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Glucagon-stimulated copeptin response in children: a proof-of-concept study
Rita Indirli1,2, Federico Giacchetti1, Eriselda Profka1,2
1Endocrinology Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico di Milano, Milan, Italy.
Frontiers in Endocrinology
|June 29, 2026
Summary
The glucagon stimulation test (GST) effectively increases copeptin levels in children, showing promise for diagnosing polyuria-polydipsia syndrome (PPS). Further research is needed to confirm its diagnostic accuracy in pediatric cases.
Area of Science:
- Pediatric Endocrinology
- Diagnostic Testing
- Hormone Assays
Background:
- The diagnostic workup for polyuria-polydipsia syndrome (PPS) in children is not well-established.
- Non-osmotic copeptin-stimulating agents are being investigated for PPS diagnosis.
- Glucagon stimulation test (GST) shows a robust copeptin response in adults, but data in children are lacking.
Purpose of the Study:
- To investigate the copeptin response to the glucagon stimulation test (GST) in children.
- To evaluate GST's potential in diagnosing growth hormone (GH) deficiency and PPS in pediatric patients.
Main Methods:
- Twenty children (9 girls, mean age 10.3 years) without PPS underwent GST.
- Plasma glucose, GH, cortisol, and copeptin levels were measured pre- and post-glucagon injection at multiple time points.
Main Results:
- GST induced a significant increase in copeptin levels, with peak concentration at 150 minutes (+87%).
- Median copeptin increased from 4.1 pmol/L at baseline to 10.6 pmol/L at peak.
- No adverse events were reported during the GST procedure.
Conclusions:
- GST is a safe and effective method for stimulating copeptin secretion in children with normal neurohypophysial function.
- Further studies are warranted to establish GST's accuracy in the differential diagnosis of pediatric PPS.
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