Endocrine Abstracts

Arginine vasopressin (AVP) and oxytocin (OXT) are neuropeptides produced in hypothalamic nuclei and released into circulation from axon terminals projecting to the posterior pituitary. A disrupted hypothalamic-pituitary axis caused by inflammation, tumours, or head trauma can cause AVP deficiency, also known as central diabetes insipidus (cDI), a condition characterised by polyuria and consecutive polydipsia. Once diagnosed, desmopressin, a selective AVP receptor 2 agonist, is...

Background: The differential diagnosis between central diabetes insipidus and primary polydipsia is challenging. To date, the most reliable approaches are copeptin measurement after hypertonic saline infusion or arginine, which is a known growth hormone secretagogue but has recently been shown also to stimulate the neurohypophysis. Similar to arginine, glucagon is also known to stimulate growth hormone release, but its effect on the neurohypophysis and in the differential diag...

Introduction: The syndrome of inappropriate antidiuresis (SIAD) is the most common cause of euvolemic hyponatremia. Besides fluid restriction, increasing free water clearance is an effective treatment approach that can be achieved through osmotic diuresis by administering oral urea. Dietary proteins are metabolized into soluble excretable urea by the liver. We hypothesized that dietary protein could increase free water clearance through urea-induced osmotic diuresis and theref...

Background and Objectives: The differential diagnosis between arginine vasopressin (AVP) deficiency (AVP-D, formerly known as central diabetes insipidus) and primary polydipsia (PP) remains challenging. To date, the method with the highest diagnostic accuracy is osmotically-stimulated copeptin – a surrogate marker of AVP – using hypertonic saline infusion. However, this method is often limited to experienced hospitals, requires close monitoring, and may be cumbersome...

Introduction: Smoking harms women more than men and women seem to be less successful in quitting. Greater concerns about post-cessational weight in women and gender differences in craving and reward processing have been postulated as possible explanations. Our group recently showed that the GLP-1 analogue dulaglutide reduces post-cessational weight gain. We hypothesize that women compared to men might profit more from the weight-lowering effects of dulaglutide in terms of abst...

Introduction: The differential diagnosis between arginine vasopressin deficiency (AVP-D), formally known as central diabetes insipidus, and primary polydipsia (PP) is challenging. In clinical routine, psychopathologic findings are often used as a hallmark for diagnosing PP; thus, it is often referred to as psychogenic polydipsia. Yet, psychopathologic characteristics are barely assessed in patients with AVP-D, and to date, no data exist comparing AVP-D and PP with regard to th...

Background: The syndrome of inappropriate antidiuresis (SIAD) can be treated with oral urea. Proteins are metabolized into urea by the liver. We hypothesized that dietary protein could increase free water clearance through urea-induced osmotic diuresis.ObjectivesTo investigate the effect of protein supplementation on plasma sodium levels in chronic SIAD.Methods: This is a monocentric open-label proof-of-concept trial conducted at the University Hospital ...

Introduction: Distinguishing arginine vasopressin deficiency (AVP-D, central diabetes insipidus) from primary polydipsia (PP) is challenging. The method with the highest diagnostic accuracy, hypertonic saline-stimulated copeptin, is often limited to experienced hospitals, requires close monitoring, and may be cumbersome for patients. A standardised, validated stepwise assessment and probability score to rule out AVP-D in the initial baseline evaluation is currently lacking.</p...

Importance: 3,4-Methylenedioxymethamphetamine (MDMA, ‘ecstasy’) is a trending recreational drug but also has potential to enter clinical practice. Acute hyponatremia is a serious complication arising from ingesting even a single dose of MDMA. The assumed aetiology is a vasopressin release inducing the syndrome of inappropriate anti-diuresis combined with increased thirst causing polydipsia and thus water intoxication.Methods: Pooled analysis of...

Background: Hyponatremia is highly prevalent in patients with COVID-19. One of the most common causes of hyponatremia in these patients is the syndrome of inadequate antidiuresis (SIAD). Interleukin 6 (IL-6) is a key mediator of inflammation in COVID-19. We hypothesized that hyponatremia in COVID-19 is due to IL-6 mediated non-osmotic arginine vasopressin (AVP) secretion, and that the inverse association between IL-6 and plasma sodium concentration is stronger in COVID-19 comp...