Relationships Between Morning And Afternoon WUT (Weight, Urine Color, And Thirst) Criteria And Hydration Markers

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A Venn diagram decision tool consisting of weight, urine color, and thirst (WUT) is suggested to measure hydration status. The WUT Venn diagram has been used as a practical hydration status assessment tool; however, this relationship has only been investigated using a first-morning urine sample. PURPOSE: To investigate relationships between morning and afternoon WUT criteria, blood and urine markers. METHODS: Twelve men (age: 21 ± 2; mass: 81.2 ± 15.0 kg) and ten women (age: 22 ± 3; mass: 65.6 ± 13.6 kg) completed the study. Body mass, urine color, urine specific gravity (USG), urine osmolality (UOSM), thirst level, and plasma osmolality (POSM) were collected as a first-morning and afternoon spot urine (2:00-4:00 CST) for 3 consecutive days in a free-living situation and 3 consecutive days in a euhydrated state. Body mass loss >1%, urine color >5, and thirst level ≥ 5 were used as dehydration thresholds. The number of markers that indicated dehydration levels were counted and categorized into either 3, 2, 1, or 0 WUT markers indicating dehydration (defined by either USG, UOSM, or POSM). One-way ANOVA with Tukey pairwise comparisons were used to assess differences in USG, UOSM, and POSM between different numbers of WUT markers. Receiver operating characteristics analysis was performed to calculate the predictive value of 0, 1, 2, or 3 hydration markers in detecting a dehydrated or euhydrated state. RESULTS: Morning and afternoon 1, 2, and 3 WUT markers were not significantly different (ps > .05) for USG and POSM. Morning and afternoon 0, 2, and 3 WUT markers were not significantly different for UOSM. Morning and afternoon 3 WUT resulted in a specificity of 0.990 and 1.000, 0.990 and 1.000, and 0.977 and 0.990 for USG > 1.020, UOSM >700 mOsm, and POSM >290 mOsm, respectively. Meeting at 2 WUT for morning and afternoon resulted in a specificity of 0.869 and 0.973, and 0.845 and 0.971 for USG and UOSM, respectively. Meeting at 1 WUT for morning and afternoon resulted in a sensitivity of 0.939 and 0.810 and 0.914 and 0.714 for USG and UOSM, respectively. CONCLUSION: These results suggest that when 2 or 3 WUT markers are met, urine and blood hydration markers indicate dehydration, and when 1 WUT marker is met, USG and UOSM may indicate not dehydration. The WUT Venn diagram can assess hydration status when an afternoon spot urine sample is used.

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