Increased extracellular water measured by bioimpedance analysis and increased serum levels of atrial natriuretic peptide in polymyalgia rheumatica patients : Signs of volume overload.
Z Rheumatol
; 80(2): 140-148, 2021 Mar.
Article
en En
| MEDLINE
| ID: mdl-32761369
ABSTRACT
BACKGROUND:
Water retention is a typical feature of acute inflammatory episodes, chiefly implemented by the sympathetic nervous system (SNS) and the hypothalamic-pituitary-adrenal (HPA) axis. This is an important compensatory mechanism counteracting expected water loss, e.g., due to sweating. Both the SNS and HPA axis are activated in polymyalgia rheumatica (PMR). As retention mechanisms may similarly apply in this disease, we hypothesized increased water retention in PMR.METHODS:
Using bioimpedance analysis body composition was investigated in 64 healthy controls and 32 treatment-naive PMR patients. All PMR patients satisfied the 2012 EULAR/ACR classification criteria for PMR. 32 PMR patients were tested before and after 7 days of glucocorticoid-based therapy. Serum levels of pro-atrial natriuretic peptide (proANP) were investigated in all PMR patients and 15 healthy controls.RESULTS:
Extracellular water (ECW) was markedly higher in PMR patients than in controls (mean⯱ SD 49.1⯱ 6.0% versus 36.3⯱ 2.5% of total body water, pâ¯< 0.001). Patients with PMR demonstrated significantly higher serum levels of proANP compared to controls. Even before glucocorticoid treatment was initiated, systolic and diastolic blood pressure were higher in PMR patients compared to controls. Extracellular water levels did not change in PMR patients upon 7 days of intensified treatment.CONCLUSION:
This study demonstrated increased extracellular water and elevated serum levels of proANP as signs of fluid overload in patients with PMR. Volume changes are imprinted as long-lasting mechanisms as water distribution is not affected by short-term anti-inflammatory therapy.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Polimialgia Reumática
Tipo de estudio:
Diagnostic_studies
Límite:
Humans
Idioma:
En
Revista:
Z Rheumatol
Año:
2021
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
ALEMANHA
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ALEMANIA
/
DE
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DEUSTCHLAND
/
GERMANY