Diagnostic Accuracy of Copeptin in the Differential Diagnosis of patients with Diabetes Insipidus: A Systematic Review and Meta-analysis

Link to article at PubMed

Endocr Pract. 2023 May 22:S1530-891X(23)00413-5. doi: 10.1016/j.eprac.2023.05.006. Online ahead of print.


OBJECTIVE: Accurate diagnosis of diabetes insipidus (DI) is of significant importance for correct management. We aimed to evaluate the diagnostic accuracy of copeptin measurements in the differential diagnosis between DI and primary polydipsia (PP).

METHODS: A literature search of electronic databases from Jan. 1st, 2005 to July 13th, 2022 was performed. Primary studies that evaluated the diagnostic accuracy of copeptin in patients with DI and PP were eligible. Two reviewers independently screened relevant articles and extracted data. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 tool was used to assess the quality of the included studies. The hierarchical summary receiver operating characteristic model and bivariate method were used.

RESULTS: Seven studies including 422 patients with polydipsia-polyuria syndrome (PPS), 189 (44.79%) of whom with arginine vasopressin-deficiency (AVP-D, cranial DI) and 212 (50.24%) with PP, were included. The summary estimates of the diagnostic performance of stimulated copeptin to differentiate between PP and AVP-D were 0.93 (95% confidence interval [CI] 0.89-0.97) for sensitivity, 0.96 (95% CI 0.88-1.00) for specificity, respectively. Baseline copeptin level had high performance to identify AVP- resistance (AVP-R, nephrogenic DI), with pooled sensitivity of 1.00 (95% CI 0.82-1.00) and specificity of 1.00 (95% CI 0.98-1.00); however, it showed little value in the differentiation between PP and AVP-D.

CONCLUSION: Copeptin measurement is a useful tool for the differential diagnosis of patients with DI and PP. Stimulation before copeptin measurement is necessary in the diagnosis of AVP-D.

PMID:37225043 | DOI:10.1016/j.eprac.2023.05.006

Leave a Reply

Your email address will not be published. Required fields are marked *