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Novel perspectives of sodium handling in type 2 diabetes mellitus

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Hanson, Petra, Arkill, K. P., Merry, C. L. R., Hussain , M. S., Meersmann, T., Randeva, Harpal S., Pavlovskaya, G. E., O'Hare, Paul J. and Barber, Thomas M. (2022) Novel perspectives of sodium handling in type 2 diabetes mellitus. Expert Review of Endocrinology and Metabolism, 17 (4). pp. 333-341. doi:10.1080/17446651.2022.2092094 ISSN 1744-6651. [ 🗎 Public]. [ (✓) hoa:511 ]

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Official URL: https://doi.org/10.1080/17446651.2022.2092094

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Abstract

Introduction
As a key regulator of body water, sodium homeostasis forms an essential component of human physiology. Type 2 Diabetes Mellitus (T2D)-associated sodium overload stems from chronic renal retention of sodium, contributing toward the development of adverse cardiovascular sequelae.

Areas covered
Our traditional model of sodium regulation invokes two compartments: extracellular fluid (ECF [plasma and interstitial fluid]) and intracellular fluid (ICF). Data from the Mars program reveal inconsistencies with this two-space model, including mismatches between net body sodium and water. Recent data utilizing 23Na magnetic resonance imaging (MRI) show a preponderance of bound sodium within human dermis, consistent with a third space repository and providing compelling evidence to support a three-space model in which dermal sodium binding facilitates sodium homeostasis within the ECF and ICF. This buffer is impaired in T2D, with diminishment of dermal bound sodium that may promote deleterious sequelae of sodium overload within the ECF and ICF.

Expert opinion
Future studies should focus on novel therapeutic opportunities for sodium regulation in T2D and other conditions of sodium dysregulation. The ratio of free:bound dermal sodium (reflecting sodium storage capacity) could be utilized as a clinical biomarker for salt and water balance, to improve diagnostic accuracy and facilitate clinical decision-making.

Item Type: Journal Article
Subjects: Q Science > QM Human anatomy
Q Science > QP Physiology
R Medicine > RA Public aspects of medicine
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Biomedical Sciences > Translational & Experimental Medicine > Metabolic and Vascular Health (- until July 2016)
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH): Homeostasis, Sodium -- Physiological transport, Drinking water -- Sodium content, Diabetes , Diabetes -- Treatment, Dermis , Glycosaminoglycans
Journal or Publication Title: Expert Review of Endocrinology and Metabolism
Publisher: Taylor & Francis
ISSN: 1744-6651
Official Date: 21 June 2022
Dates:
DateEvent
21 June 2022Available
16 June 2022Accepted
Volume: 17
Number: 4
Page Range: pp. 333-341
DOI: 10.1080/17446651.2022.2092094
Status: Peer Reviewed
Publication Status: Published
Access rights to Published version: Open Access (Creative Commons)
Date of first compliant deposit: 11 August 2022
Date of first compliant Open Access: 11 August 2022
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