Copeptin and the syndrome of inappropriate antidiuresis (SIAD) after pituitary transsphenoidal surgery

IF 2.7 Q3 ENDOCRINOLOGY & METABOLISM Endocrinology, Diabetes and Metabolism Pub Date : 2024-01-17 DOI:10.1002/edm2.467

Agathoklis Efthymiadis, Riccardo Pofi, Hussam Rostom, Tim James, Brian Shine, Nish Guha, Simon Cudlip, Mirjam Christ-Crain, Aparna Pal

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Abstract

Objective

This study evaluates the predictive value of copeptin for syndrome of inappropriate antidiuresis (SIAD) postpituitary transsphenoidal surgery (TSS).

Design

Data from 133 consecutive patients undergoing TSS (November 2017–October 2022) at Oxford University Hospitals NHS trust are presented in this retrospective study.

Methods

Logistic regression (LR) and receiver operating characteristic (ROC) curves were performed to evaluate the diagnostic utility of copeptin. The Mann–Whitney U test was used to compare copeptin levels between the SIAD and no SIAD groups.

Results

Fourteen patients (10.8%) developed SIAD. Copeptin was available in 121, 53 and 87 patients for Days 1, 241 and 8 post-TSS, respectively. LR for Day 1 copeptin to predict SIAD gave an odds ratio (OR) of 1.0 (95%CI 42 0.84–1.20, p = .99), area under-ROC curve (AUC) was 0.49; Day 2 copeptin OR was 0.65 (95%CI 0.39–1.19, 43 p = .77), AUC was 0.57 LR for Day 1 sodium to predict SIAD gave an odds ratio (OR) of 1.0 (95%CI 0.85–1.21, p = .99), AUC was 0.50.

Conclusions

In conclusion, our data provide no evidence for copeptin as a predictive marker for post-TSS SIAD.

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垂体经蝶手术后的谷丙转氨酶和不适当抗利尿综合征（SIAD）

目的本研究评估了 copeptin 对垂体经蝶手术（TSS）后不适当抗利尿综合征（SIAD）的预测价值。设计本回顾性研究提供了牛津大学医院 NHS 信托基金会接受 TSS 手术的 133 名连续患者（2017 年 11 月至 2022 年 10 月）的数据。方法采用逻辑回归（LR）和接收器操作特征曲线（ROC）评估 copeptin 的诊断效用。采用 Mann-Whitney U 检验比较 SIAD 组和非 SIAD 组的 copeptin 水平。结果 14 名患者（10.8%）出现了 SIAD。TSS后第1天、第241天和第8天分别有121名、53名和87名患者检测到铜肽。预测 SIAD 的第 1 天 copeptin LR 的几率比 (OR) 为 1.0 (95%CI 42 0.84-1.20, p = .99)，ROC 曲线下面积 (AUC) 为 0.49；第 2 天 copeptin OR 为 0.65（95%CI 0.39-1.19，43 p = .77），AUC 为 0.57；第 1 天钠预测 SIAD 的比值比 (OR) 为 1.0（95%CI 0.85-1.21，p = .99），AUC 为 0.50。结论总之，我们的数据没有提供证据表明 copeptin 可作为 TSS 后 SIAD 的预测标志物。

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