FGF-21 levels in polyuria-polydipsia syndrome. Issue 12 (December 2018)

• Record Type: Journal Article
• Authors: Refardt, Julie; Sailer, Clara Odilia; Winzeler, Bettina; Betz, Matthias Johannes; Chifu, Irina; Schnyder, Ingeborg; Fassnacht, Martin; Fenske, Wiebke; Christ-Crain, Mirjam
• Is Part Of: Endocrine connections. Volume 7:Issue 12(2018)
• Page Start: 1501
• Page End: 1506
• Publication Date: 2018-12
• Subjects: FGF21 -- diabetes insipidus -- primary polydipsia -- osmotic stimulation -- copeptin; Endocrinology -- Periodicals; 616.4005
• DOI: 10.1530/EC-18-0469
• Languages: English
• ISSNs: 2049-3614

Abstract

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.