Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
Center for Eating Disorders, Odense University Hospital, Odense, Denmark.
Brain Behav. 2020 Apr;10(4):e01551. doi: 10.1002/brb3.1551. Epub 2020 Feb 19.
Antidiuretic hormone (ADH) is involved in the response to stress and in depression and anxiety. However, studies on ADH in anorexia nervosa (AN) show conflicting results. A major reason for this may be methodological challenges due to short half-life of ADH in circulation and rapid degradation in vitro. To overcome these obstacles, copeptin, the C-terminal fragment stemming from the ADH precursor, has been increasingly used as a stable clinical measure for ADH. Furthermore, copeptin has been recognized as a biomarker of insulin resistance in obesity.
We measured fasting copeptin in plasma from 25 normohydrated, stable women with AN (BMI 13.0 ± 2.0) and 25 age-matched women.
No difference in copeptin levels was found (6.8 ± 1.8 vs. 5.5 ± 0.5 pmol/L). Confirmatory, copeptin concentrations were correlated to insulin resistance assessed by the homeostasis model assessment of insulin resistance.
We report for the first time that copeptin level as a marker of ADH activity is not altered in fluid- and electrolyte-stabilized patients with severe AN patients, indicating that ADH may not be crucial in the pathophysiological involvement of psychologic stress in AN.
抗利尿激素（ADH）参与应激反应以及抑郁和焦虑。然而，有关厌食症（AN）中 ADH 的研究结果却存在矛盾。造成这种情况的一个主要原因可能是由于 ADH 在循环中的半衰期短且体外迅速降解，因此在方法学上存在挑战。为了克服这些障碍，ADH 前体的 C 端片段—— copeptin 已被越来越多地用作 ADH 的稳定临床测量指标。此外，copeptin 已被认为是肥胖症胰岛素抵抗的生物标志物。
我们测量了 25 名水合稳定的 AN 女性（BMI 13.0±2.0）和 25 名年龄匹配的女性的空腹血浆 copeptin。
copeptin 水平无差异（6.8±1.8 与 5.5±0.5 pmol/L）。确认性分析显示，copeptin 浓度与胰岛素抵抗评估的稳态模型评估胰岛素抵抗呈正相关。
我们首次报道，在液体和电解质稳定的严重 AN 患者中，作为 ADH 活性标志物的 copeptin 水平没有改变，这表明 ADH 可能在 AN 中心理应激的病理生理参与中并不重要。
