[Analysis of risk factors for central diabetes insipidus in Langerhans cell histiocytosis].

Abstract

To explore the clinical characteristics of patients with Langerhans cell histiocytosis (LCH) and the risk factors for the occurrence of central diabetes insipidus(CDI). A retrospective analysis was conducted on the clinical data of 139 patients hospitalized for LCH at the First Medical Center of Chinese PLA General Hospital from October 2009 to March 2025. Among them, 76 were male and 63 were female, with the age at diagnosis of 21 (6, 39) years. The patients were divided into a CDI group (n=20) and a non-CDI group (n=119) according to the occurrence of CDI. Multivariate logistic regression analysis was used to identify the risk factors for CDI in patients with LCH. Among the 139 patients, single-system single-lesion LCH was the most common type (94/139, 67.6%), while multi-system involvement was observed in 39 cases (39/139, 28.0%). The most frequently involved organ was the bone (107/139, 77.0%). There were 24 cases (24/139, 17.3%) of LCH patients involving the central nervous system (CNS). Among them, 20 cases presented with CDI, and 10 cases (10/20, 50.0%) were complicated with anterior pituitary dysfunction. The proportions of patients with single-system single-lesion involvement and bone involvement in the CDI group were lower than those in the non-CDI group, while the proportions of patients with multisystem involvement without risk organ involvement, CNS involvement, skin and soft tissue involvement, and thyroid involvement were higher in the CDI group (all P<0.05). After adjusting for age, sex and body mass index, multivariate logistic regression analysis revealed that multi-system involvement without high-risk organ involvement (OR=6.868, 95%CI: 2.305-20.289), skin and soft tissue involvement (OR=6.318, 95%CI: 1.109-35.983), and thyroid involvement (OR=7.212, 95%CI: 1.053-49.395) were positively associated with the occurrence of CDI, while single-system single-lesion involvement (OR=0.323, 95%CI: 0.118-0.885) and bone involvement (OR=0.082, 95%CI: 0.027-0.253) were negatively associated with CDI. Among patients with LCH, those presenting with multisystem involvement without high-risk organ (liver, spleen, bone marrow) involvement, skin and soft tissue involvement, or thyroid involvement had higher odds of CDI.