Serum Copeptin Research Articles

The effects of proton pump inhibitors on the development of post-stenting major adverse cardiovascular events in patients with acute coronary syndrome

Proton pump inhibitors (PPIs) are recommended for the prevention of gastrointestinal bleeding in acute coronary syndrome (ACS) patients who receive dual antiplatelet therapy (DAPT) after percutaneous coronary intervention (PCI) but have been associated with an increased risk of major adverse cardiovascular events (MACE) in these patients. We aimed to investigate the relationship between serum asymmetric dimethylarginine (ADMA) and copeptin levels and MACE in those who started on imminent DAPT and PPI therapy after PCI. 90 patients with ACS were included in this prospective observational study and divided into three groups lansoprazole (n=30), rabeprazole (n=31), and pantoprazole (n=29). The serum ADMA and copeptin levels were examined at the time of diagnosis, at the end of 1st and 6th month. MACE was defined as mortality, recurrent AMI (acute myocardial infarction), and CST (coronary stent thrombosis) development after PCI. MACE developed in two patients in the first month and eight patients (8.9%) after six months of follow-up. At six months, CST was seen in only two patients (2.2%). At the first-month evaluation, while a significant increase was observed in serum ADMA levels at the time of admission (p<0.001), the copeptin levels decreased significantly in all patients (p<0.001). In the 6th month, the serum ADMA and copeptin levels significantly increased compared to the time of admission and 1st-month evaluation in all groups (p<0.001). PPIs might significantly influence serum ADMA and copeptin levels in patients undergoing coronary stenting due to ACS. Nevertheless, we did not notice clinical extrapolation of the potential effects.

Copeptin Reflect Left Ventricular Systolic Function at Early Stage of Acute Myocardial Infarction in a Pig Model.

Measurement of biomarkers early after acute myocardial infarction (AMI) might provide a cost-effective and widely available tool to assess infarct severity, myocardial dysfunction, and clinical outcomes. We aimed to induce AMI in miniature pigs, measure the levels of serum biomarkers and global LV function dynamically and explore the release kinetics and optimal sampling time points of copeptin and its correlation with global LV function. We induced AMI in the experimental group using a closed-chest model. Left ventricular (LV) function was detected by dual-source computed tomography (DSCT) and serum copeptin was determined by ELISA. The serum copeptin levels were increased at 1 hour, peaked at 3 hours, gradually decreased after 6 hours, and returned to baseline 3 days after AMI. At 3 to 6 hours, the copeptin cutoff of 16.97 to 17.44 pmol/l had 100% sensitivity and 100% specificity (P ⩽ .001) for AMI. Serum copeptin levels at 3 hours and 3 days were negatively correlated with the 3-hours LVEF (P ⩽ .001), respectively. Serum copeptin levels change in time, and measurements at 3 to 6 hours after AMI had the highest predictive value.

Diagnostic Utility of Serum Copeptin Level in Children with Febrile Seizures

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Combined Arginine and Insulin Stimulation Elicits a Robust and Consistent Copeptin Response in Short Children

Introduction: Copeptin, co-secreted with arginine vasopressin, is regulated by osmotic and volume stimuli but also responds to intravenous arginine and insulin-induced hypoglycemia. The serum copeptin response to the latter agents has been studied in adults but only to a limited extent in children. The objective of this study was to describe the copeptin response to combined arginine and insulin in children with normal posterior pituitary function. Methods: We conducted a prospective, single-arm assessment of serum copeptin concentrations in children (age 7–16 years, n = 38) undergoing growth hormone stimulation testing with an arginine-insulin tolerance test (AITT) for short stature or growth deceleration in a tertiary referral center. After overnight fasting, arginine (500 mg/kg) was administered between 0 and 30 min intravenously (IV) followed by insulin (0.1 units/kg IV) at 60 min. Copeptin serum concentrations were measured at baseline (0 min), at the post-arginine peak (60 min), and at the post-insulin peak (90 min; 30 min post-insulin), respectively. The main outcome was the peak copeptin concentration. Results: Mean ± SD copeptin concentrations increased from 9.9 ± 5.0 pmol/L at 0 min to 13.2 ± 5.8 pmol/L at 60 min (p < 0.0001 vs. 0 min) and 27.7 ± 14.2 pmol/L at 90 min (p < 0.0001 vs. 0 and 60 min). There was no significant correlation between copeptin concentrations and age, BMI, pubertal status, cortisol, growth hormone, or glucose concentrations. Discussion/Conclusion: Arginine and insulin appear to have an additive and consistent effect resulting in significant stimulation of copeptin secretion in children. The AITT may be a useful tool to evaluate for normal posterior pituitary function in this age-group, with potential implications for the evaluation of polyuria-polydipsia syndrome.

Evaluation of cardiovascular system and determination of cardiometabolic risk using novel biomarkers in childhood obesity

BackgroundObesity is a metabolic disorder that is defined as excessive increase in body fat tissue. Early recognition of obesity in children is essential to prevent complications that may occur in both childhood and adulthood. ObjectivesThe purpose of this study was to assess cardiometabolic risk and to investigate the association between novel biomarkers and cardiovascular disease in obese children. MethodsThis research was performed between June 2014 and January 2015 in the Pamukkale University Faculty of Medicine. Fifty obese children and, 29 healthy children were included in the study. Fasting levels of serum lipids, glucose and insulin, serum copeptin, BNP, and ADM were measured. Thickness of main CIMT and EAT were assessed with 2D echocardiogram. M-mode echocardiographic measurements, mitral and tricuspid valve measurements with PDE, and tricuspid and interventricular septum measurements with TDE were performed in both groups. Treadmill stress testing was performed in the same patient group. ResultsLevels of total cholesterol and LDL were significantly higher in obese group. Serum BNP and serum ADM levels were significantly lower in obese group. Left ventricular mass index, CIMT and EAT were statistically higher in obese group. Left ventricular end-systolic diameter, left ventricular end-diastolic diameter, interventricular septum diameter, posterior wall thickness were significantly higher in obese group than in control group. Time to reach target heart rate in treadmill stress testing was significantly shorter in obese group than in control group. ConclusionChildhood obesity is associated with significant changes in the myocardial structure based on echocardiography. Thickness of carotid intima-media and epicardial fat tissue can be used as predictive markers of atherosclerosis in obese children. Our study demonstrated that exercise capacity is significantly lower, and hemodynamic response to exercise is defective in obese children.

Copeptin: A potential marker for the prediction of poor ovarian reserve in the ınfertile women.

There is actually no evidence regarding the physiological effects of copeptin in infertile women with different ovarian reserve types. This study aimed to investigate the relationship of serum copeptin level with poor ovarian reserve (POR) and to reveal the predictive value of copeptin for POR development in the infertile women. All participant women were classified as the control group (n=77) included the women with diagnosis of unexplained infertility and the POR group (n=61) was composed of the women who met the European Society of Human Reproduction and Embryology consensus on POR [serum anti-Müllerian hormone (AMH) concentrations below 1.1 ng/mL]. The biochemical tests, including estradiol (E2), follicle stimulating hormone (FSH), luteinizing hormone, AMH and copeptin were analysed. The analyses of serum copeptin concentrations were measured by the means of competitive enzyme immunoassay. A significant increase in the serum copeptin level existed only in the POR group. There was a significant positive correlation between serum copeptin with E2 and FSH levels in the POR group. Significant negative correlations between copeptin and AMH concentrations (r=-0.310, p=0.015) and between copeptin concentration and antral follicle counts (r=-0.284, p=0.027) were detected only in the POR group. The estimated areas under receiver operating characteristic curves for serum concentration were found to be statistically significant with a cut-off value of 3.52 (95% confidence interval 0.519-0.709), sensitivity 0.90 and specificity 0.72. This study confirmed that there was an elevated serum copeptin concentration in the infertile women with POR and that serum copeptin concentration may have a predictive value for POR diagnosis.

A Copeptin as a Predictor Marker for Insulin Resistance Among Women with Polycystic Ovary Syndrome

Background: A polycystic ovarian syndrome (PCOS) is a common endocrine syndrome in which women have a wide range of clinical presentations; insulin resistance was linked to its pathogenesis. Objective: We aimed to investigate the copeptin role as a predictive marker of insulin resistance among PCOS women. Material and Methods: In University Hospital, we included 280 women, with 140 of them being healthy controls. 140 out of 280 cases of PCOS subdivided into two groups depending on the insulin resistance; group 1 with homeostasis model assessment for the insulin resistance &lt; 2.5. Group 2 with homeostasis model assessment for the insulin resistance &gt;2.5. The evaluation of body mass index and blood pressure for all besides the blood sampling for estimation of a follicular stimulating hormone, luteinizing hormone, prolactin, estradiol, sex hormone-binding globulin, total testosterone, fasting insulin dehydroepiandrosterone sulfate, C-reactive protein, plasma glucose, free androgen index, and plasma copeptin using the Copeptin-Human EIA Kit besides the transvaginal ultrasound for ovarian assessment. Results: When compared to other groups, PCOS women with positive insulin resistance &gt;2.5 had a significantly higher plasma copeptin level. The ROC curve calculated a 1.94 pmol/L; plasma copeptin cutoff value for detecting the insulin resistance in PCOS with 88 % sensitivity value and 36 % specificity, AUC was 0.88. Conclusion: The significant positive relationship between serum copeptin and insulin resistance with high sensitivity implies its usefulness as a marker of insulin resistance among PCOS patients with a high prediction of its complication.

RF25 | PMON113 Subarachnoid Hemorrhage Complicated by Nephrogenic and Central Diabetes Insipidus

Abstract Introduction Diabetes insipidus (DI) is a rare complication of subarachnoid hemorrhage (SAH) and associated with worse prognosis and increased mortality. We present a case of combined nephrogenic and central DI together with osmotic diuresis as a result of SAH and discuss the pathophysiology. Case A 63-year-old female without significant past medical history was found unresponsive. CT head followed by angiography confirmed extensive SAH arising from a saccular anterior communicating artery (Acoma) aneurysm. She underwent emergent coil embolization and right frontal external ventriculostomy drain placement. Postoperatively, she developed polyuria (300-400 mL/hour) and hypernatremia (156 mEq/L) concerning for the development of DI. Serum osmolality was elevated at 316 mOsm/kg, urine osmolality inappropriately low relative to serum osmolality at 289 mOsm/kg but also unexpectedly high for complete DI, serum potassium 2.9 mEq/L and urine potassium elevated urine at 9 mEq/L. Serum copeptin was 6 pmol/L and inappropriately low for nephrogenic DI, suggesting a mixed central and peripheral process as well as contribution from osmotic diuresis. Intravenous (IV) desmopressin (DDAVP) only slightly reduced the polyuria. Management was complicated by adypsia and persistent hypokalemia requiring ongoing replacement. IV fluid, which had initially consisted of high-osmolality Plasma-Lyte (294 mOsm/L), matched to urine output, was switched to D5W, leading to a significant decrease in polyuria. On post-operative day 17, DDAVP was discontinued with normalization of sodium (137 mEq/L), potassium (3.8 mEq/L) and urine output. Three months post-operatively, she was asymptomatic with intact pituitary function and no hypokalemia. Discussion Hypokalemia in patients with SAH is thought due to acute intracellular shift of potassium caused by excessive β2-adrenergic activity generated endogenously by the sympathetic nervous system. In our patient, there was also likely contribution from distal tubular delivery of sodium from osmotic diuresis, leading to increased urinary potassium losses and hypokalemia-induced partial nephrogenic DI which was further complicated by partial central DI as suggested by the inappropriately low copeptin level for nephrogenic DI in face of a high serum osmolality and inappropriately low urine osmolality. As the vascular supply to anterior hypothalamus is derived from the Acoma, rupture may compromise perfusion affecting neuronal populations in the lamina terminalis that regulate thirst and AVP secretion in response to hyperosmolarity. Early detection of DI is critical because hypovolemia can predispose to cerebral vasospasm and worsen outcomes. This case also depicts the importance of careful consideration of sources of osmolar loads such as the composition of administered IV fluids, and aggressive potassium replacement to maintain DDAVP sensitivity. Conclusion DI should be considered in polyuria syndrome with hypernatremia after a neurosurgical event. Nephrogenic and central DI and adypsia can manifest following SAH, with sources of iatrogenic osmolar load further complicating the clinical picture. Early recognition and treatment may reduce morbidity and mortality. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m., Monday, June 13, 2022 1:12 p.m. - 1:17 p.m.

PMON180 Extremely Elevated Serum Copeptin Concentrations Following Venipuncture Occur in Approximately 5% of Children and May Affect Proper Interpretation of Copeptin Measurement

Abstract Introduction The secretion of copeptin, an easily measurable surrogate of arginine vasopressin (AVP), is mainly regulated by osmotic and volume stimuli, but also increases in situations of physical stress. Venipuncture has been found to be a stressful procedure, due to physical pain and anxiety, particularly in children. Falsely elevated copeptin concentrations can substantially affect establishment of reference intervals and interpretation of results in conditions such as syndrome of inappropriate antidiuresis, sepsis, infections. We thus tested the hypothesis that venipuncture, as a stressful stimulus, could stimulate copeptin secretion in children. Subjects &amp; Methods We evaluated 92 children (75% males, 5-19 years) enrolled in a study assessing fasting and stimulated serum copeptin concentrations in response to arginine-hydrochloride (500 mg/kg IV in 30 minutes, ArgST) or insulin (0.1 U/Kg IV, insulin tolerance test/ITT) during GH stimulation tests in healthy short children. Subjects underwent phlebotomy for placement of an IV cannula (angiocath) by trained nurses, without percutaneous anesthesia. Copeptin was measured at 0 min. and at sampling times of the expected copeptin peak (60 min post arginine; 45, 60 min post-insulin) by the immunometric B.R.A.H.M.S. Kryptor assay (Quest laboratories) Results Two distinct groups of fasting copeptin values were identified. The majority of subjects, 86/92 (93.5%, "controls") had serum copeptin concentrations in the expected range for overnight fasting (median 9, IQR 6-12, range 2-29 pM/L). Six subjects (6.5%) were outliers with very elevated copeptin values (&amp;gt;50 in one, &amp;gt;100 pM/L in five of them). In 50 controls who underwent ArgST, copeptin increased from a median of 9 (IQR 6-13, range 2-25) to 11 (IQR 8-15, range 2-28) pM/L at 60 min; In the 5 outliers who underwent ArgST, it paradoxically decreased, but remained elevated, from 272 (IQR 154-406, range 62-1361) to 95.5 (IQR58-128, range 42-282) pM/L at 60 min. Similarly, in 8 controls who underwent ITT, copeptin increased minimally from a median of 8 (IQR 7-11, range 5-12) to 10 (IQR10-14, range 6-17) at 45 min, and 9(IQR 2-13, range 8-12) pM/L at 60 min. In the outlier who underwent ITT, copeptin decreased from 202 (0 min) to 63 (45 min) and 51(60 min) pM/L. None of these children had abnormalities of fluid regulation (polydipsia, polyuria, abnormal serum Na+ levels). The highest copeptin level (&amp;gt;1000 pM/L) occurred in a subject who had 3 successive attempts at phlebotomy. Conclusions Very elevated serum concentrations of copeptin occur in a minority of pediatric subjects undergoing phlebotomy, suggesting that pain of venipuncture can be a potent stimulus of copeptin secretion. Unexplained high values were observed in another pediatric study (Bonnet, Clin Endocrinol 2022;96: 47-53). This information is relevant to clinicians measuring copeptin for diagnostic or prognostic purposes or to establish reference values. Presentation: Monday, June 13, 2022 12:30 p.m. - 2:30 p.m.

COPEPTIN LEVEL IN PATIENTS WITH DIABETIC NEPHROPATHY WITH ACE GENE POLYMORPHISM

Aim of the study was to determine the copeptin level in the blood serum of patients with type 2 diabetes mellitus (T2DM) depending on the kidney’s function and accounting for the Alu Ins/Del (rs4646994) polymorphism of the angiotensin-converting enzyme (ACE) gene. Materials and methods: 146 patients with T2DM complicated by diabetic nephropathy (DN) were examined. Patients were divided into 4 groups according to the chronic kidney disease stage. Control group – 30 healthy subjects. Serum levels of copeptin and insulin were determined by ELISA using appropriate kits in accordance with the manufacturers' instructions. Genotyping was performed using TagMan allelic discrimination assay. Results. Our study has shown that the development of DN in T2DM is accompanied by a significant increase of copeptin level in blood serum compared with the control group and with diabetic patients without signs of nephropathy. The highest copeptin levels were found in patients with albuminuria and impaired glomerular filtration rate. In patients with T2DM, a significant linear correlation founded between copeptin level and serum creatinine (r = 0.247, p &lt; 0.03). We found more significant violations of glucose metabolism in DN patients with high serum levels of copeptin compared with patients with normal values of this factor. In particular significant increase in serum, copeptin was accompanied by an increase in the HOMA index and insulin level. In patients with T2DM – carriers of the homozygous I/I genotype were founded a reliable association with increasing copeptin levelы in blood serum, in contrast to D/D and I/D genotypes. Conclusions. The highest copeptin levels were founded in carriers of the homozygous I/I genotype of the Alu Ins/Del polymorphism of the ACE gene. An increase in the copeptin level has a certain genetic determinism, and its high level correlates with impaired glucose metabolism and the development of nephropathy in T2DM. Serum copeptin can be considered as a diagnostic marker of renal and metabolic lesions in T2DM. Keywords: diabetic nephropathy, copeptin, arginine-vasopressin system, diabetes mellitus, angiotensin-converting enzyme, ACE gene polymorphism.

Serum Copeptin and Renalase in Correlation to Left Ventricular Hypertrophy in Hemodialysis Patients

Serum Copeptin and Renalase in Correlation to Left Ventricular Hypertrophy in Hemodialysis Patients

ST2 and copeptine – modern biomarkers for monitoring the effectiveness of treatment of decompensated heart failure in patients after acute myocardial infarction

The aim of the study was to increase the efficiency of diagnostic methods to find means to improve the treatment of patients with decompensated heart failure in the post-infarction period.&#x0D; Materials and methods. This study is based on an examination of 120 patients with decompensated HF (60 patients with STEMI and 60 with non-STEMI). Patients with previous STEMI complicated by decompensated heart failure were divided into groups, depending on their treatment. The studied groups were homogeneous in terms of age, sex, the severity of the course of the disease, duration of the post-infarction period, and the presence of clinical manifestations of decompensation. The patients were observed on the first day after hospitalization, after 1 and 2 months after treatment. Copeptin serum levels were assayed using the EK 065-32, EIA Copeptine kit (RayBiotech, Inc., USA). ST-2 in blood serum was determined with the help of the Presage ST-2 kit (Critical Diagnostics, USA). The level of ST2 was determined in ng/ml.&#x0D; Results. We analysed the effect of therapy on the level of ST2 in the blood serum of examined patients with STEMI and non-STEMI complicated by decompensated heart failure. All the treatment regimens we proposed led to a significant decrease in the level of this peptide in blood serum after the end of the treatment. In patients of group I who received basic therapy drugs, the average ST2 concentration was (49.47±1.77) ng/ml before treatment. After 1 and 2 months of therapy, it was (44.92±1.22) ng/ml and (41.67±1.18) ng/ml, respectively (p˂0.05). The patients with decompensated heart failure after non-STEMI from group I had a copeptin level of (18.13±0.10) pg/ml before treatment and probably decreased to levels of (16.29±0.15) pg/ml and (15.09±0.14) pg/ml after 1 and 2 months under the influence standard therapy.&#x0D; Conclusions. We found the dependence of copeptin and ST2 levels on decompensated HF in the early and late post-infarction periods. It was established that the use of the therapy with a combination of the studied drugs led to a more intense decrease in serum copeptin, compared to therapy with succinic acid, arginine drugs, and standard therapy (p˂0.05). Using a differentiated treatment algorithm for patients with decompensated heart failure in the post-infarction period, copeptin and ST2 in blood serum increases the effectiveness of treatment and prevents complications.

Serum levels of copeptin predict adverse outcomes and improve risk prediction of TRISS and MGAP scores in patients with multiple trauma: A single-center prospective cohort study.

Multiple trauma deserves early prognostication and stratification. Copeptin, a precursor of vasopressin, is produced in response to stress. We examined the association between serum levels of copeptin and mortality risk in patients with multiple trauma. We aimed to also enhance the previously established Trauma-Related Injury Severity Score (TRISS) and Mechanism, GCS, Age, and Arterial Pressure (MGAP) score with the additional consideration of copeptin levels. This single-center prospective cohort study enrolled patients who presented to the emergency department with potential major injuries. The serum levels of copeptin were measured, and the correlation to clinical severity in terms of 30-day mortality and requirement of intensive care management was analyzed. By combining copeptin levels with TRISS or MGAP, comparison between performance of the original models with the copeptin-enhanced models was performed via discrimination, calibration, and reclassification analyses. There was a significant increase in copeptin levels in patients who died within 30 days (median 644.4 pg/L, interquartile range [472.5, 785.9]) or were admitted to intensive care units (233.8 pg/L, [105.7, 366.4]), compared with those who survived (37.49 pg/L, [17.88, 77.68]). Adding the natural log of copeptin levels to the established TRISS and MGAP models improved the AUC of TRISS from 0.89 to 0.96, and that of MGAP from 0.82 to 0.95. Both calibrations as measured by Brier's scores and reclassification as measured by net reclassification improvement or integrated discrimination improvement demonstrated significant improvements. A Web-based calculator was built to generate predicted mortality rates of various models for convenient clinical use. Admission serum copeptin levels were correlated with clinical severity in multiple trauma. Coupling copeptin with preexisting trauma severity scores improved prediction accuracy. Copeptin shows promise as a novel biomarker for the prediction of trauma outcome. Prognostic and Epidemiologic; Level III.

Clinical significance of copeptin as an early predictor of renal graft dysfunction in renal transplant recipients

Background: Copeptin is the carboxyl-terminal part of the vasopressin precursor protein, and its concentration is an independent predictor of the onset of chronic kidney disease and a rapid decline in the glomerular filtration rate. The glomerular filtration rate is regarded as the best indicator of kidney transplant function and is a predictor of graft and patient survival. We investigated the clinical significance of copeptin as an early predictor of renal graft dysfunction in renal transplant recipients.Methods: We measured serum creatinine, cystatin C, and copeptin concentrations in renal transplant recipients on the day of their operation, as well as on postoperative days 3, 7, 30, and 365. Acute rejection was defined as a sudden decrease in renal function accompanied by histological changes.Results: Eight renal transplant recipients were enrolled in the study from July 2018 to December 2019. Four patients experienced histologically confirmed transplant rejection. All four cases involved acute T-cell rejection. No significant correlation was found between the copeptin level and the presence or absence of rejection at any time point. In subgroup analyses, changes in creatinine, the estimated glomerular filtration rate, cystatin, and copeptin did not show statistical significance.Conclusions: We anticipated that copeptin would be useful to identify individuals at high risk of transplant rejection; however, our study failed to show an association. Further research will be needed to overcome the limitations of this study.

Association of Serum Albumin and Copeptin with Early Clinical Deterioration and Instability in Community-Acquired Pneumonia.

Background: There is a paucity of data on biomarkers for the early deterioration and clinical instability of patients in community-acquired pneumonia (CAP), as treatment failure occurs in the first seven days in 90% of patients. Aim: To evaluate serum albumin and copeptin with CURB-65, PSI scoring and ATS/IDSA minor criteria for the prediction of early mortality or ICU-admission (7 days) and clinical instability after 72 h. Methods: In 100 consecutive hospitalized adult CAP patients, PSI-scores, CURB-65 scores, ATS/IDSA 2007 minor criteria, copeptin and albumin on admission were evaluated. Univariate and multivariate Cox regression analysis was performed to assess independent risk factors for early combined mortality or ICU admission. Predictive powers of albumin and copeptin were tested with ROC curves and ICU-free survival probability was tested using Kaplan−Meier analysis. Results: Albumin was lower and copeptin higher in patients with short-term adverse outcomes (p < 0.05). Cox regression analysis showed that albumin [HR (95% CI): 0.41 (0.18−0.94, p = 0.034)] and copeptin [HR (95% CI): 1.94 (1.03−3.67, p = 0.042)] were independent risk factors for early combined mortality or ICU admission (7 days). The Kaplan−Meier analysis observed that high copeptin (>27.12 ng/mL) and low albumin levels (<2.85 g/dL) had a lower (p < 0.001) survival probability. The diagnostic accuracy of albumin was better than copeptin. The inclusion of albumin and copeptin into ATS/IDSA minor criteria significantly improved their predictive power. Conclusions: Both biomarkers serum albumin and copeptin can predict early deterioration and clinical instability in hospitalized CAP patients and increase the prognostic power of the traditional clinical scoring systems.

Vasopressin marker copeptin and the development of renal and metabolic disorders in patients with type 2 diabetes

Abstract. The aim of the study was to evaluate the possibility of using copeptin as a marker of renal and metabolic dysfunction in patients with type 2 diabetes.&#x0D; Methods: In this cross-sectional, observational study included 78 patients with type 2 diabetes mellitus complicated by diabetic nephropathy (DN) were examined. Patients were divided into 4 groups according to the stage of chronic kidney disease. Control group - 15 healthy subjects. Serum levels of copeptin and insulin were determined by enzyme-linked immunosorbent assay.&#x0D; Results: our studies have shown that the development of DN in type 2 diabetes is accompanied by a significant increase of copeptin concentration in blood plasma compared with controls and with diabetic patients without signs of nephropathy. The highest values of copeptin were found in the later stages of DN - in patients with albuminuria and impaired kidney filtration function. In patients with type 2 diabetes, a significant direct correlation was found between copeptin level and serum creatinine (r = 0.247, p &lt;0.03). We found more significant violations of glucose metabolism in DN patients with high serum levels of copeptin compared with patients with normal values of this factor. In particular, an increase in serum copeptin was accompanied by a significant increase in the HOMA index and insulin concentration.&#x0D; Conclusions. Our data indicate that the copeptin level reflects the functional state of the kidneys and can be considered a diagnostic marker of renal and cardiovascular lesions in type 2 diabetes.

Changes in Serum Copeptin and Sphingosine 1-Phosphate in Patients with Restenosis after Stent Implantation of Symptomatic Intracranial Artery Stenosis.

To determine the changes of serum copeptin and sphingosine 1-phosphate (S1P) in patients with restenosis after stent implantation of symptomatic intracranial artery stenosis. An observational study. Changyi people's Hospital, China, from February 2016 to November 2019. A total of 76 patients with symptomatic intracranial artery stenosis and stent implantation were divided into the restenosis group (n = 16) and the non-restenosis group (n=60) according to the intracranial artery restenosis occurred after the follow-up of 1 year. Levels of serum copeptin and S1P were compared between the groups. There were significant differences in diabetes mellitus and hypertension between the two groups (p<0.001 and p = 0.017, respectively). There were no significant differences in serum copeptin and S1P levels between the two groups before and 3 days after the operation (p = 0.927, 0.792, 0.776, and 0.906, respectively). Postoperative follow-up of one year, levels of serum copeptin in the restenosis group were higher than those in the non-restenosis group (p<0.001), and levels of serum S1P in the restenosis group were lower than those in the non-restenosis group (p = 0.003). High serum copeptin level, low serum S1P level, hypertension, and diabetes mellitus are independent risk factors promoting restenosis after stent implantation in patients with symptomatic intracranial artery stenosis. Copeptin, Sphingosine 1-phosphate (S1P), Symptomatic intracranial artery stenosis, Stent implantation, Restenosis.

Predictive Value of Serum Copeptin as a Severity Marker of Community-Acquired Pneumonia in Pediatrics

Predictive Value of Serum Copeptin as a Severity Marker of Community-Acquired Pneumonia in Pediatrics

Correlation of copeptin with osmolarity and electrolytes in diabetes Mellitus: A tertiary center outpatient experience.

Background: Arginine Vasopressin (AVP) plays a significant role in the pathophysiology of Diabetes Mellitus (DM) and its related nephropathy. Timely detection of copeptin, a surrogate biomarker of AVP, would help in minimizing the osmoregulatory complications secondary to DM. The study aimed to correlate serum copeptin levels with serum osmolarity and electrolytes in subjects with progressive stages of DM. Methodology: A total of 120 patients were recruited as controls, pre-diabetes, DM without nephropathy, and nephropathy. Serum copeptin levels were measured by Enzyme-Linked Immunosorbent Assay. At the same time, routine biochemical tests for diabetes and renal function were done from the affiliated diagnostic laboratory. Results: The mean copeptin and osmolarity levels were 207.74 ± 192.08 pg/ml and 302.29 ± 18.13 mOsm/kg, respectively. Both, the copeptin and osmolarity levels raises progressively from controls to various stages of DM and share significant positive correlation (r=0.214, p=0.019). Osmolarity was also correlated significantly with RBS (r=0.262), BUN (r=0.844), Na+ (r=0.210) and K+ (r=0.461). Conclusion: The significant correlation of copeptin with osmolarity highlights the importance of the AVP system in regulating body fluid equilibrium in diabetic patients progressing towards nephropathy. Timely detection of copeptin can play an important role in the early management of the disease.

Evaluation of the Relationship between Serum Copeptin Level and Diabetic Retinopathy in Patients with Type 2 Diabetes

Evaluation of the Relationship between Serum Copeptin Level and Diabetic Retinopathy in Patients with Type 2 Diabetes