多尿多饮综合征患者的血浆 Apelin 浓度。
Plasma Apelin Concentrations in Patients With Polyuria-Polydipsia Syndrome.
机构信息
Clinic of Endocrinology, Diabetes, and Metabolism (S.A.U., N.F., M.C.-C.), Department of Clinical Research, University Hospital Basel, Petersgraben 4, CH-4031 Basel, Switzerland; Max-Planck-Institute for Metabolism Research (K.T.), D-50868 Cologne, Germany; Integrated Research and Treatment Center for Adiposity Diseases (W.F.), Leipzig University Medical Center, Medical Research Center Building, 04103 Leipzig, Germany; Laboratory of Central Neuropeptides in the Regulation of Body Fluid Homeostasis and Cardiovascular Functions (N.d.M., C.L.-C.), Center for Interdisciplinary Research in Biology, College de France, Inserm U1050, Paris F-75005, France; Assistance publique des hôpitaux de Paris (A.B.), European Georges Pompidou Hospital, Clinical Investigation Center, Paris F-75015, France; Division of Endocrinology, Diabetes, and Clinical Nutrition (F.K., C.S.), University Hospital Bern-Inselspital, CH-3010 Bern, Switzerland; Department of Internal Medicine (B.A.), Spital Rheinfelden, CH-4310 Rheinfelden, Switzerland; University Clinic of Internal Medicine (J.R.), Kantonsspital Baselland, CH-4101 Bruderholz, Switzerland; Division of Endocrinology, Metabolism, and Molecular Medicine and Center for Genetic Medicine (P.K.), Northwestern University, Chicago, Illinois 60611; Division of Endocrinology, Diabetology, and Metabolism, Medical University Clinic (B.M.), Kantonsspital Aarau, CH-5001 Aarau, Switzerland; and Department of Neurology (M.K.), University Hospital Zurich, CH-8091 Zurich, Switzerland.
出版信息
J Clin Endocrinol Metab. 2016 May;101(5):1917-23. doi: 10.1210/jc.2016-1158. Epub 2016 Mar 11.
CONTEXT
Apelin and arginine vasopressin are antagonists in the regulation of body fluid and osmotic homeostasis. There are no data about apelin levels in patients with polyuria-polydipsia syndrome (PPS).
OBJECTIVE
To investigate plasma apelin levels and plasma apelin to copeptin ratios in patients with PPS and healthy volunteers using copeptin as a surrogate marker for arginine vasopressin.
DESIGN, PARTICIPANTS, AND SETTING: We included 41 patients with PPS in this post hoc analysis of a prospective study performed in tertiary care hospitals in Switzerland and Germany and 113 healthy volunteers as a control group.
OUTCOME MEASURES
Plasma apelin and copeptin levels were measured in 15 patients with complete central diabetes insipidus (DI), seven patients with complete nephrogenic DI, 19 patients with primary polydipsia (PP), and 113 healthy volunteers.
RESULTS
Plasma apelin levels were highest in patients with complete nephrogenic DI (413 pmol/L; interquartile range, 332-504 pmol/L; P = .01) and lower in patients with PP (190 [172-215] pmol/L; P < .001) or complete central DI (209 [174-241] pmol/L; P = .02) as compared to healthy volunteers (254 [225-311] pmol/L). Plasma apelin to copeptin ratio in patients with PP (53 [38-92] pmol/pmol; P > .9) was similar to healthy volunteers (57 [37-102] pmol/pmol). In contrast, the apelin to copeptin ratio was higher in patients with complete central DI (89 [73-135] pmol/pmol; P = .02) and lower in patients with complete nephrogenic DI (7 [6-10] pmol/pmol; P < .001) compared to healthy volunteers.
CONCLUSION
In PP, normal plasma apelin to copeptin ratio attests a normal water homeostasis. In contrast, in patients with central or nephrogenic DI, the increased or decreased apelin to copeptin ratio, respectively, reflects a disturbed osmotic and body fluid homeostasis.
背景
Apelin 和精氨酸加压素是调节体液和渗透稳态的拮抗剂。目前尚无多尿多饮综合征（PPS）患者的 Apelin 水平数据。
目的
使用 copeptin 作为精氨酸加压素的替代标志物，研究 PPS 患者和健康志愿者的血浆 Apelin 水平和血浆 Apelin 与 copeptin 的比值。
设计、参与者和设置：我们将瑞士和德国的三家三级保健医院进行的前瞻性研究中的 41 例 PPS 患者纳入本事后分析，并将 113 名健康志愿者作为对照组。
观察指标
在 15 例完全中枢性尿崩症（DI）患者、7 例完全肾源性 DI 患者、19 例原发性多饮症（PP）患者和 113 名健康志愿者中测量血浆 Apelin 和 copeptin 水平。
结果
完全肾源性 DI 患者的血浆 Apelin 水平最高（413 pmol/L；四分位间距，332-504 pmol/L；P =.01），PP 患者（190 [172-215] pmol/L；P <.001）或完全中枢性 DI 患者（209 [174-241] pmol/L；P =.02）的血浆 Apelin 水平均低于健康志愿者（254 [225-311] pmol/L）。PP 患者的 Apelin 与 copeptin 比值（53 [38-92] pmol/pmol；P >.9）与健康志愿者相似（57 [37-102] pmol/pmol）。相比之下，完全中枢性 DI 患者的 Apelin 与 copeptin 比值较高（89 [73-135] pmol/pmol；P =.02），而完全肾源性 DI 患者的比值较低（7 [6-10] pmol/pmol；P <.001）。
结论
在 PP 中，正常的血浆 Apelin 与 copeptin 比值证明水的内环境稳定。相反，在中枢性或肾源性 DI 患者中，分别升高或降低的 Apelin 与 copeptin 比值反映了渗透压和体液内环境的紊乱。
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