Oral Levodopa Stimulates Copeptin Secretion in Children and Adolescents with Intact Posterior Pituitary Function

IF 3.7 3区医学 Q2 ENDOCRINOLOGY & METABOLISM Endocrine Practice Pub Date : 2024-11-01 DOI:10.1016/j.eprac.2024.08.006

Shirui Wang MD , Xinke Zhou BSc , Yuelun Zhang PhD , Qi Zhang MMSc , Bochuan Huang BM , Yutong Wang BM , Siyu Liang MD , Xiang Zhou MD , Xinqi Cheng MD , Hui Pan MD , Shi Chen MD , Huijuan Zhu MD

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Abstract

Background

Copeptin stimulation tests can be used in the differential diagnosis of polyuria-polydipsia syndrome. Current stimulation methods rely on intravenous or subcutaneous administration. Oral stimulus can further simplify the diagnostic approach. The levodopa stimulation test is widely used in the evaluation of growth hormone deficiency, and the dopamine pathway was reported to be associated with arginine vasopressin secretion. This study aims to investigate the effect of oral levodopa on copeptin secretion.

Methods

This study was a prospective observational single-center cohort study. Patients <18 years old with short stature and no symptoms of polyuria or polydipsia undergoing the levodopa stimulation test for suspected growth hormone deficiency were recruited from May 2023 to Nov 2023. Copeptin and growth hormone were measured at 0, 30, 60, 90, and 120 min during the levodopa test. The insulin tolerance test with copeptin and growth hormone measured at the same time points was conducted in part of patients.

Results

Forty-four participants were included in the final analysis. In the levodopa stimulation test, the median (interquartile range) copeptin concentration increased from 5.20 (3.51, 8.25) pmol/L to a maximum of 19.36 (8.97, 108.08) pmol/L (P < .001), 3.94 (1.41, 13.88) times that of the baseline (P < .001). Compared with the insulin tolerance test, peak copeptin in the levodopa test was significantly higher (34.61 [13.67, 98.96] vs 8.88 [7.14, 15.42] pmol/L, P = .009). Higher copeptin was associated with a larger dose of levodopa.

Conclusions

Oral levodopa could be used to stimulate copeptin.

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口服左旋多巴可刺激垂体后叶功能完好的儿童和青少年分泌谷肽。

背景：谷肽刺激试验可用于多尿多饮综合征的鉴别诊断。目前的刺激方法依赖于静脉注射或皮下注射。口服刺激可进一步简化诊断方法。左旋多巴刺激试验被广泛用于生长激素缺乏症（GHD）的评估，有报道称多巴胺通路与精氨酸加压素分泌有关。该研究旨在探讨口服左旋多巴对促肾上腺皮质激素分泌的影响：该研究是一项前瞻性观察性单中心队列研究。研究招募了 2023 年 5 月至 2023 年 11 月期间因疑似 GHD 而接受左旋多巴刺激试验的小于 18 岁、身材矮小且无多尿或多尿症状的患者。在左旋多巴试验的 0、30、60、90 和 120 分钟测量谷肽和生长激素（GH）。对部分患者进行了胰岛素耐量试验，并在同一时间点测量了谷丙肽和生长激素：结果：44 名参与者被纳入最终分析。在左旋多巴刺激试验中，中位数（四分位数间距，IQR）的 copeptin 浓度从 5.20 (3.51, 8.25) pmol/L 升至最高 19.36 (8.97, 108.08) pmol/L (P < 0.001)，是基线的 3.94 (1.41, 13.88) 倍 (P < 0.001)。与胰岛素耐受试验相比，左旋多巴试验中的峰值 copeptin 明显更高（34.61 (13.67, 98.96) vs 8.88 (7.14, 15.42) pmol/L，P = 0.009）。较高的 copeptin 与较大的左旋多巴剂量有关：结论：口服左旋多巴可刺激肌肽。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Endocrine Practice ENDOCRINOLOGY & METABOLISM-

CiteScore

7.60

自引率

2.40%

发文量

546

审稿时长

41 days

期刊介绍： Endocrine Practice (ISSN: 1530-891X), a peer-reviewed journal published twelve times a year, is the official journal of the American Association of Clinical Endocrinologists (AACE). The primary mission of Endocrine Practice is to enhance the health care of patients with endocrine diseases through continuing education of practicing endocrinologists.