Arginine-Stimulated Copeptin-Based Diagnosis of Central Diabetes Insipidus in Children and Adolescents
Authors' conclusion
Our results suggest that arginine-stimulated serum copeptin concentrations are a sensitive and specific diagnostic tool for CDI in paediatric patients, which may replace and simplify the conventional diagnostic pathway of water deprivation testing and hypertonic saline infusion.
Study context
- Population
- Paediatric patients with suspected pituitary disorders who underwent standard arginine testing; single centre51 males · 18 females
- Participants
- 69 patients
- Comparison
- Arginine-stimulated serum copeptin in central diabetes insipidus (CDI) vs matched controls vs primary polydipsia
- CDIn = 32
- Controlsn = 32reference
- Primary polydipsia (PP)n = 5
- Outcome
- Diagnostic accuracy of arginine-stimulated copeptin, published cut-off 3.8 pmol/L, for confirming CDI
- Follow-up
- 60 min after arginine infusion
Methodological detailssingle-centre, matched controls, Copeptin measured with B.R.A.H.M.S Copeptin-proAVP KRYPTOR® immunofluorescence assay in samples stored a median of 4.6 years (1.3-10.84)
- Single-centre
- Matched controls
- Copeptin measured with B.R.A.H.M.S Copeptin-proAVP KRYPTOR® immunofluorescence assay in samples stored a median of 4.6 years (1.3-10.84)
Performance
As reported in the abstract
Sensitivity
100%
Specificity
86.5%
Further findings
| Outcome | CDI | Controls | PP |
|---|---|---|---|
| Median serum copeptin before and 60 min after arginine · before vs 60 min after arginine infusion | median 1.44 (IQR 1.10–1.87) | median 6.96 (IQR 4.51–12.89) pmol/L | median 9.58 (IQR 8.19–11.42) pmol/L |
| Baseline median (IQR 3.47-8.36) | — not stated in the abstract | 4.47 pmol/L | — not stated in the abstract |
| Baseline median (IQR 1.21-2.12) | 1.46 pmol/L | — not stated in the abstract | — not stated in the abstract |
| Baseline median (IQR 3.95-6.33) | — not stated in the abstract | — not stated in the abstract | 4.40 pmol/L |
— not stated in the abstract
- Median serum copeptin before and 60 min after arginine — Change before vs after arginine in Controls
- p < 0.001
- Median serum copeptin before and 60 min after arginine — Change before vs after arginine in CDI
- p = 0.645, ns
- Median serum copeptin before and 60 min after arginine — Change before vs after arginine in PP
- p < 0.001
Original publication
Arginine-Stimulated Copeptin-Based Diagnosis of Central Diabetes Insipidus in Children and Adolescents. Horm Res Paediatr. Published 22 August 2023. doi:10.
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