Distribution of plasma copeptin levels and influence of obesity in children and adolescents

Abstract

In recent years, a more stable AVP surrogate, called copeptin, has been used as an adjuvant diagnostic tool for dysnatremia in adults and appears to be promising even in the pediatric age. The aim of this study is to present the distribution of plasma copeptin in a large pediatric cohort and to observe the influence of fluid consumption and obesity on its values. A cohort of 128 children and adolescents was divided into two groups on the basis of nocturnal deprivation (group A) or free access to oral fluids in the 6-8 h before blood collection (group B). At all distribution percentiles, copeptin levels were higher (p < 0.0001) in group A, as were plasma sodium levels and osmolality (p = 0.02 and p = 0.008, respectively). The influence of BMI on copeptin levels was investigated by dividing the cohort into nonobese (group C) and obese children and adolescents (group D). Copeptin levels were higher in group D (p = 0.04). Conclusion: The measurement of copeptin could represent a useful tool for the diagnostic pathway of dysnatremic conditions, but its interpretation should take into consideration the state of hydration. Furthermore, it could also be a promising marker for obesity and metabolic syndrome, although this hypothesis needs further studies to be confirmed.

Copeptin assays in children for the differential diagnosis of polyuria‐polydipsia syndrome and reference levels in hospitalized children

“…In contrast, the values reported for adults mostly correspond to patients with lithium-induced nephrogenic diabetes insipidus, whose baseline copeptin levels tend to be lower, ranging from 25.2 to 40.4 pmol/l 24 and 21.4 to 117 pmol/l. 18 While other studies have found that copeptin levels were higher in patients with obesity, 16,17 there was no statistically significant correlation in this study between copeptin concentration and BMI.…”

“…(2.5-2.6 pmol/l) in studies of 40 21 and more recently 128 children. 17 However, the 95th copeptin percentile in our control group is much higher than reported previously for the upper limit of the normal range. This is because very high copeptin concentrations (>30 pmol/l)…”

“…[7][8][9][10][11] Copeptin levels also vary by sex, 6,12,13 renal function, 12,14 and body mass index (BMI), 15 with concentrations seeming to be elevated in children with obesity. 16,17 The normal range in adults was determined in 2006, 6,12 between 1 and 13 pmol/L. Copeptin has been used as a diagnostic tool for PPS since 2011, with a baseline level >20 pmol/l without prior water deprivation being diagnostic of nephrogenic diabetes insipidus.…”

“…20 The use of copeptin in children has only been evaluated in a few small studies. 17,[21][22][23] Normal copeptin levels, measured without water deprivation have been found to range from about 2.4 pmol/l to either 8.6 pmol/l 21 or 13.1 pmol/l. 17 Similar values have been reported in the control groups of several other paediatric studies evaluating copeptin in various pathologies.…”

The levels of endothelin, renin, copeptin, testosterone, estradiol, osteocalcin and PIVKA-II in adolescents aged 17 years with newly diagnosed hypertension

“…Останніми роками копептин використовується для діагностики диснатріємії в дорослих і дітей. Він також може бути маркером ризику ожиріння та метаболічного синдрому [7]. Наші дані (табл.…”