@article{RefardtSailerWinzeleretal.2018,
  author    = {Refardt, Julie and Sailer, Clara Odilia and Winzeler, Bettina and Betz, Matthias Johannes and Chifu, Irina and Schnyder, Ingeborg and Fassnacht, Martin and Fenske, Wiebke and Christ-Crain, Mirjam},
  title     = {FGF-21 levels in polyuria-polydipsia syndrome},
  series = {Endocrine Connections},
  volume    = {7},
  journal   = {Endocrine Connections},
  number    = {12},
  doi       = {10.1530/EC-18-0469},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-225085},
  pages     = {1501-1506},
  year      = {2018},
  abstract  = {The pathomechanism of primary polydipsia is poorly understood. Recent animal data reported a connection between fibroblast growth factor 21 (FGF-21) and elevated fluid intake independently of hormonal control by the hormone arginine-vasopressin (AVP) and osmotic stimulation. We therefore compared circulating FGF-21 levels in patients with primary polydipsia to patients with AVP deficiency (central diabetes insipidus) and healthy volunteers. In this prospective cohort study, we analyzed FGF-21 levels of 20 patients with primary polydipsia, 20 patients with central diabetes insipidus and 20 healthy volunteers before and after stimulation with hypertonic saline infusion targeting a plasma sodium level >= 150 mmol/L. The primary outcome was the difference in FGF-21 levels between the three groups. Baseline characteristics were similar between the groups except for patients with central diabetes insipidus being heavier. There was no difference in baseline FGF-21 levels between patients with primary polydipsia and healthy volunteers (122 pg/mL (52,277) vs 193 pg/mL (48,301), but higher levels in patients with central diabetes insipidus were observed (306 pg/mL (114,484); P=0.037). However, this was not confirmed in a multivariate linear regression analysis after adjusting for age, sex, BMI and smoking status. Osmotic stimulation did not affect FGF-21 levels in either group (difference to baseline: primary polydipsia -23 pg/mL (-43, 22); central diabetes insipidus 17 pg/mL (-76, 88); healthy volunteers -6 pg/mL (-68, 22); P=0.45). To conclude, FGF-21 levels are not increased in patients with primary polydipsia as compared to central diabetes insipidus or healthy volunteers. FGF-21 therefore does not seem to be causal of elevated fluid intake in these patients.},
  subject      = {Fibroblast Growth Factor-21},
  language  = {en}
}