Korean J Fam Pract. 2018; 8(5): 747-751  https://doi.org/10.21215/kjfp.2018.8.5.747
The Association between Urine Specific Gravity and Obesity in Men in Korea: The Fifth Korean National Health and Nutrition Examination Survey in 2010-2012
Jeong-Im Ha1, Ji-Hyun Kim1, Jae-Min Park2,*, Kyoung Jin Kim1, Eun-Jung Oh1, Jae-Kyung Choi1, Hyuk-Jung Kweon1, Dong-Yung Cho1
1Department of Family Medicine, Konkuk University Medical Center, Konkuk University School of Medicine; 2Department of Family Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Jae-Min Park
Tel: +82-2-2030-7822, Fax: +82-2-2030-7748
E-mail: milkcandy82@naver.com
ORCID: http://orcid.org/0000-0001-8873-8832
Received: July 12, 2017; Revised: August 10, 2017; Accepted: August 20, 2017; Published online: October 20, 2018.
© The Korean Academy of Family Medicine. All rights reserved.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: As the prevalence of obesity is increasing worldwide, improving hydration status as a strategy to overcome weight-related problems is attracting attention. However, the relationship between hydration status and obesity remains uncertain. We aimed to investigate the association between inadequate hydration and obesity among men in Korea using urine specific gravity as a hydration marker.
Methods: In this study, we used data acquired from the Korean National Health and Nutrition Examination Survey, which was conducted during 2010–2012, and included men aged 20–59 years. The primary outcome of interest was body mass index, which is measured in continuous values and categorized as either obese (body mass index ≥25 kg/m2) or normal (body mass index <25 kg/m2). Individuals with urine-specific gravity values of ≥1.020 were considered inadequately hydrated. Linear and logistic regression analyses were performed with continuous body mass index and obesity status as the outcomes, respectively. Models were adjusted for known confounders, including age, regular exercise status, current smoking status, habitual coffee consumption, and regular alcohol intake.
Results: In this nationally representative sample (n=4,404), 48.02% of participants were inadequately hydrated. Individuals with inadequate hydration had a higher body mass index (P=0.048) than those who were adequately hydrated. After adjustment for potential confounding variables, the odds ratio (95% confidence interval) of the inadequate hydration group for obesity was 1.05 (0.84–1.32).
Conclusion: Inadequate hydration is positively associated with a higher body mass index but not with obesity.
Keywords: Inadequate Hydration; Body Mass Index; Obesity; Urine Specific Gravity
References
  1. Babor TF, Higgins-Biddle JC, Saunders JB, Monteiro MG. The alcohol use disorders identification test: guidelines for use in primary health care. Geneva:World Health Organization; 2001.
  2. Haslam DW, James WP. Obesity. Lancet 2005; 366: 1197-209.
    CrossRef
  3. Muckelbauer R, Sarganas G, Grüneis A, Müller-Nordhorn J. Association between water consumption and body weight outcomes: a systematic review. Am J Clin Nutr 2013; 98: 282-99.
    Pubmed CrossRef
  4. Dennis EA, Flack KD, Davy BM. Beverage consumption and adult weight management: a review. Eat Behav 2009; 10: 237-46.
    Pubmed KoreaMed CrossRef
  5. Parretti HM, Aveyard P, Blannin A, Clifford SJ, Coleman SJ, Roalfe A, et al. Efficacy of water preloading before main meals as a strategy for weight loss in primary care patients with obesity: RCT. Obesity (Silver Spring) 2015; 23:1785-91.
    Pubmed CrossRef
  6. Chang T, Ravi N, Plegue MA, Sonneville KR, Davis MM. Inadequate hydration, BMI, and obesity among US adults: NHANES 2009-2012. Ann Fam Med 2016; 14: 320-4.
    Pubmed KoreaMed CrossRef
  7. Baron S, Courbebaisse M, Lepicard EM, Friedlander G. Assessment of hydration status in a large population. Br J Nutr 2015; 113: 147-58.
    Pubmed CrossRef
  8. Shirreffs SM. Markers of hydration status. Eur J Clin Nutr 2003; 57 Suppl 2:S6-9.
    Pubmed CrossRef
  9. Hamouti N, Del Coso J, Avila A, Mora-Rodriguez R. Effects of athletes’ muscle mass on urinary markers of hydration status. Eur J Appl Physiol 2010; 109: 213-9.
    Pubmed CrossRef
  10. Hamouti N, Del Coso J, Mora-Rodriguez R. Comparison between blood and urinary fluid balance indices during dehydrating exercise and the subsequent hypohydration when fluid is not restored. Eur J Appl Physiol 2013;113: 611-20.
    Pubmed CrossRef
  11. Madero M, Sarnak MJ. Creatinine-based formulae for estimating glomerular filtration rate: is it time to change to chronic kidney disease epidemiology collaboration equation? Curr Opin Nephrol Hypertens 2011; 20: 622-30.
    Pubmed CrossRef
  12. WHO, IASO, IOTF. The Asia-Pacific perspective: redefining obesity and its treatment. Melbourne: Health Communications Australia; 2000.
  13. Rowat A, Smith L, Graham C, Lyle D, Horsburgh D, Dennis M. A pilot study to assess if urine specific gravity and urine colour charts are useful indicators of dehydration in acute stroke patients. J Adv Nurs 2011; 67: 1976-83.
    Pubmed CrossRef
  14. Fernández-Elías VE, Martínez-Abellán A, López-Gullón JM, Morán-Navarro R, Pallarés JG, De la Cruz-Sánchez E, et al. Validity of hydration noninvasive indices during the weightcutting and official weigh-in for Olympic combat sports. PLoS One 2014; 9: e95336.
    Pubmed KoreaMed CrossRef
  15. Chun MY. Validity and reliability of Korean version of international physical activity questionnaire short form in the elderly. Korean J Fam Med 2012;33: 144-51.
    Pubmed KoreaMed CrossRef
  16. Kenney EL, Long MW, Cradock AL, Gortmaker SL. Prevalence of inadequate hydration among US children and disparities by gender and race/ethnicity:National Health and Nutrition Examination Survey, 2009-2012. Am J Public Health 2015; 105: e113-8.
    Pubmed KoreaMed CrossRef
  17. Manz F, Wentz A. 24-h hydration status: parameters, epidemiology and recommendations. Eur J Clin Nutr 2003; 57 Suppl 2: S10-8.
    Pubmed CrossRef
  18. Oppliger RA, Magnes SA, Popowski LA, Gisolfi CV. Accuracy of urine specific gravity and osmolality as indicators of hydration status. Int J Sport Nutr Exerc Metab 2005; 15: 236-51.
    Pubmed CrossRef
  19. Cheuvront SN, Ely BR, Kenefick RW, Sawka MN. Biological variation and diagnostic accuracy of dehydration assessment markers. Am J Clin Nutr 2010; 92: 565-73.
    Pubmed CrossRef
  20. Vivanti A, Harvey K, Ash S. Developing a quick and practical screen to improve the identification of poor hydration in geriatric and rehabilitative care. Arch Gerontol Geriatr 2010; 50: 156-64.
    Pubmed CrossRef


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