TY  - JOUR
A1  - Refardt, Julie
A1  - Sailer, Clara Odilia
A1  - Winzeler, Bettina
A1  - Betz, Matthias Johannes
A1  - Chifu, Irina
A1  - Schnyder, Ingeborg
A1  - Fassnacht, Martin
A1  - Fenske, Wiebke
A1  - Christ-Crain, Mirjam
T1  - FGF-21 levels in polyuria-polydipsia syndrome
JF  - Endocrine Connections
N2  - 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.
KW  - FGF21
KW  - diabetes insipidus
KW  - primary polydipsia
KW  - osmotic stimulation
KW  - copeptin
KW  - Fibroblast Growth Factor-21
KW  - Klotho-related molecules
KW  - Copeptin
KW  - Diagnosis
KW  - PF-05231023
KW  - Resistance
KW  - Men
Y1  - 2018
U6  - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-225085
VL  - 7
IS  - 12
ER  -