Body potassium by four-pi 40K counting: an anthropometric correction

Four-pi whole body counting for the 1.46 meV photon of 40K has apparent advantages over single-crystal or two-pi counters in efficiency and in subject geometry independence. However, our studies of obese populations have disclosed a systematic undermeasurement of 40K, suggesting that nonhomogeneous K distribution results in systematic undercounting of 40K. In the current study 42K, emitting a 1.52 meV photon, was used in 109 volunteers ranging from 50 to 181 kg, and multiregression covariance analysis was applied to develop correction formulas based on anthropometrics. These corrections quantitatively account for the unappreciated loss of 40K and 42K photons in annular adipose tissue that surrounds the lean body, in which most K+ is concentrated. The correction ranges from 1 to 28% and is a linear (although different) function of weight in both sexes. Thus corrected, body potassium measurements, taken in conjunction with exchangeable sodium and water measurements, provide estimates for whole body osmolality that match measured serum values. Such a quantitative accounting for previously "lost" cation in 58 subjects provides independent evidence for the appropriateness and accuracy of the correction. With this correction, body potassium was recalculated in the 1,492 adult members of a previously reported group of 3,083 subjects.