretion in winter might thus affect several of these pathways and potentially result in a relevant reduction of incident cardiometabolic disease.…”

Section: Discussionsupporting

confidence: 89%

“…Previous epidemiological studies have found increased water intake during the warm season [40, 41]. Another study found serum osmolality among elderly to be higher during the spring, and urine to be more concentrated during the winter and the spring, than during the summer and autumn [38], further pointing at a less hydrated state, and thus elevated VP concentration, during the cold season.…”

Section: Discussionmentioning

confidence: 96%

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Seasonal variation of vasopressin and its relevance for the winter peak of cardiometabolic disease: A pooled analysis of five cohorts

et al. 2022

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Background Vasopressin concentration is typically higher at night, during stress, and in males, but readily lowered by water intake. Vasopressin is also a causal candidate for cardiometabolic disease, which shows seasonal variation. Objective To study whether vasopressin concentration varies by season in a temperate climate. Methods The vasopressin surrogate marker copeptin was analyzed in fasting plasma samples from five population‐based cohorts in Malmö, Sweden (n = 25,907, 50.4% women, age 18–86 years). We investigated seasonal variation of copeptin concentration and adjusted for confounders in sinusoidal models. Results The predicted median copeptin level was 5.81 pmol/L (7.18 pmol/L for men and 4.44 pmol/L for women). Copeptin exhibited a distinct seasonal pattern with a peak in winter (mid‐February to mid‐March) and nadir in late summer (mid‐August to mid‐September). The adjusted absolute seasonal variation in median copeptin was 0.62 pmol/L (95% confidence interval [CI] 0.50; 0.74, 0.98 pmol/L [95% CI 0.73; 1.23] for men and 0.46 pmol/L [95% CI 0.33; 0.59] for women). The adjusted relative seasonal variation in mean log copeptin z‐score was 0.20 (95% CI 0.17; 0.24, 0.18 [95% CI 0.14; 0.23] in men and 0.24 [95% CI 0.19; 0.29] in women). The observed seasonal variation of copeptin corresponded to a risk increase of 4% for incident diabetes mellitus and 2% for incident coronary artery disease. Conclusion The seasonal variation of the vasopressin marker copeptin corresponds to increased disease risk and mirrors the known variation in cardiometabolic status across the year. Moderately increased water intake might mitigate the winter peak of cardiometabolic disease.

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 96%

Seasonal variation of vasopressin and its relevance for the winter peak of cardiometabolic disease: A pooled analysis of five cohorts

et al. 2022

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“…The incidence of hyponatremia however was similar (7.5% in heatwave group, 8.9% in control group). Tanaka et al analyzed serum and urine biochemistry of community‐dwelling adults above 65 years undergoing a routine health check‐up in one hospital in Japan 29 . There was no significant seasonal association with serum sodium concentrations taken after an overnight fast.…”

Section: Resultsmentioning

confidence: 99%

Dysnatremia in a changing climate: A global systematic review of the association between serum sodium and ambient temperature

Wootton,

Grossmann,

Warren

2024

Clinical Endocrinology

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ObjectiveBoth hyponatremia and hypernatremia have been reported to occur more frequently with higher ambient temperatures, although the underlying mechanisms are not well understood. Global temperatures are rising due to climate change, which may impact the incidence of dysnatremia worldwide. We aimed to identify, collate and critically appraise studies analyzing the relationship between climate measures (outdoor temperature, humidity) and serum sodium concentrations.DesignSystematic review, reported in accordance with PRISMA guidelines.MethodsMEDLINE and Embase were searched with relevant key terms. Studies assessing the effect on serum sodium measurement of elevated temperature or humidity versus a comparator were included.ResultsOf 1466 potentially relevant studies, 34 met inclusion criteria, originating from 23 countries spanning all inhabited continents. The majority (30 of 34, 88%) reported a significant association between outdoor temperature and dysnatremia, predominantly lower serum sodium with increased ambient temperature. Humidity had a less consistent effect. Individuals aged above 65 years, children, those taking diuretics and antidepressants, those with chronic renal impairment or those undertaking physical exertion had increased vulnerability to heat‐associated dysnatremia. The risk of bias was assessed to be high in all but four studies.ConclusionsHigher ambient temperature is consistently associated with an increased incidence of hyponatremia. We infer that hyponatremia presentations are likely to rise with increasing global temperatures and the frequency of extreme heat events secondary to climate change. Evidence‐based public health messages, clinician education and reduction in fossil fuel consumption are necessary to reduce the expected burden on healthcare services worldwide.

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“…Participants’ selection was performed as in our previous work. 5 Community-dwelling adults who had undergone an annual health checkup at Nihon University Hospital (Tokyo, Japan) between January 2019 and December 2019 were potentially eligible. The exclusion criteria were as follows: (1) aged <65 years, (2) unmeasured serum sodium level, and (3) severely reduced kidney function: estimated glomerular filtration rate (eGFR) <30 mL/min/1.73 m 2 .…”

Section: Methodsmentioning

confidence: 99%

“… 4 Previously, we found that most community-dwelling older individuals had a plasma osmolality of ≥300 mOsm/L in the early morning after an overnight fast, suggesting water-loss dehydration. 5 Therefore, we presumed that hypernatremia among community-dwelling older individuals in Japan may be overlooked.…”

Section: Introductionmentioning

confidence: 99%

Impact of Female Sex on the Susceptibility to Hypernatremia Among Older Community-Dwelling Individuals in Japan

Tanaka¹,

Fujishiro²,

Imatake³

et al. 2022

IJGM

Self Cite

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Purpose Older individuals are at high risk for hypernatremia. However, actual data on serum sodium levels and differences between the sexes remain unclear in the older Japanese population. This study aimed to describe the data regarding serum sodium level and hypernatremia prevalence and to investigate whether female sex is associated with an increased risk of hypernatremia. Patients and Methods We retrospectively analyzed the data of adults aged ≥65 years without severely reduced kidney function who underwent an annual health checkup in 2019. Serum sodium levels were investigated as the outcome and corrected for glucose, if necessary. Clinical characteristics were compared between women and men. Results In the 903 participants consisting of 273 women and 630 men who were enrolled in this study, the overall prevalence of hypernatremia, defined as a serum sodium level ≥145 mmol/L, was 12.5%. Female participants showed significantly more frequent hypernatremia than male participants (17.6% vs 10.3%, p = 0.003) and higher serum sodium levels (median [interquartile range]; 143.0 [142.0, 144.0] vs 142.4 [141.5, 144.0], p <0.001). Serum creatinine (sCr), but not estimated glomerular filtration rate (eGFR), was correlated with serum sodium levels ( r s = −0.108, p = 0.001). In the binary logistic regression analysis, female sex was significantly associated with hypernatremia (odds ratio, 1.89; 95% confidence interval, 1.23–2.89; p = 0.004) even after adjusting for age, alcohol use, antihypertensive agent use, body mass index, and winter season. The association between female sex was reduced and no longer significant after adjusting for sCr, although the association remained unchanged after adjustment for eGFR. Conclusion One-eighth of the older community dwellers in Japan exhibits hypernatremia after an overnight fast, and female sex is a significant risk factor. Since sCr is a surrogate of muscle mass, smaller muscle mass possibly mediates the association between female sex and hypernatremia.

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Seasonal variation in hydration status among community‐dwelling elderly in Japan

Cited by 10 publications

References 22 publications

Seasonal variation of vasopressin and its relevance for the winter peak of cardiometabolic disease: A pooled analysis of five cohorts

Seasonal variation of vasopressin and its relevance for the winter peak of cardiometabolic disease: A pooled analysis of five cohorts

Dysnatremia in a changing climate: A global systematic review of the association between serum sodium and ambient temperature

Impact of Female Sex on the Susceptibility to Hypernatremia Among Older Community-Dwelling Individuals in Japan

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