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. 2023 Sep 27;12(11):e230042.
doi: 10.1530/EC-23-0042. Print 2023 Nov 1.

Copeptin levels increase in response to both insulin-induced hypoglycemia and arginine but not to clonidine: data from GH-stimulation tests

Jelena Stankovic  1 , Kurt Kristensen  2   3 , Niels Birkebæk  3 , Jens Otto Lunde Jørgensen  1 , Esben Søndergaard  1   2
Affiliations

Copeptin levels increase in response to both insulin-induced hypoglycemia and arginine but not to clonidine: data from GH-stimulation tests

Jelena Stankovic et al. Endocr Connect. .

Abstract

Background: The diagnosis of the polyuria-polydipsia syndrome is challenging. Copeptin is a robust biomarker of arginine vasopressin (AVP) secretion. Arginine, which stimulates growth hormone (GH), has been shown also to stimulate copeptin secretion via unknown mechanisms.

Aim: The aim was to investigate copeptin levels in response to three different GH stimulation tests in patients suspected of GH deficiency.

Methods: In this cross-sectional study, we measured plasma copeptin levels at baseline and at 60, 105, and 150 min in patients undergoing a stimulation test for growth hormone deficiency with either arginine (n = 16), clonidine (n = 8) or the insulin tolerance test (ITT) (n = 10).

Results: In patients undergoing the arginine test, the mean age was 9 years, and 10 years for clonidine. The ITT was only performed in adult patients (>18 years) with a mean age of 49 years. Copeptin level increased significantly from baseline to 60 min after arginine (P <0.01) and ITT (P < 0.01). By contrast, copeptin level tended to decrease after clonidine stimulation (P = 0.14).

Conclusion: These data support that infusion of arginine increases plasma copeptin levels and reveal a comparable response after an ITT. We hypothesize that the underlying mechanism is abrogation of somatostatin-induced AVP suppression.

Keywords: arginine; clonidine; copeptin; insulin tolerance test; pituitary.

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Conflict of interest statement

The first author, Stankovic J., has received a speaker’s fee from OTSUKA Pharmaceuticals. Other authors declare they have no financial interest.

Figures

Figure 1
Figure 1
Plasma copeptin concentration during stimulation with arginine for patients with and without AVP deficiency are shown. (Data are shown as mean with 95% CI.)
Figure 2
Figure 2
Plasma copeptin concentration during the ITT for patients with and without AVP deficiency. (Data are shown as mean with 95% CI.)
Figure 3
Figure 3
Plasma copeptin concentration during stimulation with clonidine. (Data are shown as mean with 95% CI.)
See this image and copyright information in PMC

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