ArticleScientific reports2025
Non-linear association between extracellular water/total body water ratio and all-cause mortality: a population-based cohort study.
Article in Scientific reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed.
- Article
- Age modifies the prognostic relevance of extracellular water-to-total body water ratio in rheumatoid arthritis: a retrospective cohort study.BMC rheumatology · 2026Article
- Association between total body water and the risk of gastrointestinal symptoms: evidence from NHANES and Mendelian randomization analyses.BMC gastroenterology · 2026Article
- Association of serum albumin and obesity: Mediation effect of extracellular fluid, percent body fat and C-reactive protein.Medicine · 2026Article
- Serum albumin and hypertension: The mediating roles of BMI, C-reactive protein and extracellular fluid.Asia Pacific journal of clinical nutrition · 2026Article
- Article
- Extracellular-to-total body water ratio is associated with comorbidity and cardiorespiratory fitness in older adults with post-COVID-19 syndrome.Frontiers in nutrition · 2026Article
- Analysis of factors influencing the increase of extracellular water ratio in tumor patients without edema signs.Frontiers in medicine · 2025Article
Corrections and comments
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Authors and funding
7 authors.
Funding
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Abstract
Early extracellular water (ECW) alterations might act as preclinical markers of disease, as these changes often occur in early stages. Quantifying this relationship could provide insights into clinical practice and evaluating nutritional interventions in personalized health. This study examined the association between extracellular water/total body water ratio (ECW/TBW) and all-cause mortality in adults using data from the National Health and Nutrition Examination Survey (1999-2004) and mortality follow-up until 2019. Among 6338 participants, 307 died over 20 years. Kaplan-Meier curves showed higher mortality with elevated ECW/TBW (log-rank P = 0.038). Multivariable Cox models indicated the highest ECW/TBW quartile (≥ 44.6%) had an adjusted HR of 1.60 (95% CI 1.15-2.23; P = 0.005). Restricted cubic spline analysis revealed a J-shaped non-linear relationship (P = 0.009), with an inflection point at 42.4%. Piecewise regression showed an adjusted HR of 1.10 (95% CI 1.05-1.15; P < 0.001) for ECW/TBW ≥ 42.4%. Specifically, each one-unit increase in ECW/TBW beyond the inflection point was associated with a 10% higher risk of all-cause mortality. This suggests ECW/TBW could be a useful marker for risk assessment and guiding interventions.
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