Disrupted adrenocorticotropic hormone (ACTH) and cortisol response to osmotic and non-osmotic stress in patients with arginine vasopressin deficiency
Authors' conclusion
An altered ACTH and cortisol response pattern to stress in patients with AVP-Deficiency was observed, indicating impaired regulation of the HPA axis. This alteration was primarily driven by differences observed for non-osmotic stress.
Study context
- Population
- Patients with hypotonic polyuria-polydipsia syndrome undergoing hypertonic saline and arginine infusion testing, seven tertiary centers
- Participants
- 20 vs 10
- Comparison
- ACTH and cortisol response to hypertonic saline and arginine infusion: AVP-D vs primary polydipsia (PP)
- AVP-Deficiencyn = 20
- PPn = 10reference
- Primary endpoint
- Change in plasma ACTH and cortisol from baseline to expected peak (pooled linear mixed-effects model)
Methodological detailsmulticentre, seven tertiary centers
- Multicentre
- Seven tertiary centers
Primary result
As reported in the abstract
Each group vs PPDifference in ACTH increase, ng/L (95% CI)P value
AVP-Deficiency
7.0(0.8–13.3)
P = 0.04Each group vs PPDifference in cortisol increase, nmol/L (95% CI)P value
AVP-Deficiency
106(24–188)
P = 0.02Further findings
| Outcome | Estimate | |
|---|---|---|
| Change in plasma ACTH and cortisol upon hypertonic salineBetween AVP-Deficiency and PP | difference in ACTH change 0.3 ng/L (95% CI −10.0 to 11.0) | |
| Increase in plasma ACTH and cortisol upon arginine infusionAVP-Deficiencyvs PP | difference in ACTH increase 9.2 ng/L (95% CI 1.8–17) | |
| −20−1001020Difference, ng/L (linear scale) |
| Outcome | Estimate | |
|---|---|---|
| Change in plasma ACTH and cortisol upon hypertonic salineBetween AVP-Deficiency and PP | difference in cortisol change 78 nmol/L (95% CI −32 to 188) | |
| Increase in plasma ACTH and cortisol upon arginine infusionAVP-Deficiencyvs PP | difference in cortisol increase 141 nmol/L (95% CI 40–242) | |
| −1000100200300Difference, nmol/L (linear scale) |
Original publication
Disrupted ACTH and cortisol response to osmotic and non-osmotic stress in patients with arginine vasopressin deficiency. Eur J Endocrinol. Published 11 June 2025. doi:10.
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