Insulin-Induced Copeptin Response in Children and Adolescents to Diagnose Arginine Vasopressin Deficiency
Authors' conclusion
Our results suggest that insulin-stimulated serum copeptin concentrations are a sensitive and specific diagnostic tool for AVD in paediatric patients, which allows us to test multiple pituitary hormone axes simultaneously in a single test.
Study context
- Population
- Paediatric patients with suspected pituitary insufficiency who underwent standard insulin tolerance testing
- Participants
- 25 vs 43
- Comparison
- Insulin-stimulated copeptin in arginine vasopressin deficiency (AVD) vs controls without polyuria-polydipsia syndrome
- AVDn = 25
- Controlsn = 43reference
- Outcome
- Maximum insulin-stimulated copeptin cut-off for diagnosis of AVD (ROC analysis)
Methodological detailssingle-centre, non-matched controls, Copeptin measured by automated immunofluorescence assay in −20°C stored samples before and 30, 45, 60 min after insulin
- Single-centre
- Non-matched controls
- Copeptin measured by automated immunofluorescence assay in −20°C stored samples before and 30, 45, 60 min after insulin
Performance
As reported in the abstract
| Test or model | Sensitivity | Specificity |
|---|---|---|
| Maximum copeptin cut-off 3.0 pmol/L | 91.7% | 94.1% |
Maximum copeptin cut-off 3.0 pmol/L
Sensitivity91.7%
Specificity94.1%
Further findings
Maximum copeptin after insulin · median 30 min (AVD)
Basal serum osmolarity · median basal
| Outcome | AVD | Controls | P value |
|---|---|---|---|
| Basal copeptin · median basal | median 1.51 (IQR 0.91–1.95) pmol/L | 4.41 (IQR 3.36–6.68) pmol/L | P < 0.001 |
- Maximum copeptin after insulin — Increase from basal in AVD
- p = 0.113
- Maximum copeptin after insulin — Increase from basal in controls
- p < 0.001
Original publication
Insulin-Induced Copeptin Response in Children and Adolescents to Diagnose Arginine Vasopressin Deficiency. Horm Res Paediatr. Published 18 September 2024. doi:10.
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