Extra cellular water and increase in capillary permeability to albumin in overweight women with swelling syndrome

OBJECTIVE: To evaluate extracellular water (ECW) in the recumbent and the u pright position, in overweight and lean women with swelling syndrome, and t o correlate the excess in ECW with an increase in capillary filtration of a lbumin (CFA). PATIENTS: Fifty-one women with a swelling syndrome were investigated, 26 of whom were overweight. MEASUREMENTS: ECW was measured by the bioelectrical impedance method, in th e recumbent position and again after a postural test which consisted of wal king around for 30 min. CFA was studied by an isotopic test using 99m techn etium-labelled albumin. RESULTS: ECW increased (>107% of the theoretical value) in 22 of the 26 ove rweight patients and 23 of the 25 lean patients. The CFA isotopic test was abnormal in half ((11/22) of the overweight patients with increased ECW and in three of the four overweight patients with a normal ECW value. It: was abnormal in 18 of the 23 lean patients with increased ECW and in the two le an patients with a normal ECW value. During the postural test, a significan t (by greater than or equal to 4%) increase in ECW occurred in a higher pro portion of overweight patients tested (14/22) than among the lean women tes ted (0/5; P = 0.04). CONCLUSIONS: The swelling syndrome is indeed related to an increase in ECW in lean and overweight subjects and to a further increase in ECW after a po stural test only in the overweight patients, it is also associated with mic rocirculatory disorders in most Of the lean patients who complain of swelli ng and in only half of the overweight patients with the same complaints, wh ich suggests that other factors (e.g. hormonal disorders) may be involved i n the overweight patients.