Role of Early Postoperative Measurement of Copeptin in Prediction of Diabetes Insipidus Following Pituitary Surgery in Adults: A Systematic Review Plus Meta-analysis

IF 1.9 4区 医学 Q3 CLINICAL NEUROLOGY
Alireza Sharifi , Peter H. Hwang , Ali Kouhi , Mohaddeseh Zojaji , Mohammad E. Ghaffari , Sahar Ghaedsharaf
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引用次数: 0

Abstract

Background

Early diagnosis of diabetes insipidus (DI), a complication following pituitary surgery, can avoid catastrophic results such as lethargy or even death. Measurement of arginine vasopressin (AVP) may help the early diagnosis, but its direct assaying is challenging. Copeptin, which is co-secreted in equimolar quantities to AVP, is suggested to be a reliable marker in prediction of postoperative DI. Therefore, this systematic review plus meta-analysis aims to discover this possible role.

Methods

Google Scholar, PubMed, Scopus, Web of Science, Embase, and Cochrane library were systematically searched up to August 2024. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them. A meta-analysis was conducted to assess the discriminative performance of copeptin.

Results

In total, 8 cohort studies including 1255 participants met the inclusion criteria. The median copeptin levels were significantly lower in DI groups compared with non-DI groups in all included studies (P < 0.005). Meta-analysis of areas under the curve demonstrated that early measurement of copeptin level had an accuracy of 0.791 (standard error: 0.0198, 95% CI: 0.752 to 0.830), which was statistically significant (P < 0.001).

Conclusions

Copeptin level was significantly lower in DI patients than in non-DI patients who underwent pituitary surgery. Early measurement, as soon as possible (from the first hour to 48 hours after the operation) of copeptin after pituitary surgeries has good, but not excellent, accuracy to exclude postoperative DI.
术后早期测量 Copeptin 在预测成人垂体手术后糖尿病性尿崩症中的作用:系统综述加荟萃分析。
目的:垂体手术后的并发症--糖尿病性尿崩症(DI)的早期诊断可避免嗜睡甚至死亡等灾难性后果。精氨酸加压素(AVP)的测定有助于早期诊断,但其直接测定具有挑战性。与 AVP 等摩尔量共同分泌的 Copeptin 被认为是预测术后 DI 的可靠标志物。因此,本系统综述和荟萃分析旨在发现这种可能的作用:方法:对谷歌学术、PubMed、Scopus、Web of Science、Embase 和 Cochrane 图书馆进行了系统检索(截至 2024 年 8 月)。采用了系统综述和荟萃分析首选报告项目(PRISMA)和问题/人群、干预、比较和结果(PICO)指南。两位作者独立审阅了符合条件的文章,并对其质量进行了评估。进行了一项荟萃分析以评估 copeptin 的鉴别性能:共有 8 项队列研究(包括 1255 名参与者)符合纳入标准。在所有纳入的研究中,与非DI组相比,DI组的中位数 copeptin 水平明显较低(P < 0.005)。AUCs的元分析表明,早期测量宫缩肽水平的准确度为0.791(SE:0.0198,95% CI:0.752至0.830),具有统计学意义(P < 0.001):结论:接受垂体手术的DI患者的谷丙转氨酶水平明显低于非DI患者。垂体手术后尽早(术后 1 小时至 48 小时内)测量谷丙转氨酶对排除术后 DI 有良好但非极佳的准确性。
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
World neurosurgery
World neurosurgery CLINICAL NEUROLOGY-SURGERY
CiteScore
3.90
自引率
15.00%
发文量
1765
审稿时长
47 days
期刊介绍: World Neurosurgery has an open access mirror journal World Neurosurgery: X, sharing the same aims and scope, editorial team, submission system and rigorous peer review. The journal''s mission is to: -To provide a first-class international forum and a 2-way conduit for dialogue that is relevant to neurosurgeons and providers who care for neurosurgery patients. The categories of the exchanged information include clinical and basic science, as well as global information that provide social, political, educational, economic, cultural or societal insights and knowledge that are of significance and relevance to worldwide neurosurgery patient care. -To act as a primary intellectual catalyst for the stimulation of creativity, the creation of new knowledge, and the enhancement of quality neurosurgical care worldwide. -To provide a forum for communication that enriches the lives of all neurosurgeons and their colleagues; and, in so doing, enriches the lives of their patients. Topics to be addressed in World Neurosurgery include: EDUCATION, ECONOMICS, RESEARCH, POLITICS, HISTORY, CULTURE, CLINICAL SCIENCE, LABORATORY SCIENCE, TECHNOLOGY, OPERATIVE TECHNIQUES, CLINICAL IMAGES, VIDEOS
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