{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T14:16:56Z","timestamp":1784557016352,"version":"3.55.0"},"reference-count":52,"publisher":"Bioscientifica","issue":"12","license":[{"start":{"date-parts":[[2018,12,1]],"date-time":"2018-12-01T00:00:00Z","timestamp":1543622400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["ec.bioscientifica.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2018,12]]},"abstract":"<jats:p>\n                    The pathomechanism of primary polydipsia is poorly understood. Recent animal data reported a connection between fibroblast growth factor 21 (FGF-21) and elevated fluid intake independently of hormonal control by the hormone arginine-vasopressin (AVP) and osmotic stimulation. We therefore compared circulating FGF-21 levels in patients with primary polydipsia to patients with AVP deficiency (central diabetes insipidus) and healthy volunteers. In this prospective cohort study, we analyzed FGF-21 levels of 20 patients with primary polydipsia, 20 patients with central diabetes insipidus and 20 healthy volunteers before and after stimulation with hypertonic saline infusion targeting a plasma sodium level \u2265150\u2009mmol\/L. The primary outcome was the difference in FGF-21 levels between the three groups. Baseline characteristics were similar between the groups except for patients with central diabetes insipidus being heavier. There was no difference in baseline FGF-21 levels between patients with primary polydipsia and healthy volunteers (122\u2009pg\/mL (52,277) vs 193\u2009pg\/mL (48,301), but higher levels in patients with central diabetes insipidus were observed (306\u2009pg\/mL (114,484);\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.037). However, this was not confirmed in a multivariate linear regression analysis after adjusting for age, sex, BMI and smoking status. Osmotic stimulation did not affect FGF-21 levels in either group (difference to baseline: primary polydipsia \u221223\u2009pg\/mL (\u221243, 22); central diabetes insipidus 17\u2009pg\/mL (\u221276, 88); healthy volunteers \u22126\u2009pg\/mL (\u221268, 22);\n                    <jats:italic>P<\/jats:italic>\n                    \u2009=\u20090.45). To conclude, FGF-21 levels are not increased in patients with primary polydipsia as compared to central diabetes insipidus or healthy volunteers. FGF-21 therefore does not seem to be causal of elevated fluid intake in these patients.\n                  <\/jats:p>","DOI":"10.1530\/ec-18-0469","type":"journal-article","created":{"date-parts":[[2018,12,27]],"date-time":"2018-12-27T11:17:46Z","timestamp":1545909466000},"page":"1501-1506","update-policy":"https:\/\/doi.org\/10.1530\/crossmarkpolicy-10","source":"Crossref","is-referenced-by-count":0,"title":["FGF-21 levels in polyuria-polydipsia syndrome"],"prefix":"10.1530","volume":"7","author":[{"given":"Julie","family":"Refardt","sequence":"first","affiliation":[{"name":"1Departments of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland"},{"name":"2Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clara Odilia","family":"Sailer","sequence":"additional","affiliation":[{"name":"1Departments of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland"},{"name":"2Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bettina","family":"Winzeler","sequence":"additional","affiliation":[{"name":"1Departments of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland"},{"name":"2Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthias Johannes","family":"Betz","sequence":"additional","affiliation":[{"name":"1Departments of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland"},{"name":"2Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Chifu","sequence":"additional","affiliation":[{"name":"3Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ingeborg","family":"Schnyder","sequence":"additional","affiliation":[{"name":"1Departments of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland"},{"name":"2Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Fassnacht","sequence":"additional","affiliation":[{"name":"3Division of Endocrinology and Diabetes, Department of Internal Medicine I, University Hospital, University of W\u00fcrzburg, W\u00fcrzburg, Germany"},{"name":"4Central Laboratory, University Hospital W\u00fcrzburg, W\u00fcrzburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wiebke","family":"Fenske","sequence":"additional","affiliation":[{"name":"5Department of Endocrinology and Nephrology, University of Leipzig, Leipzig, Germany"},{"name":"6Leipzig University Medical Center, IFB Adiposity Diseases, Leipzig, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjam","family":"Christ-Crain","sequence":"additional","affiliation":[{"name":"1Departments of Endocrinology, Diabetology and Metabolism, University Hospital Basel, Basel, Switzerland"},{"name":"2Department of Clinical Research, University of Basel, Basel, Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"_","family":"_","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"416","reference":[{"key":"ref131","doi-asserted-by":"crossref","first-page":"505","DOI":"10.2337\/db11-0838","article-title":"FGF21 Analogs of sustained action enabled by orthogonal biosynthesis demonstrate enhanced antidiabetic pharmacology in 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Endocrinology"},{"key":"ref271","first-page":"333","article-title":"The regulation of vasopressin function in health and disease","volume":"33","year":"1976","journal-title":"Recent Progress in Hormone Research"},{"key":"ref451","first-page":"1","article-title":"Primary polydipsia in the medical and psychiatric patient: characteristics, complications and therapy","volume":"147","year":"2017","journal-title":"Swiss Medical Weekly"},{"key":"ref141","first-page":"1338.e4","article-title":"The hormone FGF21 stimulates water drinking in response to ketogenic diet and alcohol","volume":"27","year":"2018","journal-title":"Cell Metabolism"},{"key":"ref161","doi-asserted-by":"crossref","first-page":"e0202182","DOI":"10.1371\/journal.pone.0202182","article-title":"FGF21 increases water intake, urine output and blood pressure in rats","volume":"13","year":"2018","journal-title":"PLoS ONE"},{"key":"ref181","doi-asserted-by":"crossref","first-page":"505","DOI":"10.1210\/jc.2017-01891","article-title":"Release and decay kinetics of copeptin vs AVP in response to osmotic alterations in healthy volunteers","volume":"103","year":"2018","journal-title":"Journal of Clinical Endocrinology and Metabolism"},{"key":"ref211","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/S0920-9964(01)00292-4","article-title":"Polydipsia and schizophrenia in a psychiatric hospital: a replication study","volume":"57","year":"2002","journal-title":"Schizophrenia Research"},{"key":"ref41","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1146\/annurev-physiol-021115-105339","article-title":"Understanding the physiology of FGF21","volume":"78","year":"2016","journal-title":"Annual Review of Physiology"},{"key":"ref491","doi-asserted-by":"crossref","first-page":"427","DOI":"10.1016\/j.cmet.2016.02.001","article-title":"A long-acting FGF21 molecule, PF-05231023, decreases body weight and improves lipid profile in non-human primates and type 2 diabetic subjects","volume":"23","year":"2016","journal-title":"Cell Metabolism"},{"key":"ref311","doi-asserted-by":"crossref","first-page":"74","DOI":"10.1038\/nrendo.2016.206","article-title":"FGF21 and metabolic disease in 2016: a new frontier in FGF21 biology","volume":"13","year":"2017","journal-title":"Nature reviews. Endocrinology"},{"key":"ref111","doi-asserted-by":"crossref","first-page":"1314","DOI":"10.1210\/en.2016-1917","article-title":"A novel Fc-FGF21 with improved resistance to proteolysis, increased affinity toward \u03b2-klotho, and enhanced efficacy in mice and cynomolgus monkeys","volume":"158","year":"2017","journal-title":"Endocrinology"},{"key":"ref361","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.cca.2017.11.007","article-title":"An implication of Klotho-related molecules in different smoking-related health outcomes between men and women","volume":"476","year":"2018","journal-title":"Clinica Chimica Acta"},{"key":"ref321","first-page":"135","article-title":"Fibroblast growth factor-21 serum concentrations are associated with metabolic and hepatic markers in humans","volume":"216","year":"2013","journal-title":"Journal of Endocrinology"},{"key":"ref61","first-page":"135","article-title":"Fibroblast growth factor-21 serum concentrations are associated with metabolic and hepatic markers in humans","volume":"216","year":"2013","journal-title":"Journal of Endocrinology"},{"key":"ref241","doi-asserted-by":"crossref","first-page":"1051","DOI":"10.1111\/bcp.12676","article-title":"Pharmacokinetics and pharmacodynamics of PF-05231023, a novel long-acting FGF21 mimetic, in a first-in-human study","volume":"80","year":"2015","journal-title":"British Journal of Clinical Pharmacology"},{"key":"ref191","first-page":"1","article-title":"Primary polydipsia in the medical and psychiatric patient: characteristics, complications and therapy","volume":"147","year":"2017","journal-title":"Swiss Medical Weekly"}],"container-title":["Endocrine Connections"],"original-title":[],"link":[{"URL":"https:\/\/ec.bioscientifica.com\/view\/journals\/ec\/7\/12\/EC-18-0469.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/ec.bioscientifica.com\/downloadpdf\/journals\/ec\/7\/12\/EC-18-0469.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T13:43:12Z","timestamp":1784554992000},"score":1,"resource":{"primary":{"URL":"http:\/\/journals.bioscientifica.com\/ec\/article\/7\/12\/1501-1506\/451"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,12]]},"references-count":52,"journal-issue":{"issue":"12"},"URL":"https:\/\/doi.org\/10.1530\/ec-18-0469","relation":{},"ISSN":["2049-3614"],"issn-type":[{"value":"2049-3614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,12]]}}}