J D Adams1, Giannis Arnaoutis2, Evan C Johnson3, Lisa T Jansen4,5, Dimitris Bougatsas2, Catalina Capitan-Jimenez6, Andy Mauromoustakos7, Demosthenes B Panagiotakos2, Erica T Perrier8, Isabelle Guelinckx8, Stavros A Kavouras9. 1. Department of Health and Human Performance, College of Charleston, Charleston, SC, USA. 2. Department of Nutrition and Dietetics, Harokopio University, Athens, Greece. 3. Human Integrated Physiology Laboratory, University of Wyoming, Laramie, WY, USA. 4. New Balance Foundation Obesity Prevention Center, Division of Endocrinology, Boston Children's Hospital, Boston, MA, USA. 5. Harvard Medical School, Boston, MA, USA. 6. Department of Nutrition, Universidad Hispanoamericana, San Jose, Costa Rica. 7. Agricultural Statistics Lab, University of Arkansas, Fayetteville, AR, USA. 8. Health, Hydration and Nutrition Science, Danone Research, Palaiseau, France. 9. Hydration Science Lab, College of Health Solutions, Arizona State University, Phoenix, AZ, USA. stavros.kavouras@asu.edu.
Abstract
BACKGROUND/ OBJECTIVES: To test the diagnostic ability of two combined practical markers for elevated urine osmolality (underhydration) in free-living adults and children. SUBJECTS/ METHODS: One hundred and one healthy adults (females n = 52, 40 ± 14 y, 1.70 ± 0.95 m, 76.7 ± 17.4 kg, 26.5 ± 5.5 kg/m2) and 210 children (females = 105, 1.49 ± 0.13 m, 43.4 ± 12.6 kg, 19.2 ± 3.2 kg m-2) collected urine for 24-h. Urine was analyzed for urine osmolality (UOsm), color (UC), while the number of voids (void) was also recorded. Receiver Operating Characteristic (ROC) analysis was performed for UC, void, and combination of UC and void, to determine markers' diagnostic ability for detecting underhydration based on elevated UOsm (UOsm ≥ 800 mmol kg-1). RESULTS: Linear regression analysis revealed that UC was significantly associated with UOsm in both adults (R2 = 0.38; P < 0.001) and children (R2 = 0.45; P < 0.001). Void was significantly associated with UOsm in both adults (R2 = 0.13; P < 0.001) and children (R2 = 0.15; P < 0.001). In adults, when UC > 3 and void <7 were combined, the overall diagnostic ability for underhydration was 97% with sensitivity and specificity of 100% and 88%, respectively. In children, UC > 3 and void <5 had an overall diagnostic ability for underhydration of 89% with sensitivity and specificity of 100% and 62%, respectively. CONCLUSIONS: Urine color alone and the combination of urine color with void number can a valid and simple field-measure to detect underhydration based on elevated urine osmolality.
BACKGROUND/ OBJECTIVES: To test the diagnostic ability of two combined practical markers for elevated urine osmolality (underhydration) in free-living adults and children. SUBJECTS/ METHODS: One hundred and one healthy adults (females n = 52, 40 ± 14 y, 1.70 ± 0.95 m, 76.7 ± 17.4 kg, 26.5 ± 5.5 kg/m2) and 210 children (females = 105, 1.49 ± 0.13 m, 43.4 ± 12.6 kg, 19.2 ± 3.2 kg m-2) collected urine for 24-h. Urine was analyzed for urine osmolality (UOsm), color (UC), while the number of voids (void) was also recorded. Receiver Operating Characteristic (ROC) analysis was performed for UC, void, and combination of UC and void, to determine markers' diagnostic ability for detecting underhydration based on elevated UOsm (UOsm ≥ 800 mmol kg-1). RESULTS: Linear regression analysis revealed that UC was significantly associated with UOsm in both adults (R2 = 0.38; P < 0.001) and children (R2 = 0.45; P < 0.001). Void was significantly associated with UOsm in both adults (R2 = 0.13; P < 0.001) and children (R2 = 0.15; P < 0.001). In adults, when UC > 3 and void <7 were combined, the overall diagnostic ability for underhydration was 97% with sensitivity and specificity of 100% and 88%, respectively. In children, UC > 3 and void <5 had an overall diagnostic ability for underhydration of 89% with sensitivity and specificity of 100% and 62%, respectively. CONCLUSIONS: Urine color alone and the combination of urine color with void number can a valid and simple field-measure to detect underhydration based on elevated urine osmolality.
Authors: Floris C Wardenaar; Daniel Thompsett; Kaila A Vento; Kathryn Pesek; Dean Bacalzo Journal: Int J Environ Res Public Health Date: 2021-04-13 Impact factor: 3.390