Bone turnover in arginine vasopressin deficiency: a comparative study with primary polydipsia and healthy controls
Abstract
Context: Arginine vasopressin (AVP) and oxytocin are neurohormones with opposing effects on bone in preclinical models, while their relevance in humans remains uncertain. Data on bone metabolism in individuals lacking AVP release-and possibly also oxytocin-such as patients with AVP deficiency (AVP-D, also known as central diabetes insipidus) remain scarce, although the limited available evidence suggests a potentially deleterious effect.
Objective: This study aimed to evaluate bone turnover markers in patients with AVP-D compared to individuals with primary polydipsia (PP) and healthy controls (HC).
Methods: This was a secondary analysis of the prospective URANOS Trial (NCT05890690) conducted from June 2023 to June 2024. After excluding patients on chronic steroid therapy (except budesonide and replacement therapy), prior osteoporotic fractures, long-term antiresorptive treatment, or medications known to adversely affect bone metabolism (eg, aromatase inhibitors), 46 participants were included (HC = 22, AVP-D = 11, PP = 13). All individuals were assessed for bone resorption (C-terminal telopeptide of type I collagen [CTX]) and bone formation (N-terminal propeptide of type I collagen [P1NP]) markers, as well as 25OH-vitamin D, serum calcium, and phosphate. The bone formation index (defined as P1NP/CTX ratio) was calculated.
Results: Serum calcium, phosphate, and P1NP levels were comparable across groups, whereas 25OH-vitamin D concentrations were lower in patients with AVP-D…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 46 participants or records.
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