Department of Diabetes and Endocrinology, Princess Alexandra Hospital, Brisbane, Australia.
Faculty of Medicine, University of Queensland, Brisbane, Australia.
Clin Endocrinol (Oxf). 2021 May;94(5):820-826. doi: 10.1111/cen.14417. Epub 2021 Feb 4.
Measurement of hypertonic saline-stimulated copeptin has recently been described for the differentiation of polyuria-polydipsia syndrome. This study aims to determine the copeptin response to intravenous 3% hypertonic saline, including evaluation of adverse effects, in a local cohort of healthy adults >18 years in Australia.
Prospective clinical study.
Twenty healthy volunteers (10 males and 10 females) were recruited. Participants underwent infusion of 3% hypertonic saline via a previously described standardized protocol, until the plasma sodium was ≥150 mmol/L, with measurement of plasma copeptin.
Mean peak sodium was 152 mmol/L ± SD 1.4 with osmolality 315 mmol/kg ± SD 3.9. Median volume of hypertonic saline infused to reach target sodium ≥ 150 mmol/L was 1536 mL (IQR 1362, 1992). Mean rate of plasma sodium rise was 5.9 mmol/L/hour ± SD 1.5. Hypertonic saline-stimulated copeptin had non-parametrical distribution with median of 33.8 pmol/L (IQR 27.6, 63.6). Overall median symptom burden was 6/10 (range 3/10-9/10). Copeptin was significantly higher for those who experienced nausea and/or vomiting (n = 13) (median 39.0 pmol/L; IQR 32.5, 90), compared to those participants who did not experience either (median 20.0 pmol/L; IQR 13.0, 31.0) (P = 0.003). There were no serious adverse events.
Hypertonic saline-stimulated copeptin measurements were similar in our population compared with previously reported reference intervals in healthy volunteers. There is a wide range of stimulated copeptin measurements in the healthy population. Nausea and vomiting are common adverse effects which enhance the copeptin response.
最近有研究描述了高渗盐水刺激的 copeptin 可用于鉴别多尿多饮综合征。本研究旨在确定 3%高渗盐水静脉输注后 copeptin 的反应，包括评估澳大利亚当地健康成年人（>18 岁）中的不良反应。
前瞻性临床研究。
招募了 20 名健康志愿者（10 名男性和 10 名女性）。参与者按照先前描述的标准化方案接受 3%高渗盐水输注，直到血浆钠浓度≥150mmol/L，同时测量血浆 copeptin。
平均峰值钠浓度为 152mmol/L±SD 1.4，渗透压为 315mmol/kg±SD 3.9。达到目标钠浓度≥150mmol/L 所需输注的高渗盐水中位数为 1536mL（IQR 1362，1992）。血浆钠浓度升高的平均速率为 5.9mmol/L/小时±SD 1.5。高渗盐水刺激的 copeptin 呈非参数分布，中位数为 33.8pmol/L（IQR 27.6，63.6）。总体中位症状负担为 6/10（范围 3/10-9/10）。有恶心和/或呕吐症状的 13 名参与者（中位数 39.0pmol/L；IQR 32.5，90）的 copeptin 明显高于无此类症状的参与者（中位数 20.0pmol/L；IQR 13.0，31.0）（P=0.003）。无严重不良事件。
与健康志愿者的先前报道的参考区间相比，高渗盐水刺激的 copeptin 测量值在我们的人群中相似。健康人群中存在广泛的刺激 copeptin 测量范围。恶心和呕吐是常见的不良反应，会增强 copeptin 的反应。
