Pediatric Endocrinology, University Children's Hospital Tübingen, Tübingen, Germany.
Department for Diagnostic Laboratory Medicine, Institute for Clinical Chemistry and Pathobiochemistry, University Hospital Tübingen, Tübingen, Germany.
Clin Endocrinol (Oxf). 2023 Apr;98(4):548-553. doi: 10.1111/cen.14880. Epub 2023 Feb 5.
Copeptin is secreted in isomolar amounts along with arginine vasopressin peptide (AVP) from the neurohypophysis. Its stability makes it a perfect candidate for the endocrine approach in the diagnosis of AVP deficiency (AVPD; cranial diabetes insipidus; CDI). However, pediatric reference values are lacking.
This is a monocentric retrospective analysis of donated residual serum samples from 72 children and adolescents who underwent arginine or growth hormone-releasing hormone-arginine stimulation to test GH secretory capacity from 2018 to 2022.
Copeptin was measured in baseline, 30-, and 60-min samples by BRAHMS Copeptin proAVP Kryptor immunofluorescence assay.
Of the 72 patients, 4 suffered from complete AVPD (CDI). The baseline level of copeptin in the 68 non-AVPD (non-CDI) patients was highly variable (range: 1.3-44.4 pmol/L). The increase after arginine was moderate (30 min range: 1.6-40.4 pmol/L). The median baseline and peak copeptin levels were 5.6 and 8.0 pmol/L, respectively. The 2.5th percentile of the baseline and peak values of copeptin were 2.1 and 3.3 pmol/L, respectively. The increase and peak value of copeptin were inversely related to age (R = -.405; p = .011, and R = -.335; p = .0072, respectively) but not to gender, body mass index (standard deviation score) or GH secretion. In the four patients with AVPD (CDI), baseline or stimulated copeptin was below the 2.5th percentile of non-AVPD (non-CDI) patients.
Stimulated copeptin is a promising parameter for the differential diagnosis of polyuria-polydipsia syndrome. However, the low copeptin increase after arginine and the high limit of quantification of the assay are problematic for use in paediatrics.
copeptin 与精氨酸血管加压素肽（AVP）一样从神经垂体等量分泌。其稳定性使其成为诊断 AVP 缺乏症（颅性尿崩症；CDI）的内分泌方法的理想候选物。然而，儿科参考值尚缺乏。
这是 2018 年至 2022 年期间对 72 名接受精氨酸或生长激素释放激素-精氨酸刺激以测试 GH 分泌能力的儿童和青少年的捐赠剩余血清样本进行的单中心回顾性分析。
BRAHMS Copeptin proAVP Kryptor 免疫荧光测定法测量基线、30 分钟和 60 分钟样本中的 copeptin。
在 72 名患者中，有 4 名患有完全 AVP 缺乏症（CDI）。68 名非 AVP 缺乏症（非 CDI）患者的基础 copeptin 水平变化很大（范围：1.3-44.4 pmol/L）。精氨酸后的增加幅度适中（30 分钟范围：1.6-40.4 pmol/L）。中位数基线和峰值 copeptin 水平分别为 5.6 和 8.0 pmol/L。copeptin 基线和峰值的第 2.5 百分位数分别为 2.1 和 3.3 pmol/L。copeptin 的增加和峰值与年龄呈负相关（R=-0.405；p=0.011 和 R=-0.335；p=0.0072），但与性别、体重指数（标准差评分）或 GH 分泌无关。在 4 名 AVP 缺乏症（CDI）患者中，基线或刺激后的 copeptin低于非 AVP 缺乏症（非 CDI）患者的第 2.5 百分位数。
刺激 copeptin 是鉴别多尿-多饮综合征的有前途的参数。然而，精氨酸后 copeptin 增加幅度低和测定的定量限高是儿科应用的问题。
