IJCS | Volume 31, Nº3, May/ June 2018

280 Camargo et al. Manual lymphatic drainage, natriuresis and lipolysis International Journal of Cardiovascular Sciences. 2018;31(3)274-281 Original Article function by binding into receptors located in renal tubules and in the glomerular zone of the adrenal glands, inhibiting sodium reabsorption by decreased renin secretion, resulting in lower production of angiotensin II, aldosterone and vasopressin. Graugaard-Jensen et al. 12 reported that changes in endogenous estrogen have no effects on plasma ANP levels. In contrast, in our study, women of the OCPu had higher estrogen levels and greater urinaryANP excretion. According to Schlueter et al., 6 ANP lipolytic effect occurs via GMPc formation, which induces triglyceride degradation. However, MLD did not affect urinary excretion of ANP or glycerol, suggesting that venous return promoted by this procedure was not sufficiently effective to stimulate ANP and exert a lipolytic effect readily observable in the urine. Our data corroborate those found by Krupek et al. 8 These authors reported that 12 sessions of MLD had no effect on urinary glycerol excretion in 3 healthy, young women. However, different from our study, the authors investigated the chronic effect rather than the acute effect of MLD. One limitation of our study was the fact that urine collectionwas carried out in the mornings, which limited the participation of many eligible volunteers. Conclusion One session of MLD promoted an acute effect on natriuresis in women not taking OCP and glycerol and ANPsecretion inOCPusers by increasing theseparameters. Acknowledgements We thank all volunteers who participated in this study; the University of Campinas (UNICAMP) and Methodist University of Piracicaba (UNIMEP) for the facilities; FAPESP (2013/20510-2) and CAPES for the financial support. Author contributions Conception and design of the research: Grassi-Kassisse DM, Pires-de-Campos MSM. Acquisition of data: Camargo EAM, Souza AL, Marcorin DM, Rodrigues LL, Crege DRXO, Ishizu LY. Analysis and interpretation of the data: Camargo EAM, Borghi F, Grassi-Kassisse DM, Pires-de-Campos MSM. Statistical analysis: Camargo EAM, Borghi F, Grassi-Kassisse DM, Pires-de-Campos MSM. Obtaining financing: Grassi-Kassisse DM, Pires- de-Campos MSM. Writing of the manuscript: Camargo EAM, Borghi F, Silva PC, Grassi-Kassisse DM, Pires-de- Campos MSM. Critical revision of the manuscript for intellectual content: Camargo EAM, Borghi F, Silva PC, Grassi-Kassisse DM, Pires-de-CamposMSM. Supervision / as the major investigador: Camargo EAM, Grassi- Kassisse DM, Pires-de-Campos MSM. Potential Conflict of Interest No potential conflict of interest relevant to this article was reported. Sources of Funding This study was funded by CAPES e Fapesp. Study Association This article is part of the thesis of master submitted by Érica A. M. Camargo, from Universidade de Campinas (UNICAMP). Ethics approval and consent to participate This study was approved by the Ethics Committee of the Faculdade de Ciências Médicas da Unicamp under the protocol number CAAE: 24537613.2.0000.5404. All the procedures in this studywere in accordance with the 1975 Helsinki Declaration, updated in 2013. Informed consent was obtained from all participants included in the study. 1. Williams A. Manual lymphatic drainage: exploring the history and evidence base. Br J Community Nurs. 2010;15(4):S18-24. doi: 10.12968/ bjcn.2010.15.Sup5.78111. 2. Stachenfeld NS. Sex hormone effects on body fluid regulation. Exerc Sport Sci Rev. 2008;36(3):152-9. doi: 10.1097/JES.0b013e31817be928. 3. StachenfeldNS, Keefe DL. Estrogen effects on osmotic regulation of AVP and fluid balance. Am J Physiol Endocrinol Metab. 2002;283(4):E711-21. doi: 10.1152/ajpendo.00192.2002. 4. Stachenfeld NS, Taylor HS. Progesterone increases plasma volume independent of estradiol. J Appl Physiol (1985). 2005;98(6):1991-7. doi: 10.1152/japplphysiol.00031.2005. References