Does clonidine stimulate copeptin in children?

Gerhard Binder; Karin Weber; Andreas Peter; Roland Schweizer

doi:10.1515/jpem-2024-0498

Article

Does clonidine stimulate copeptin in children?

Gerhard Binder , Karin Weber , Andreas Peter and Roland Schweizer

Published/Copyright: January 1, 2025

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 38 Issue 2

Abstract

Objectives

Copeptin is secreted in isomolar amounts along with AVP. Its stability makes it a perfect biomarker of AVP deficiency. In children, dynamic GH tests were shown to stimulate copeptin. Here, we retrospectively studied the effect of clonidine on copeptin release.

Methods

This is a monocentric retrospective analysis of donated residual serum samples from 42 children with suspected growth hormone deficiency (GHD) who underwent clonidine stimulation between 2020 and 2023. Copeptin was measured in baseline, 30-, 60-, 90- and 120-min samples by BRAHMS Copeptin proAVP Kryptor immunofluorescence assay.

Results

There were 20 patients with GHD and 22 without; no patient had polyuria-polydipsia syndrome. Median age was 6.7 years (quartiles; 5.6–7.8), and the median height was −2.92 SDS (−3.42 to −2.34). The median baseline level of copeptin was 5.6 pmol/L (3.4–9.6). Median copeptin mildly decreased to 4.5 pmol/L (3.0–10.0) after 30 min; this change was not significant (p=0.45). Thereafter, median values remained low at 4.6, 4.6, and 4.6 pmol/L (60, 90, and 120 min). There was no correlation between baseline copeptin levels and the diagnosis of GHD.

Conclusions

The clonidine stimulation test does not stimulate copeptin release and is not suitable for the assessment of AVP deficiency in children.

Keywords: arginine vasopressin deficiency; clonidine; copeptin; diabetes insipidus; growth hormone

Corresponding author: Gerhard Binder, Pediatric Endocrinology, University-Children’s Hospital, Hoppe-Seyler-Str.1, 72076 Tübingen, Germany, E-mail: gerhard.binder@med.uni-tuebingen.de

Acknowledgments

We are grateful to families and patients for providing residual blood samples.

Research ethics: This study and the use of biobank samples were approved by the Ethics Committee of the Medical Faculty of Tübingen (768/2023BO2).
Informed consent: All care givers gave their written informed consent for the unrestricted scientific use of the biobank samples.
Author contributions: GB: Conceptualization, methodology, writing the original draft, and editing; KW: Methodology, formal analysis, editing, and review; AP: Methodology, formal analysis, editing, and review; RS: Methodology, formal analysis, editing, and review. All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Use of Large Language Models, AI and Machine Learning Tools: None declared.
Conflict of interest: The authors state no conflict of interest.
Research funding: None declared.
Data availability: The data that support the findings of this study are available from the corresponding author G.B. upon reasonable request.

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Received: 2024-10-17

Accepted: 2024-12-16

Published Online: 2025-01-01

Published in Print: 2025-02-25

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https://doi.org/10.1515/jpem-2024-0498

Keywords for this article

arginine vasopressin deficiency; clonidine; copeptin; diabetes insipidus; growth hormone