Urinary oxytocin secretion after pituitary surgery, early arginine vasopressin deficiency and syndrome of inappropriate antidiuresis.

IF 3.7 3区医学 Q2 Medicine

Endocrine Pub Date : 2024-12-17 DOI:10.1007/s12020-024-04131-5

Paul E Constanthin, Nathalie Isidor, Sophie De Seigneux, Shahan Momjian

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引用次数: 0

Abstract

Purpose: Transient arginine vasopressin deficiency (AVP-D), previously called diabetes insipidus, is a well-known complication of transsphenoidal pituitary surgery (TPS) with no definite predictive biomarker to date making it difficult to anticipate. While oxytocin (OXT) was previously suggested as a possible biomarker to predict syndrome of inappropriate diuresis (SIAD)-related hyponatraemia after TPS, its secretion in patients presenting with AVP-D remains poorly understood. We therefore hypothesized that OXT might present a different secretion in the case of AVP-D which would support its potential as an early biomarker of AVP-D. Moreover, we hypothesized that abnormal secretion of OXT might occur later on, notably with SIAD.

Methods: We measured the urinary output of OXT in 67 consecutive patients subjected to TPS and compared the values of oxytocin between time-points and OXT ratio between groups. The primary endpoint of our study was to identify a difference in urinary OXT excretion in patients suffering from AVP-D compared to patients remaining normonatraemic. As a secondary endpoint, we compared the evolution of OXT secretion after the diagnosis of AVP-D in both groups, comparing the patients that later developed SIAD with the ones that did not.

Results: Patients developing AVP-D showed a delay in the increase of OXT secretion after TPS as shown by a significantly lower ratio of OXT between the first postoperative day and the day of surgery (0.88 VS 1.68, p = 0.0162, IC:0.2979-0.2642) but a significantly higher ratio of OXT between the fourth and the first postoperative days (1.17 VS 0.53, p = 0.0006, IC:-2.109-0.6092). Moreover, normonatraemic patients that did not show normalization of OXT levels at day 4 after surgery tended to develop SIAD later on.

Conclusion: Taken together, these results show for the first time that OXT release might help predict AVP-D after TPS and differentiate it from other pathologies of water-sodium balance.

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垂体术后尿后叶催产素分泌、早期精氨酸抗利尿素缺乏及不适当抗利尿综合征。

目的：短暂性精氨酸抗利尿激素缺乏症（AVP-D），以前称为尿崩症，是经蝶垂体手术（TPS）的一种众所周知的并发症，迄今尚无明确的预测性生物标志物，因此难以预测。虽然催产素（OXT）先前被认为是预测TPS后不适当利尿（SIAD）相关低钠血症综合征的可能生物标志物，但其在AVP-D患者中的分泌情况仍知之甚少。因此，我们假设OXT可能在AVP-D的情况下呈现不同的分泌，这将支持其作为AVP-D的早期生物标志物的潜力。此外，我们假设OXT的异常分泌可能会在以后发生，特别是SIAD。方法：对67例连续TPS患者的尿中OXT量进行测定，比较各组间催产素在不同时间点的值及OXT比值。我们研究的主要终点是确定AVP-D患者与正常血液患者相比尿OXT排泄的差异。作为次要终点，我们比较了两组AVP-D诊断后OXT分泌的演变，比较了后来发展为SIAD的患者和未发展为SIAD的患者。结果：AVP-D患者TPS后OXT分泌增加延迟，术后第一天与手术当天OXT比值显著降低（0.88 VS 1.68, p = 0.0162, IC:0.2979 ~ 0.2642），但术后第4天与第1天OXT比值显著升高（1.17 VS 0.53, p = 0.0006, IC:-2.109 ~ 0.6092）。此外，在手术后第4天OXT水平未显示正常化的正常贫血患者倾向于在随后发生SIAD。结论：综上所述，这些结果首次表明OXT释放可能有助于预测TPS后AVP-D，并将其与其他水钠平衡病理区分开来。

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 医学-内分泌学与代谢

CiteScore

6.40

自引率

5.40%

发文量

期刊介绍： Well-established as a major journal in today’s rapidly advancing experimental and clinical research areas, Endocrine publishes original articles devoted to basic (including molecular, cellular and physiological studies), translational and clinical research in all the different fields of endocrinology and metabolism. Articles will be accepted based on peer-reviews, priority, and editorial decision. Invited reviews, mini-reviews and viewpoints on relevant pathophysiological and clinical topics, as well as Editorials on articles appearing in the Journal, are published. Unsolicited Editorials will be evaluated by the editorial team. Outcomes of scientific meetings, as well as guidelines and position statements, may be submitted. The Journal also considers special feature articles in the field of endocrine genetics and epigenetics, as well as articles devoted to novel methods and techniques in endocrinology. Endocrine covers controversial, clinical endocrine issues. Meta-analyses on endocrine and metabolic topics are also accepted. Descriptions of single clinical cases and/or small patients studies are not published unless of exceptional interest. However, reports of novel imaging studies and endocrine side effects in single patients may be considered. Research letters and letters to the editor related or unrelated to recently published articles can be submitted. Endocrine covers leading topics in endocrinology such as neuroendocrinology, pituitary and hypothalamic peptides, thyroid physiological and clinical aspects, bone and mineral metabolism and osteoporosis, obesity, lipid and energy metabolism and food intake control, insulin, Type 1 and Type 2 diabetes, hormones of male and female reproduction, adrenal diseases pediatric and geriatric endocrinology, endocrine hypertension and endocrine oncology.