Trial reportThe Journal of clinical endocrinology and metabolism2026
The Time of the Hypertonic Saline Infusion Test for the Diagnosis of AVP Deficiency Can Be Shortened With LC-MS/MS.
Trial report in The Journal of clinical endocrinology and metabolism, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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12 authors.
Funding
Abstract
contextIn clinical practice, plasma arginine vasopressin (AVP) concentrations have been measured with a radioimmunoassay (RIA). However, RIAs have limitations, such as long turnaround time, use of radioisotopes, and restricted antibody availability. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) offers a promising alternative, eliminating the need for radioisotopes and antibodies while providing faster results.
objectiveThis study aimed to assess the usefulness of LC-MS/MS for measuring plasma AVP concentrations in diagnosing AVP deficiency (AVP-D).
methodsWe included 16 patients with AVP-D and 28 controls. All participants underwent a hypertonic saline infusion test (HST), during which plasma AVP concentrations were measured using RIA and LC-MS/MS. Regression coefficients (gradients) for serum sodium vs plasma AVP concentrations were evaluated at 90 and 120 minutes, and receiver-operating characteristic analyses were performed based on these regression coefficients.
resultsThe area under the receiver-operating characteristic curve at 90 minutes was 0.97 (95% CI, 0.83-1.00) and 0.93 (95% CI, 0.80-0.98) for LC-MS/MS and RIA, respectively. A regression gradient cutoff with optimal values distinguished AVP-D from controls with a sensitivity of 100% in LC-MS/MS and RIA, whereas the specificity was 96% and 81% with LC-MS/MS and RIA, respectively. Sensitivity or specificity did not differ in 120 minutes between the 2 methods.
conclusionLC-MS/MS demonstrated superior diagnostic accuracy for AVP-D at 90 minutes of HST, indicating that the HST time can be shortened from 120 to 90 minutes by measuring AVP with LC-MS/MS. CLINICAL
trial registrationThe study was registered with the University Hospital Medical Information Network (UMIN) registry (UMIN000043023).
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