Role of Early Postoperative Measurement of Copeptin in Prediction of Diabetes Insipidus Following Pituitary Surgery in Adults: A Systematic Review Plus Meta-analysis.

Autor: Sharifi A; Department of Otolaryngology Head and Neck Surgery, Amir A'lam Hospital, Tehran University of Medical Sciences, Tehran, Iran; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Hwang PH; Department of Otolaryngology - Head and Neck Surgery, Stanford University School of Medicine, Palo Alto, California, USA., Kouhi A; Department of Otolaryngology Head and Neck Surgery, Amir A'lam Hospital, Tehran University of Medical Sciences, Tehran, Iran; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran., Zojaji M; Digestive Diseases Research Center, Tehran University of Medical Sciences, Tehran, Iran., Ghaffari ME; Department of Epidemiology and Biostatistics, Faculty of Health, Qom University of Medical Sciences, Qom, Iran., Ghaedsharaf S; Department of Otolaryngology Head and Neck Surgery, Amir A'lam Hospital, Tehran University of Medical Sciences, Tehran, Iran; School of Dentistry, Shahid Beheshti University, Tehran, Iran. Electronic address: Alireza.muq.93@gmail.com.
Jazyk: angličtina
Zdroj: World neurosurgery [World Neurosurg] 2024 Oct 28; Vol. 193, pp. 46-53. Date of Electronic Publication: 2024 Oct 28.
DOI: 10.1016/j.wneu.2024.10.006
Abstrakt: Background: Early diagnosis of diabetes insipidus (DI), a complication following pituitary surgery, can avoid catastrophic results such as lethargy or even death. Measurement of arginine vasopressin (AVP) may help the early diagnosis, but its direct assaying is challenging. Copeptin, which is co-secreted in equimolar quantities to AVP, is suggested to be a reliable marker in prediction of postoperative DI. Therefore, this systematic review plus meta-analysis aims to discover this possible role.
Methods: Google Scholar, PubMed, Scopus, Web of Science, Embase, and Cochrane library were systematically searched up to August 2024. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) and Problem/Population, Intervention, Comparison, and Outcome (PICO) guidelines were used. Two authors independently reviewed the eligible articles and assessed the quality of them. A meta-analysis was conducted to assess the discriminative performance of copeptin.
Results: In total, 8 cohort studies including 1255 participants met the inclusion criteria. The median copeptin levels were significantly lower in DI groups compared with non-DI groups in all included studies (P < 0.005). Meta-analysis of areas under the curve demonstrated that early measurement of copeptin level had an accuracy of 0.791 (standard error: 0.0198, 95% CI: 0.752 to 0.830), which was statistically significant (P < 0.001).
Conclusions: Copeptin level was significantly lower in DI patients than in non-DI patients who underwent pituitary surgery. Early measurement, as soon as possible (from the first hour to 48 hours after the operation) of copeptin after pituitary surgeries has good, but not excellent, accuracy to exclude postoperative DI.
(Copyright © 2024 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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