{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T14:27:09Z","timestamp":1763389629216,"version":"3.37.3"},"reference-count":29,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,11,30]],"date-time":"2022-11-30T00:00:00Z","timestamp":1669766400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100004902","name":"Akademie der Naturwissenschaften","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100004902","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008375","name":"Universit\u00e4t Basel","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100008375","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["pericles.pericles-gcp.literatumonline.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Primary polydipsia is characterized by excessive fluid intake which may suppress vasopressin levels. It is speculated that suppressed vasopressin levels lead to a dysregulated hypothalamic\u2013pituitary\u2013adrenal (HPA) axis as vasopressin co\u2010modulates the HPA axis. However, data are contradictory. The aim of this study was to investigate markers of the HPA axis in patients with primary polydipsia compared to healthy controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Exploratory analysis combining data from two different prospective observational studies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>We included 34 patients with primary polydipsia (68% females, median aged 29.5 years (interquartile range, IQR: 26.0, 38.8) and 20 healthy controls (55% females, median age 24.0 years [IQR: 22.0, 27.2]).<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>The main outcome was difference in HPA axis activity assessed using circadian serum and salivary cortisol, 24\u2010h\u00a0urinary free cortisol\u00a0and cortisol levels before and after adrenocorticotropic hormone (ACTH) stimulation; vasopressin suppression was assessed measuring fasting copeptin levels between patients with primary polydipsia and healthy controls using Wilcoxon rank\u2010sum test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No difference was seen in circadian serum cortisol levels (<jats:italic>p<\/jats:italic>\u2009=\u2009.9), urinary free cortisol levels (<jats:italic>p<\/jats:italic>\u2009=\u2009.17)\u00a0and serum cortisol in response to ACTH stimulation (<jats:italic>p<\/jats:italic>\u2009=\u2009.77) between groups. Circadian salivary cortisol levels were significantly lower in patients with primary polydipsia compared to healthy controls with an estimated difference of \u22123.7\u2009nmol\/L (95%\u00a0CI: \u22125.5, \u22121.8\u2009nmol\/L, <jats:italic>p<\/jats:italic>\u2009&lt;\u2009.001). Fasting copeptin levels were significantly lower in patients with primary polydipsia compared to healthy volunteers (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest no difference in HPA axis activity between patients with primary polydipsia and healthy controls. The observed difference in salivary cortisol levels may be linked to a dilution effect in saliva rather than an altered stress axis considering the other findings.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.14835","type":"journal-article","created":{"date-parts":[[2022,10,20]],"date-time":"2022-10-20T06:54:19Z","timestamp":1666248859000},"page":"535-544","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Hypothalamic\u2013pituitary\u2013adrenal axis activity in patients with primary polydipsia compared to healthy controls"],"prefix":"10.1111","volume":"99","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6439-8191","authenticated-orcid":false,"given":"Clara O.","family":"Sailer","sequence":"first","affiliation":[{"name":"Departments\u00a0of Endocrinology,\u00a0Diabetology and Metabolism University Hospital Basel Basel Switzerland"},{"name":"Department of Clinical Research University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jill M","family":"Kuehne","sequence":"additional","affiliation":[{"name":"Departments\u00a0of Endocrinology,\u00a0Diabetology and Metabolism University Hospital Basel Basel Switzerland"},{"name":"Department of Clinical Research University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ismael","family":"da Concei\u00e7\u00e3o","sequence":"additional","affiliation":[{"name":"Department of Clinical Research University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3040-4685","authenticated-orcid":false,"given":"Julie","family":"Refardt","sequence":"additional","affiliation":[{"name":"Departments\u00a0of Endocrinology,\u00a0Diabetology and Metabolism University Hospital Basel Basel Switzerland"},{"name":"Department of Clinical Research University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6336-0965","authenticated-orcid":false,"given":"Mirjam","family":"Christ\u2010Crain","sequence":"additional","affiliation":[{"name":"Departments\u00a0of Endocrinology,\u00a0Diabetology and Metabolism University Hospital Basel Basel Switzerland"},{"name":"Department of Clinical Research University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8305-2700","authenticated-orcid":false,"given":"Bettina","family":"Winzeler","sequence":"additional","affiliation":[{"name":"Departments\u00a0of Endocrinology,\u00a0Diabetology and Metabolism University Hospital Basel Basel Switzerland"},{"name":"Department of Clinical Research University of Basel Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2022,11,30]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0924-9338(00)00399-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.beem.2016.02.007"},{"issue":"4344","key":"e_1_2_8_4_1","first-page":"1","article-title":"Primary polydipsia in the medical and psychiatric patient: characteristics, complications and therapy","volume":"147","author":"Sailer CO","year":"2017","journal-title":"Swiss Med Wkly"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11920-007-0025-7"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/0006-3223(94)90008-6"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1997.01830170069010"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2006-1131"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/hipo.20292"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.150.4.653"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bbr.2010.11.025"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.schres.2014.06.001"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1803760"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)31255-3"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1172\/JCI151800"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12020-020-02394-2"},{"key":"e_1_2_8_17_1","unstructured":"R Core T.\u00a0R: A Language and Environment for Statistical Computing.\u00a02018. 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