Measurement of sodium concentration in sweat samples: comparison of 5 analytical techniques

Sweat sodium concentration (SSC) can be determined using different analytical techniques (ATs), which may have implications for athletes and scientists. This study compared the SSC measured with 5 ATs: ion chromatography (IChr), flame photometry (FP), direct (DISE) and indirect (IISE) ion-selective electrode, and ion conductivity (IC). Seventy sweat samples collected from 14 athletes were analyzed with 5 instruments: the 883 Basic IC Plus (IChr, reference instrument), AAnalyst 200 (FP), Cobas 6000 (IISE), Sweat-Chek (IC), and B-722 Laqua Twin (DISE). Instruments showed excellent relative (intraclass correlation coefficient (ICC) ≥ 0.999) and absolute (coefficient of variation (CV) ≤ 2.6%) reliability. Relative validity was also excellent between ATs (ICC ≥ 0.961). In regards to the inter-AT absolute validity, compared with IChr, standard error of the estimates were similar among ATs (2.8-3.8 mmol/L), but CV was lowest with DISE (3.9%), intermediate with IISE (7.6%), and FP (6.9%) and highest with IC (12.3%). In conclusion, SSC varies depending on the AT used to analyze samples. Therefore, results obtained from different ATs are scarcely comparable and should not be used interchangeably. Nevertheless, taking into account the normal variability in SSC (∼±12%), the imprecision of the recommendations deriving from FP, IISE, IC, and DISE should have trivial health and physiological consequences under most exercise circumstances.