FGF-21 levels in polyuria-polydipsia syndrome

Refardt, Julie; Sailer, Clara Odilia; Winzeler, Bettina; Betz, Matthias Johannes; Chifu, Irina; Schnyder, Ingeborg; Fassnacht, Martin; Fenske, Wiebke; Christ-Crain, Mirjam; Drummond, Juliana; Ribeiro-Oliveira Jr, Antonio; Drescher, Tilman; Bilz, Stefan; Vogt, Deborah R.; Malzahn, Uwe; Kroiss, Matthias; Christ, Emanuel; Henzen, Christoph; Fischli, Stefan; Toenjes, Anke; Müller, Beat; Schopohl, Jochen; Flitsch, Jörg und Brabant, Georg (2018): FGF-21 levels in polyuria-polydipsia syndrome. In: Endocrine Connections, Bd. 7, Nr. 12: S. 1501-1506

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.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 2049-3614
• Sprache: Englisch