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Quality of life in the patients with central diabetes insipidus assessed by Nagasaki Diabetes Insipidus Questionnaire

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Abstract

Central diabetes insipidus (CDI) is characterized by polyuria and polydipsia due to a deficiency of vasopressin. Currently, the treatment goal for CDI is improvement of quality of life (QOL) by desmopressin (DDAVP) without developing hyponatremia. However, there is no reliable measure for QOL in CDI patients. We evaluate our original questionnaire for QOL, consisting of 12 questions focusing on polyuria, polydipsia, and DDAVP treatment, in CDI patients who underwent a switch from nasal spray to oral disintegrating tablets of DDAVP. Twenty-five CDI patients under nasal DDAVP treatment, six with newly developed CDI, and 18 healthy individuals without known polyuric/polydipsic disorders as control subjects were enrolled. QOL scores were determined by our questionnaire at the enrollment and 3 months after the start of oral DDAVP treatment and were examined by the Wilcoxon signed-rank test. Eleven questions detected improvement in QOL. The sum of the QOL scores of the eleven questions increased from 29.2 ± 5.6 under nasal to 36.8 ± 4.5 under oral DDAVP (p < 0.001). There were no clinically relevant changes in serum levels of Na. After eliminating two questions about DDAVP treatment, the sum of QOL scores was 15.3 ± 6.5 in untreated CDI patients, 24.4 ± 5.2 in those with nasal treatment, 28.9 ± 4.9 in those with oral DDAVP, and 29.5 ± 3.6 in healthy controls. The difference among groups was significant (p < 0.05 in Steel–Dwass test) except between patients treated with oral DDAVP and healthy controls. Our questionnaire can be used to accurately assess QOL in CDI patients.

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Acknowledgment

TA has received Science Promotion grant from 461 Astra Zeneca K.K.

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Authors and Affiliations

  1. Division of Endocrinology and Metabolism, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan

    Aya Nozaki, Takao Ando, Satoru Akazawa, Ikuko Sagara, Ichiro Horie, Misa Imaizumi, Toshiro Usa & Atsushi Kawakami

  2. Division of Endocrinology and Metabolism, Isahaya General Hospital, 24-1 Eisho-Higashi, Isahaya, Nagasaki, Japan

    Tsuyoshi Satoh

  3. Division of Endocrinology, Icahn School of Medicine at Mount Sinai, Box 1055, One Gustave L. Levy Place, New York, NY, USA

    Robert T. Yanagisawa

Authors
  1. Aya Nozaki
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  2. Takao Ando
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  3. Satoru Akazawa
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  4. Tsuyoshi Satoh
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  5. Ikuko Sagara
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  6. Ichiro Horie
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  7. Misa Imaizumi
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  8. Toshiro Usa
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  9. Robert T. Yanagisawa
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  10. Atsushi Kawakami
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Corresponding author

Correspondence to Takao Ando.

Electronic supplementary material

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Supplemental Fig. 1. Participants in this study. Supplementary material 1 (PDF 23 kb)

Supplementary material 2 (PDF 45 kb)

12020_2015_637_MOESM3_ESM.pdf

Supplemental Fig. 2. Prediction of beneficial effect in QOL by oral DDAVP in CDI patients under nasal DDAVP. Receiver operation characteristic curve was studied by using sum of QOL score of 11 questions, excluding Q9, and the cut-off for QOL improvement when a patient switched from nasal DDAVP to oral DDAVP was studied. a: A sum of 37 points was determined as the cut-off for not expecting improvement in QOL ≧3 points (sensitivity 50 %, specificity 99.94 %). b: A sum of 36 points was determined as the cut-off for not expecting improvement in QOL ≧4 points (sensitivity 43 %, specificity 99.29 %). Supplementary material 3 (PDF 39 kb)

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Nozaki, A., Ando, T., Akazawa, S. et al. Quality of life in the patients with central diabetes insipidus assessed by Nagasaki Diabetes Insipidus Questionnaire. Endocrine 51, 140–147 (2016). https://doi.org/10.1007/s12020-015-0637-3

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  • DOI: https://doi.org/10.1007/s12020-015-0637-3

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