Ramadan Fasting and its Influence on Serum Osmolality in Emergency Patients

Introduction: Ramadan is the ninth month of the Islamic calendar and Muslims fasting during this month. The effect of Ramadan fasting has been studied in various studies which are conducted on normal healthy individuals worldwide, but the changes of serum osmolality during Ramadan fasting are not known well. We aimed to investigate clinical worthiness of serum osmolality on fasting patients at Emergency Department (ED). Methods: This prospective, cross-sectional, case-control study was conducted on 62 fasting patients and 62 age- and sex- matched non-fasting controls in a tertiary training and research hospital ED. We obtained demographic, clinical and laboratory data including serum sodium, glucose, blood urea nitrogen, systolic and diastolic blood pressure, pulse rate and ED outcomes including discharge and hospitalization status in study and control patients. All analyses were performed using SPSS version 15.0 for Windows. Results: A total of 124 patients enrolled into the study. The median serum osmolality averages of the study and control group were found as 300 mosm/kg (IQR = 295-304) and 299 mosm/kg (IQR = 296-305), respectively (p = 0.990). In the study group, statistically significant positive correlation was observed between serum osmolality and duration of hunger, age, urea, creatinine, sodium levels (p = 0.007, p < 0.001, p < 0.001, p = 0.002, p < 0.001). Conclusion: This study has shown that serum osmolality isn't affected by Ramadan fasting on ED patients. Nonetheless, further prospective larger studies are needed to assess the relationship between serum osmolality and Ramadan fasting.