Hypoxia briefly increases diuresis but reduces plasma volume by fluid redistribution in women
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Hypoxia briefly increases diuresis but reduces plasma volume by fluid redistribution in women. / Roche, Johanna; Rasmussen, Peter; Gatterer, Hannes; Roveri, Giulia; Turner, Rachel; van Hall, Gerrit; Maillard, Marc; Walzl, Anna; Kob, Michael; Strapazzon, Giacomo; Goetze, Jens Peter; Schäfer, Simon Thomas; Kammerer, Tobias; Nader, Elie; Connes, Philippe; Robert, Mélanie; Mueller, Thomas; Feraille, Eric; Siebenmann, Christoph.
I: American journal of physiology. Heart and circulatory physiology, Bind 323, Nr. 6, 2022, s. H1068-H1079.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Hypoxia briefly increases diuresis but reduces plasma volume by fluid redistribution in women
AU - Roche, Johanna
AU - Rasmussen, Peter
AU - Gatterer, Hannes
AU - Roveri, Giulia
AU - Turner, Rachel
AU - van Hall, Gerrit
AU - Maillard, Marc
AU - Walzl, Anna
AU - Kob, Michael
AU - Strapazzon, Giacomo
AU - Goetze, Jens Peter
AU - Schäfer, Simon Thomas
AU - Kammerer, Tobias
AU - Nader, Elie
AU - Connes, Philippe
AU - Robert, Mélanie
AU - Mueller, Thomas
AU - Feraille, Eric
AU - Siebenmann, Christoph
PY - 2022
Y1 - 2022
N2 - We have recently reported that hypobaric hypoxia (HH) reduces plasma volume (PV) in men by decreasing total circulating plasma protein (TCPP). Here, we investigated whether this applies to women and whether an inflammatory response and/or endothelial glycocalyx shedding could facilitate the TCCP reduction. We further investigated whether acute HH induces a short-lived diuretic response that was overlooked in our recent study, where only 24-h urine volumes were evaluated. In a strictly controlled crossover protocol, 12 women underwent two 4-day sojourns in a hypobaric chamber: one in normoxia (NX) and one in HH equivalent to 3,500-m altitude. PV, urine output, TCPP, and markers for inflammation and glycocalyx shedding were repeatedly measured. Total body water (TBW) was determined pre- and postsojourns by deuterium dilution. PV was reduced after 12 h of HH and thereafter remained 230-330 mL lower than in NX (P < 0.0001). Urine flow was 45% higher in HH than in NX throughout the first 6 h (P = 0.01) but lower during the second half of the first day (P < 0.001). Twenty-four-hour urine volumes (P ≥ 0.37) and TBW (P ≥ 0.14) were not different between the sojourns. TCPP was lower in HH than in NX at the same time points as PV (P < 0.001), but inflammatory or glycocalyx shedding markers were not consistently increased. As in men, and despite initially increased diuresis, HH-induced PV contraction in women is driven by a loss of TCPP and ensuing fluid redistribution, rather than by fluid loss. The mechanism underlying the TCPP reduction remains unclear but does not seem to involve inflammation or glycocalyx shedding.NEW & NOTEWORTHY This study is the first to investigate the mechanisms underlying plasma volume (PV) contraction in response to hypoxia in women while strictly controlling for confounders. PV contraction in women has a similar time course and magnitude as in men and is driven by the same mechanism, namely, oncotically driven redistribution rather than loss of fluid. We further report that hypoxia facilitates an increase in diuresis, that is, however, short-lived and of little relevance for PV regulation.
AB - We have recently reported that hypobaric hypoxia (HH) reduces plasma volume (PV) in men by decreasing total circulating plasma protein (TCPP). Here, we investigated whether this applies to women and whether an inflammatory response and/or endothelial glycocalyx shedding could facilitate the TCCP reduction. We further investigated whether acute HH induces a short-lived diuretic response that was overlooked in our recent study, where only 24-h urine volumes were evaluated. In a strictly controlled crossover protocol, 12 women underwent two 4-day sojourns in a hypobaric chamber: one in normoxia (NX) and one in HH equivalent to 3,500-m altitude. PV, urine output, TCPP, and markers for inflammation and glycocalyx shedding were repeatedly measured. Total body water (TBW) was determined pre- and postsojourns by deuterium dilution. PV was reduced after 12 h of HH and thereafter remained 230-330 mL lower than in NX (P < 0.0001). Urine flow was 45% higher in HH than in NX throughout the first 6 h (P = 0.01) but lower during the second half of the first day (P < 0.001). Twenty-four-hour urine volumes (P ≥ 0.37) and TBW (P ≥ 0.14) were not different between the sojourns. TCPP was lower in HH than in NX at the same time points as PV (P < 0.001), but inflammatory or glycocalyx shedding markers were not consistently increased. As in men, and despite initially increased diuresis, HH-induced PV contraction in women is driven by a loss of TCPP and ensuing fluid redistribution, rather than by fluid loss. The mechanism underlying the TCPP reduction remains unclear but does not seem to involve inflammation or glycocalyx shedding.NEW & NOTEWORTHY This study is the first to investigate the mechanisms underlying plasma volume (PV) contraction in response to hypoxia in women while strictly controlling for confounders. PV contraction in women has a similar time course and magnitude as in men and is driven by the same mechanism, namely, oncotically driven redistribution rather than loss of fluid. We further report that hypoxia facilitates an increase in diuresis, that is, however, short-lived and of little relevance for PV regulation.
KW - acclimatization
KW - altitude
KW - female
KW - inflammation
KW - total body water
UR - http://www.scopus.com/inward/record.url?scp=85142400572&partnerID=8YFLogxK
U2 - 10.1152/ajpheart.00394.2022
DO - 10.1152/ajpheart.00394.2022
M3 - Journal article
C2 - 36269645
AN - SCOPUS:85142400572
VL - 323
SP - H1068-H1079
JO - American Journal of Physiology: Heart and Circulatory Physiology
JF - American Journal of Physiology: Heart and Circulatory Physiology
SN - 0363-6135
IS - 6
ER -
ID: 327930198