Implications of the variability in time to isotopic equilibrium in the deuterium dilution technique

Objective: To investigate the variability in isotopic equilibrium time under field conditions, and the impact of this variability on estimates of total body water (TBW) and body composition. Design and Setting: Following collection of a fasting baseline urine sample, 10 women and 10 men were dosed with deuterium oxide (0.05 g/kg body weight). Urine samples were collected every hour for 8 h. The samples were analysed using isotope ratio mass spectrometry. Time to equilibration was determined using three commonly employed data analysis approaches. Results: Isotopic equilibrium was reached by 50, 80 and 100% of participants at 4, 6 and 8 h, respectively. The mean group equilibration determined using the three different plateau determination methods were 4.8 +/- 1.5, 3.8 +/- 0.8 and 4.9 +/- 1.4 h. Isotopic enrichment, TBW, and percent body fat estimates differed between early (3-5 h), but not later sampling times (5-8 h). Conclusion: Although the three different plateau determination approaches resulted in differences in equilibration time, all suggest that sampling at 6 h or later will decrease the likelihood of error in body composition estimates resultant from incomplete isotopic equilibration in a small proportion of individuals.