Serum Levels Of Copeptin Research Articles

The Effects of Zinc Sulfate Supplementation on SerumCopeptin, C-Reactive Protein andMetabolic Markers in Zinc-Deficient Diabetic Patients on Hemodialysis: A Randomized, Double-Blind, Placebo-Controlled Trial.

We aimed to investigate the association between zinc (Zn) supplementation and serum levels of copeptin, high-sensitive C-reactive protein (hs-CRP), glycemic control, anthropometric parameters and renal function in Zn-deficient diabetic hemodialysis patients (DHPs). This randomized, double-blind, placebo-controlled trial (RCT) was conducted on 46 DHPs with Zn-deficiency. The Zn supplement group (n = 21) received a 220-mg/day Zn sulfate capsule (containing 50 mg Zn), and the control group (n = 25) received a placebo capsule (220 mg corn starch), for 8 weeks. Fasting, predialysis blood samples were taken at baseline and after 8 weeks to assess fasting blood glucose (FBG), serum insulin, copeptin, high-sensitive C-reactive protein (hs-CRP), blood urea nitrogen (BUN), creatinine (Cr) concentrations, and homoeostatic model assessment (HOMA-IR) and quantitative insulin-sensitivity check index (QUICKI). Compared to controls, serum copeptin (P < 0.001), hs-CRP (P < 0.001), BUN (P < 0.001), Cr (P < 0.001), Zn (P < 0.001), FBG (P < 0.001) levels, BMI (P < 0.001), and body weight (P < 0.001) were significantly affected following ZnSO4 supplementation for 8 weeks. In contrast, QUICKI (P = 0.57), HOMA-IR (P = 0.60), and serum insulin (P = 0.55) were not affected following Zn supplementation in comparison with patients receiving placebo. Zn sulfate supplementation appears to have favorable effects on serum copeptin and hs-CRP, FBG, and renal function in Zn-deficient DHPs. Iranian Registry of Clinical Trials Identifier: IRCT20190806044461N1.

Effect of pre-meal water intake on the serum levels of Copeptin, glycemic control, lipid profile and anthropometric indices in patients with type 2 diabetes mellitus: a randomized, controlled trial.

Water pre-load affects insulin secretion by altering the level of copeptin (C-terminal component of the arginine vasopressin hormone (AVP)) and preventing obesity by reducing food intake. The present randomized controlled trial (RCT) aimed to investigate the effects of pre-meal water intake on type 2 diabetes Mellitus (T2DM). In this study, 40 patients with T2DM were randomly assigned to two intervention groups for 8 weeks; a) drinking 1 liter of water per day before each main meal (PW group)., and b) no water consumption before any meal (NPW group). At the beginning and at the end of the study, blood samples were taken to assess glycemic indices, lipid profile, copeptin and anthropometric indices. Pre-meal water intake was associated with lower energy intake, BMI, waist circumference (WC) and greater weight loss, in compared with the controls (P < 0.0001) after 8weeks. At the end of the trial, the concentrations of fasting blood sugar (FBS) (P < 0.0001), triglyceride (TG) (P < 0.05), low-density lipoprotein cholesterol (LDL-C) (P < 0.05) and copeptin (P < 0.05) were significantly reduced following water drinking before meals. To sum up, the present study revealed that pre-meal water intake is associated with lower BMI, body weight, WC, FBS, TG, LDL-C and copeptin levels in patients with T2DM.

Copeptin levels are more elevated and associated with cardiovascular events in the unity of chronic ischemic heart and chronic kidney diseases

Objective: Copeptin comprises the C-terminal part of the Arginine vasopressin (AVP) precursor, is co-secreted with AVP and is a stable surrogate marker for AVP release, making it much easier to measure. Elevated levels of serum copeptin in both cardiovascular and renal diseases were known but the amount and predictive value of copeptin in the unity of these diseases is unknown.&#x0D; Methods: A study composed equally divided five groups, total of 150 adult patients. Group I and group II composed study groups which included the patients of chronic ischemic heart (CHID) and chronic kidney diseases (CKD) respectively. Control groups such as group III, IV and V included only patients of CHID or CKD. Copeptin, hs-CRP and pro-BNP levels were analyzed in all patients and their relationship with adverse outcomes were evaluated.&#x0D; Results: Serum levels of copeptin, hs-CRP and pro-BNP were higher in patients of study groups than patients of control groups and it was found statistically meaningful (p

Copeptin as a non-invasive biomarker in chronic thromboembolic pulmonary hypertension

Abstract Introduction Copeptin is the C-terminal fragment of the precursor protein of vasopressin. In acute pulmonary embolism, copeptin has been suggested to be a strong predictor of outcome and to provide additional predictive value to the established cardiac biomarkers high-sensitivity cardiac troponin and N-terminal pro-brain natriuretic peptide (NT-proBNP). Chronic thromboembolic pulmonary hypertension (CTEPH) is diagnosed in about 5% of patients who survive acute pulmonary embolism. Individualized risk stratification remains a challenge in the work-up of CTEPH patients. Purpose The current study investigated whether copeptin has the potential to aid the stratification of patients who have experienced pulmonary embolism and CTEPH patients. We examined the baseline (BL) levels and dynamics of copeptin during therapy in CTEPH patients who underwent balloon pulmonary angioplasty (BPA) or pulmonary endarterectomy (PEA). Moreover, the study compared copeptin levels between patients with or without therapy response. Methods The study included a total of 125 CTEPH patients scheduled for treatment. A total of 78 underwent staged BPA and 64 underwent PEA. In accordance with recent studies from our group, therapy success was defined as a decrease in meanPAP ≥25% and PVR ≥35% or a normalization below the thresholds defining pulmonary hypertension. Blood samples were collected at BL, prior to each BPA session in the BPA cohort, and at follow-up (FU) 6 months after BPA or 12 months after PEA. Copeptin was measured in thawed serum aliquots by an immunochemical method. Results The 78 patients in the BPA cohort underwent a mean of 6 BPA procedures each; there were a total of 413 interventions. The hemodynamic clinical and functional status the CTEPH patients improved after BPA and PEA therapy: meanPAP (BL: 43±9 mmHg vs. FU: 27±9 mmHg; p&amp;lt;0.001); PVR (BL: 7.6±3.4 WU vs. FU: 3.8±2.0 WU; p&amp;lt;0.001); RAP (BL: 7.9±5.8 mmHg vs. FU: 5.4±2.7 mmHg; p&amp;lt;0.001); WHO functional class [BL: I:0 / II:25 / III:80 / IV:20 vs. FU: I:56 / II:57 / III:10 / IV:2]; 6-minute-walk distance (BL: 405±99 m vs. FU: 456±112 m; p&amp;lt;0.001). The median serum levels of copeptin [BL 7.7 (4.6–14.2) pmol/L vs. FU 6.3 (3.9–12.5); p=0.009] and NT-proBNP [BL: 811 (157–1857) ng/L vs. FU: 142 (72–335) ng/L p&amp;lt;0.001] decreased significantly after therapy. The copeptin levels did not correlate with hemodynamics at BL: PVR (rrs=0.02; p=0.79) and meanPAP (rrs=0.03; p=0.75). The copeptin levels at BL (AUC=0.61) and the relative change (AUC=0.53) did not predict the endpoint of therapy response. Conclusions Copeptin levels are elevated in CTEPH patients compared with normal values in the literature. Although copeptin is known to provide additional value in the context of risk stratification in acute pulmonary embolism, it failed to provide additional diagnostic benefit in CTEPH in the current study. Funding Acknowledgement Type of funding source: Public grant(s) – National budget only. Main funding source(s): SFB 1213 area CP01

Investigation of copeptin levels in foetal congenital central nervous system anomalies

Copeptin has been shown to be associated with central nervous system pathologies. The aim of this study was to investigate the relationship between serum CCP levels and central nervous system (CNS) anomalies. In this case-control study, those at 9–14 weeks of gestation serum levels of copeptin, were assessed in pregnant women whose foetuses subsequently developed CNS anomalies (group 1: n = 60) and compared with gestational age-matched pregnant women who exhibited normal pregnancy outcomes (group 2: n = 48). The mean copeptin levels were 1.58 ± 0.40 ng/mL and 1.11 ± 0.36 ng/mL in the CNS anomalies and control groups, respectively (p < .0001). An increased level of copeptin independently predicts development of CNS anomalies, suggesting that copeptin can be used for prediction and discrimination of CNS anomalies in normal pregnancies at 9–14 weeks of gestation. Impact statement What is already known on this subject? There is no test or method to diagnose CNS anomalies in the first trimester of pregnancy. This study presents the first and new information on the relationship between serum copeptin levels and central nervous system anomalies in pregnant women whose foetuses subsequently developed CNS anomalies. What do the results of this study add? I have strongly demonstrated differences in maternal CPP levels between CNS anomalous pregnancies and healthy controls. What are the implications of these findings for clinical practice and/or further research? It has been thought that copeptin appears to be an ideal marker for central nervous system anomaly prediction at 9–14 weeks of gestational age and if confirmed in larger prospective studies. Finally, these results could not be used as parameters for prenatal CNS screening. Advanced studies, well-structured and conducted on larger populations are needed to investigate the issue further.

Copeptin and Obestatin Levels in Polycystic Ovary women and their Relation to Obesity, insulin metabolism and Cardiovascular diseases

Objective: is to investigate the correlations between the serum levels of copeptin and obestatin, carotid artery intima-media thickness (CIMT), and brachial artery flow mediated dilatation (FMD) in obese and non-obese women with PCOS. Design: Prospective randomized study. Setting: Obstetrics and Gynecology Department, El-Hussein and Sayed Galal University Hospitals, Al-Azhar University. Patient(s): We analyzed 54 patients with PCOS and 20 normal women as controls. PCOS patients were divided into two groups based on body mass index (BMI): obese group (BMI > 30 kg/m2, n = 28) and non-obese group (BMI < 30 kg/m2, n = 26). Serum Copeptin and Obestatin levels, Insulin Homeostasis Model Assessment for Insulin Resistance (HOMA-IR), CIMT and brachial artery FMD were determined and compared among both groups. Result(s): Serum Obestatin levels were significantly lower in obese PCOS group than non-obese and control. While Serum Copeptin levels were significantly higher in obese PCOS group than non-obese and control. Brachial artery FMD was lower in the PCOS groups than control. Obestatin was positively correlated with cardiovascular risk factor (FMD), whereas Copeptin was negatively correlated with FMD Conclusion(s): Obestatin and Copeptin may provide useful information regarding future cardiovascular risk in PCOS patients as Obestatin was negatively correlated and Copeptin was positively correlated with cardiovascular risk factor (FMD). Keywords: Cardiovascular diseases, Copeptin, Insulin resistance, Obesity, Obestatin, Polycystic ovary

Values of blood copeptin level as a marker of unfavorable forecast in subarachnoid haemorrhage of the brain of atraumatic origin

Objective – to evaluate of diagnostic informativeness of сopeptin serum values in determining the risk of complications in patients with subarachnoid hemorrhage.Materials and methods. A prospective cohort study of 82 patients (40 men and 42 women) with spontaneous (non-traumatic) subarachnoid hemorrhage (SAH) from the age of 23 to 72 years (average age – (49,6 ±1,3) year) was conducted.Results. Complications were recorded in 31 (74.20 %) patients with a serum level of copeptin ≥ 0.605 ng/ml on the third day of the SAH, which was in 9.49 times higher (95 % CI 3.60–24.80, р ˂0.0001) than in patients with a serum level of copeptin &lt; 0.605 ng/ml. When determining the cumulative risk of developing complications of SAH, the values ​​of positive and negative predictive values ​​of serum levels of copeptin on third day of SAH were 74.19 % and 92.20 % respectively, the accuracy of prediction (the sum of correctly classified observations) was 85.39 %.Conclusions. ROC-analysis suggests that the serum level of copeptin on third day of SAH ≥ 0.605 ng/ml is characterized by an optimal ratio of sensitivity and specificity in assessing the cumulative risk of developing such SAH complications as secondary ischemia combined with cerebral angiospasm.

Re: Assessment of Serum Levels of Copeptin and Corticotropin-Releasing Factor in Children with Monosymptomatic and Non-Monosymptomatic Nocturnal Enuresis.

No AccessJournal of UrologyUrological Survey1 May 2020Re: Assessment of Serum Levels of Copeptin and Corticotropin-Releasing Factor in Children with Monosymptomatic and Non-Monosymptomatic Nocturnal Enuresis Douglas A. CanningMD Douglas A. CanningDouglas A. Canning More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000000771.05AboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail "Re: Assessment of Serum Levels of Copeptin and Corticotropin-Releasing Factor in Children with Monosymptomatic and Non-Monosymptomatic Nocturnal Enuresis." The Journal of Urology, 203(5), p. 870 © 2020 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 203Issue 5May 2020Page: 870-870 Advertisement Copyright & Permissions© 2020 by American Urological Association Education and Research, Inc.MetricsAuthor Information Douglas A. Canning More articles by this author Expand All Advertisement PDF DownloadLoading ...

Serum Copeptin, NLPR3, and suPAR Levels among Patients with Autosomal-Dominant Polycystic Kidney Disease with and without Impaired Renal Function

Background: The pathophysiology of renal disease progression in autosomal-dominant polycystic kidney disease (ADPKD) involves not only cystogenesis but also endothelial dysfunction, leading to the activation of inflammatory and fibrotic pathways. This study evaluated the levels of biomarkers related to osmoregulation, immune system activation, and tubular injury in ADPKD patients with impaired or preserved renal function. Methods: This study included 26 ADPKD patients with modestly impaired renal function (estimated glomerular filtration rate [eGFR] 45–70 mL/min/1.73 m²; Group A), 26 age- and sex-matched ADPKD patients with relatively preserved renal function (eGFR >70 mL/min/1.73 m²; Group B), and 26 age- and sex-matched controls (Group C). Serum levels of copeptin, the inflammasome nucleotide-binding and oligomerization domain-like receptors pyrin domain-containing protein 3 (NLRP3), and soluble urokinase-type plasminogen activator receptor (suPAR) were measured with ELISA techniques. Results: Patients in Group A had higher levels of copeptin (median [interquartile range]: 50.44 [334.85] pg/mL), NLRP3 (5.86 [3.89] ng/mL), and suPAR (390.05 [476.53] pg/mL) compared to patients in Group B (32.38 [58.33], p = 0.042; 2.42 [1.96], p < 0.001; and 313.78 [178.85], p = 0.035, respectively) and Group C (6.75 [6.43]; 1.09 [0.56]; and 198.30 [28.53], respectively; p < 0.001 for all comparisons). Levels of all studied markers were also significantly higher in Group B patients compared to controls (p < 0.001), despite having similar eGFR. In patients with ADPKD, all studied biomarkers were correlated positively with asymmetric-dimethylarginine (ADMA) and endocan levels, and negatively with eGFR. ADMA and endocan levels were the only parameters independently associated with increased copeptin levels. Conclusions: This study showed that ADPKD patients with impaired and preserved renal function had higher copeptin, NLRP3, and suPAR levels than controls. Such findings support that cystogenesis and inflammation are associated with endothelial dysfunction, even in the early stages of ADKPD.

Serum copeptin as a diagnostic and prognostic biomarker of coronary artery disease among patients with type 2 diabetes mellitus

BackgroundDiabetes is one of the major risk factors for coronary artery disease (CAD); hormones implicated in cardiac diseases may play a role in diabetes development. Increased activities of the arginine-vasopressin (AVP) system were shown to be associated with type 2 diabetes mellitus (T2DM). The aim of this study was to estimate the values of serum copeptin as a predictive biomarker of CAD and to assess the correlation between copeptin and cardiometabolic risk factors in patients with T2DM.Patients and methodsThe case–control study included 110 patients with T2DM and 80 age-matched and sex-matched control group. All the participants were subjected to B-mode ultrasonography of both common carotid arteries to measure carotid intima-media thickness (mm), echocardiography, and coronary arteriography. Serum copeptin levels were measured with a new sandwich immunoassay by using a human copeptin enzyme-linked immunosorbent assay kit.ResultsPatients with T2DM had significantly higher serum copeptin levels (7.64±1.98 pmol/l) compared with control groups (4.64±1.11 pmol/l). Serum copeptin levels were significantly higher in patients with CAD (8.64±2.55 pmol/l) compared with patients without CAD (6.36±0.86 pmol/l). Interestingly, copeptin was positively correlated with cardiometabolic risks. The area under the curve of serum copeptin levels in differentiating patient with T2DM from control was 0.768 (P<0.001) and differentiating patient with CAD from the nonischemic group was 0.818 (P<0.001).ConclusionThe higher serum level of copeptin in patients with T2DM especially in the patient with CAD is strongly correlated with cardiometabolic risk factors.

Assessment of serum levels of copeptin and corticotropin-releasing factor in children with monosymptomatic and non-monosymptomatic nocturnal enuresis

Nocturnal enuresis is defined as bed-wetting in children from the age of five years that occurs during sleep; if untreated, the condition can result in social and psychological problems both for the children and their parents. Nocturnal enuresis is a complicated disease that includes multiple pathogenetic factors. Nocturnal enuresis is divided into two subgroups: monosymptomatic and non-monosymptomatic. The role of some biomarkers in patients with monosymptomatic enuresis has been reported in a small number of the studies. The aim of this research was to evaluate the serum levels of copeptin and corticotropin-releasing factor (CRF) in monosymptomatic and non-monosymptomatic nocturnal enuresis cases. Although these markers were previously examined in children with monosymptomatic enuresis, there is no study that has evaluated these markers in non-monosymptomatic children. One hundred nineteen children with nocturnal enuresis (5-16 years) and forty healthy children (5-17 years) were enrolled to the study. Of the nocturnal enuresis group, forty-nine were monosymptomatic and seventy were non-monosymptomatic. Copeptin and CRF were measured by a competitive inhibition method with enzyme-linked immunosorbent assay. The serum copeptin levels were significantly lower in children with monosymptomatic and non-monosymptomatic nocturnal enuresis than in the controls.(median, 34.7 [interquartile range (IQR): 34pg/ml], 39.8 [IQR: 29pg/ml] vs52.1 [IQR: 14pg/ml], respectively, P<0.05). The serum CRF levels were significantly lower in children with monosymptomatic and non-monosymptomatic nocturnal enuresis than in the controls (median, 35.1 [IQR: 19pg/ml], 34.05 [IQR: 24pg/ml] vs78.3 [IQR: 39pg/ml], respectively, P<0.05). There was no significant difference in copeptin and CRF levels between the children with monosymptomatic and non-monosymptomatic nocturnal enuresis. Copeptin is presumed to be a sensitive surrogate biomarker for arginine vasopressin release. To date, there are only two studies in the literature that assess the relationship between copeptin and monosymptomatic enuresis. The only study in the literature demonstrated significantly decreased levels of CRF in monosymptomatic enuretic children. It was demonstrated that the levels of copeptin and CRF differ in both children with monosymptomatic and non-monosymptomatic nocturnal enuresis from the control groups. It was also demonstrated that copeptin and CRF levels were not different between the children in monosymptomatic and non-monosymptomatic groups. Those changes in both copeptin and CRF which were shown in this study in monosymptomatic and non-monosymptomatic enuretic children may contribute to the pathogenesis of nocturnal enuresis. Further case-control studies can evaluate the copeptin and CRF levels before treatments in monosymptomatic and non-monosymptomatic patients to decide potential effectiveness of treatment.

Inflammatory biomarkers as prognostic indicators for liver cirrhosis

Background Severity of liver cirrhosis is commonly assessed by Child–Pugh and model of end-stage liver disease (MELD) scores, which reflect liver dysfunction mainly and do not assess associated systemic events, which influence the failure of other organs. Aim To study the role of serum level of copeptin (CPP) and high-sensitivity C-reactive protein (hsCRP) as indicators of prognosis in liver cirrhosis and compare these results with usual prognostic scores, raising the importance of proper management of systemic infections in cirrhotic patients to prevent cirrhosis progression. Patients and methods A cross-sectional study was carried out on 80 cirrhotic patients, who were classified into four equal groups: Child A, B, C, and Child C with systemic infections. Serum CPP and hsCRP were measured by enzyme-linked immunosorbent assay technique. Results There was a statistically significant increase in CPP serum levels among cirrhotic patients [9.70 (7.70–14.30)] in comparison with its serum level in healthy participants [5.95 (5.40–6.75)]. There were gradually increases of CPP serum levels through Child–Pugh A, B, and C groups [6.40 (5.42–8.05), 10.15 (7.75–14.20), and 13.05 (8.77–17.27), respectively] in comparison with the control group. There were positive correlations of CPP with MELD score, Child–Pugh, and hsCRP (r=0.60, 0.71, and 0.60, respectively, P Conclusion CPP and hsCRP serum levels can be used as prognostic indicators of liver cirrhosis and account for systemic infections involved in deterioration of liver cirrhosis.

Prognostic value of serum copeptin level in patients with subarachnoid haemorrhage

Subarachnoid haemorrhage (SAH) is one of the most common forms of intracranial vascular pathology and one of the severest types of cerebral circulation disorders. According to epidemiology, up to 5000 cases of SAH of an aneurysmal genesis occur annually in Ukraine with an average incidence of 12 cases / 100.000 / year per 45 million people. Purpose of the study. Evaluation of diagnostic informativeness of сopeptin serum values in determining the risk of complications in patients with subarachnoid hemorrhage. Materials and methods. A prospective, cohort study of 82 patients (40 men and 42 women, mean age 49.6 ± 1.3 years) was conducted. The diagnosis was made on the basis of clinical neuroimaging criteria. Aneurysmal genesis of SAH according to cerebral angiography was verifid in 58 (71.9 %). Serum copeptin level was determined on the 3 rd day of the disease by ELISA. The development of a complex of SAH complications in the form of secondary ischemia and cerebral angiospasm was considered as the primary end point. The threshold value of serum concentration of copeptin in the assessment of the risk of the development of SAH complications was determined by the results of ROC analysis. Results. The combination of SAH complications was diagnosed in 27 (32.9 %) patients, while the serum level of copeptin in this subcohort was signifiantly higher than that in the group of patients without complications by 44.2 % 0.738 (0.667–0.800) ng / ml versus 0.419 (0.347–0.549), P ˂ 0.01). The serum level of copeptin ≥0.605 ng / ml was found to be associated with an increase in the cumulative risk of SAH complications by 9.5 times (95 % CI 3.6–24.8, P ˂ 0.0001; AUC = 0.95 ± 0.02 95 % CI 0.90-0.99, P = 0.001; diagnostic accuracy is 85.4 %; sensitivity – 85.2 %, specifiity – 85.5 %). Conclusion. The serum level of copeptin is a highly informative marker for the detection of individual cumulative risk of complications in patients with SAH.

Copeptin as a novel marker predicting prognosis of liver cirrhosis and its major complications.

ObjectivesThe aim of the work was to assess the level of copeptin as a surrogate marker predicting the severity of liver diseases and its major complications.Patients and methodsThis was a cross-sectional study that included 40 patients and 10 controls and was performed in Tanta University Hospital between June 2016 and November 2016. The studied cases were divided into five groups: group I (10 patients): compensated cirrhosis; group II (10 patients): cirrhosis with gastrointestinal hemorrhage due to portal hypertension; group III (10 patients): cirrhosis with hepatorenal syndrome; group IV (10 patients): cirrhosis with liver cell failure; and group V (10 controls): normal healthy individuals.ResultsRegarding serum copeptin in the studied groups, copeptin showed a significant decrease in group I vs group II‚ group I vs group III, and group I vs group IV; and there was a significant increase in group II vs group III‚ group II vs group IV‚ group II vs control‚ group III vs control, and group IV vs control. No significance was detected between group I vs control and group III vs group IV.ConclusionsCopeptin is a novel marker for the determination of prognosis of liver cirrhosis. There is significant association between serum level of copeptin and complications of liver cirrhosis.

Serum copeptin and neuron specific enolase are markers of neonatal distress and long-term neurodevelopmental outcome.

The objective of this study was to evaluate the early changes in serial serum levels of copeptin and neuron-specific enolase (NSE) in neonates diagnosed with birth asphyxia, and to determine whether these biomarkers measured in the first 168 hours after birth are predictive of long-term neurodevelopmental outcome. Copeptin and NSE levels were measured from serum samples collected 6, 12, 24, 48, 72, and 168 hours after birth from 75 term neonates diagnosed with hypoxic-ischemic encephalopathy (HIE) and treated with therapeutic hypothermia for 72 hours. In addition, serum copeptin levels after birth were measured from 10 HIE diagnosed neonates, who were randomized to the normothermic arm of the TOBY cohort. All neonates underwent neurodevelopmental assessment using the Bayley Scales of Infant and Toddler Development-II at two years of age. Copeptin levels were highest at 6 hours after birth and steadily decreased, whereas the highest NSE levels were measured at 24 hours after birth. The biomarker levels correlated with blood-gas parameters (base excess, pH and lactate) at 6 and 12 hours after birth. Copeptin and NSE levels in the early postnatal period were significantly higher in neonates with poor outcome compared to those with favorable outcome at two years of age. Furthermore, in the TOBY cohort, copeptin levels were significantly lower in hypothermic compared to normothermic neonates. To conclude, copeptin and NSE measured in the early postnatal period are potential prognostic biomarkers of long-term neurodevelopmental outcome in term neonates diagnosed with HIE and treated with therapeutic hypothermia.

Association of Stress Biomarkers With 30-Day Unplanned Readmission and Death.

The theory that posthospitalization stress might increase the risk of postdischarge complications has never been investigated. To assess whether serum levels of stress biomarkers at discharge are associated with readmission and death after an acute-care hospitalization. We prospectively included 346 patients aged ≥50 years admitted to the department of general internal medicine at a large community hospital between April 8, 2013 and September 23, 2013. We measured the serum levels of several biomarkers at discharge: midregional pro-adrenomedullin, copeptin, cortisol, and prolactin. All patients were followed for up to 90 days after discharge (none was lost to follow-up). The main outcome was first unplanned readmission or death within 30 days after hospital discharge. We assessed the additional value of biomarkers to 2 validated readmission prediction scores: the LACE index (Length of stay, Admission Acuity, Charlson Comorbidity Index, and number of Emergency department visits within preceding 6 months) and the HOSPITAL score (Hemoglobin level at discharge, discharge from Oncology service, Sodium level at discharge, any Procedure performed during index hospitalization, Index admission Type, number of Admissions within preceding 12 months, and Length of stay). Forty patients (11.6%) had a 30-day unplanned readmission or death. High serum copeptin and cortisol levels were associated with an increase in the odds of unplanned readmission or death (odds ratios [95% confidence interval] 2.69 [1.29-5.64] and 3.43 [1.36, 8.65], respectively). We found no significant association with midregional pro-adrenomedullin or prolactin. Furthermore, these stress biomarkers increased the performance of two readmission prediction scores (LACE index and HOSPITAL score). High serum levels of copeptin and cortisol at discharge were independently associated with 30-day unplanned readmission or death, supporting a possible negative effect of hospitalization stress during the postdischarge period. Stress biomarkers improved the performance of prediction models and therefore could help better identify high-risk patients.

Serum Copeptin Predicts Severity and Recurrent Stroke in Ischemic Stroke Patients.

Several studies investigated the prognostic role of copeptin in stroke. The aim of this study is to assess copeptin levels in serum, and investigate their associations with risk of recurrent stroke in a 1-year follow-up study in patients with ischemic stroke. In this post hoc analysis, serum levels of copeptin and NIH stroke scale (NIHSS) were measured at the time of admission in a cohort of 316 patients with ischemic stroke. The end point was stroke recurrence after 1-year follow-up. We used logistic regression model to assess the relationship between copeptin levels and risk recurrent stroke. Logistic regression analysis considering traditional risk factors showed a relationship between serum copeptin levels and moderate-to-high clinical severity when serum copeptin was used as a continuous variable (OR, 1.05; 95% CI, 1.03-1.09). In the follow-up, 54 patients (17.1%) had a stroke recurrence. The stroke recurrence events distribution across the copeptin quartiles ranged between 5.1% (first quartile) to 23.1% (fourth quartile). In multivariate models comparing the third (OR=2.78; 95% CI 1.85-3.53) and fourth quartiles (OR=4.00; 95% CI 2.86-6.50) against the first quartile of the copeptin, levels of copeptin were associated with stroke recurrence events. A higher serum copeptin level is a predictor of both severity at admission and stroke recurrence at 1-year in stroke patients.

Serum copeptin in children exposed to maltreatment

Childhood maltreatment (CM) has been related to a persistent reprograming of stress-response. Copeptin is a marker of hypothalamic-pituitary-adrenal axis activation; however, few studies have examined copeptin levels in children exposed to CM. The aim of this study was to compare serum copeptin levels in children reporting child abuse and/or neglect and children with no history of CM. This study included 65 children with a positive history of moderate to severe CM, as reported by themselves and their parent(s) during a clinical interview, and 71 children with no history of CM as a comparison group. CM was considered moderate to severe based on the child-reported frequency of being exposed to events related to sexual abuse, physical abuse, emotional abuse, emotional neglect, and/or physical neglect. Child psychopathology symptoms were assessed using the Child Behavior Checklist (CBCL). We measured serum copeptin concentration using enzyme-linked immunosorbent assay. Children exposed to CM exhibited higher levels of serum copeptin compared to children without CM when controlling for sex, age, and psychiatric morbidity. The CBCL total score, including internalizing and externalizing symptoms, was higher in children with CM. We found no correlation between copeptin and CBCL scores for internalizing symptoms and externalizing symptoms. CM is associated with copeptin serum levels independently of age, sex, and symptom severity. Copeptin is a promising new biomarker for children with a history of abuse and/or neglect.

Serum levels of copeptin are associated with type 2 diabetes and diabetic complications in Chinese population

PurposeThe aim of this study was to investigate copeptin levels in serum, and assess their associations with type 2 diabetes (T2DM) and diabetic complications. MethodsIn this post hoc analysis, serum levels of copeptin were tested in 306 patients with T2DM. Clinical information including diabetic retinopathy (DR) and diabetic nephropathy (DN) were collected. The relation of serum copeptin with DR and DN were investigated with the use of logistic regression models according to equal quartiles of the distributions of serum copeptin. ResultsWe found that serum copeptin levels were significantly higher in diabetes as compared to normal controls [9.4(IQR, 7.4–12.5) pmol/L vs. 4.1(IQR, 2.5–6.2) pmol/L; P<0.0001]. In multivariate analysis, there was an increased risk of T2DM associated with copeptin levels (OR 1.312, 95% CI: 1.204–1.403; P<0.0001) after adjusting for possible confounders. After adjustment for possible confounders, serum copeptin levels were positively associated with the DR (odds ratio [OR], 1.117; 95% confidence interval [CI], 1.072–1.241; P<0.001) and DN (OR, 1.259; 95% CI, 1.198–1.323; P<0.001). Compared with the first quartile of serum copeptin levels, the ORs for DR and DN were as follows: second quartile, 1.19 (95% CI, 0.94–1.51, P=0.12) and 1.37 (95% CI, 0.78–2.37, P=0.28); third quartile, 1.61 (95% CI, 1.18–2.43, P=0.005) and 2.12 (95% CI, 1.32–3.27, P=0.003); fourth quartile, 2.83 (95% CI, 2.04–4.93; P<0.001) and 3.48 (95% CI, 1.77–7.03; P<0.001), respectively. ConclusionsUsing a post-hoc analysis our data show that elevated serum levels of copeptin are associated with type 2 diabetes and diabetic complications in Chinese population, suggesting a potential role of the AVP system (copeptin) in the pathophysiology of diabetes.

Prognostic Value of Hypothalamic Copeptin in Acute Ischemic Stroke

Background: Some studies showed that copeptin, a hypothalamic hormone derived from the precursor of vasopressin, may be useful in the prediction of outcome of ischemic cerebral stroke. The aim of this work was to search if there is any correlation between serum copeptin, in the first day of ischemic stroke, and its clinical severity, radiological findings and also its predictive value of functional outcome in these patients. Methods: This study was conducted on 55 patients of both sexes with ischemic cerebral stroke admitted to Neurology Department, Menofyia University within 24 hours of the onset of ischemic stroke. Patients were subjected to general and neurological examination, laboratory assessment (routine and serum level of copeptin), and brain computerized tomography (CT), or magnetic resonance imaging (MRI). The anatomical site of stroke was evaluated by using the Oxford Community Stroke Project (OCSP) classification. The etiological subtypes of stroke were classified according to Trial of Organization 10172 in Acute Stroke Treatment (TOAST) classification. Stroke severity was evaluated by Scandinavian stroke scale (NIHSS) and disability by modified Rankin scale (MRS) at admission and at 30 days. Results: The results showed high statistically significant correlation between the mean value of copeptin level and severity of stroke on admission (P < 0.001), and also with the size of the infarction (P < 0.001). There was statistically significant difference (P = 0.011) of copeptin level among the studied groups regarding the site of stroke. Additionally, there was high statistically significant difference (P < 0.001) between copeptin level and the etiological subtypes of stroke. The favorable outcome of the stroke was with cutoff point of copeptin below 21.5 ng/mL. Conclusion: Serum copeptin may help in the prediction of severity of ischemic stroke, its size, site, etiological subtypes and functional outcome. J Neurol Res. 2016;6(2-3):41-45 doi: http://dx.doi.org/10.14740/jnr377w