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...

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: 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...

Introduction: Patients with arginine vasopressin deficiency (AVP-D), known as central diabetes insipidus (cDI), often report psychological symptoms such as heightened anxiety levels, difficulties describing emotions, and depressed mood despite adequate treatment with desmopressin. Given the anatomical proximity, disruptions of the hypothalamic-pituitary axis causing an AVP-D could also disturb the oxytocin (OXT) system. OXT regulates socio-emotional functioning, including fear...

Background: Central diabetes insipidus (cDI), a rare neuroendocrine condition affecting 1 in 25.000, is characterized by deficiency of arginine vasopressin. Data about treatment-related side effects, psychological co-morbidities, and incidence of wrong management due to confusion with diabetes mellitus are scarce and limited to small studies or case series. Furthermore, increasing interest has arisen on a potential need for re-naming the condition.<p class="abstex...

Background: The main challenge in the diagnosis of arginine vasopressin deficiency (AVP-deficiency, formerly known as central diabetes insipidus), is its distinction against primary polydipsia. Hypertonic saline stimulated copeptin showed a high diagnostic accuracy of 97% in distinguishing between AVP-deficiency and primary polydipsia (Fenske W, Refardt J, NEJM 2018), but comprises discomfort for patients and requires close sodium monitoring. Arginine stimulated copeptin showe...