Plasma Carboxy-Terminal Provasopressin (Copeptin): A Novel Marker of Insulin Resistance and Metabolic Syndrome

Saleem, Umer; Khaleghi, Mahyar; Morgenthaler, Nils G.; Bergmann, Andreas; Struck, Joachim; Mosley, Thomas H.; Kullo, Iftikhar J.

doi:10.1210/jc.2008-2278

Cited by 141 publications

(145 citation statements)

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“…With regard to the differences in copeptin levels in men and women, the higher plasma copeptin level in men was consistently observed in our study and in previous studies [4,[29][30][31]. Sex is one of the major determinants of plasma levels of copeptin.…”

Section: Discussionsupporting

confidence: 90%

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Sex differences in the association between plasma copeptin and incident type 2 diabetes: the Prevention of Renal and Vascular Endstage Disease (PREVEND) study

et al. 2012

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Aims/hypothesis Vasopressin plays a role in osmoregulation, glucose homeostasis and inflammation. Therefore, plasma copeptin, the stable C-terminal portion of the precursor of vasopressin, has strong potential as a biomarker for the cardiometabolic syndrome and diabetes. Previous results were contradictory, which may be explained by differences between men and women in responsiveness of the vasopressin system. The aim of this study was to evaluate the usefulness of copeptin for prediction of future type 2 diabetes in men and women separately. Methods From the Prevention of Renal and Vascular Endstage Disease (PREVEND) study, 4,063 women and 3,909 men without diabetes at baseline were included. A total of 208 women and 288 men developed diabetes during a median follow-up of 7.7 years. Results In multivariable-adjusted models, we observed a stronger association of copeptin with risk of future diabetes in women (OR 1.49 [95% CI 1.24, 1.79]) than in men (OR 1.01 [95% CI 0.85, 1.19]) (p interaction <0.01). The addition of copeptin to the Data from the Epidemiological Study on the Insulin Resistance Syndrome (DESIR) clinical model improved the discriminative value (C-statistic,+0.007, p00.02) and reclassification (integrated discrimination improvement [IDI] 0 0.004, p<0.01) in women. However, we observed no improvement in men. The additive value of copeptin in women was maintained when other independent predictors, such as glucose, high sensitivity C-reactive protein (hs-CRP) and 24 h urinary albumin excretion (UAE), were included in the model. Conclusions/interpretation The association of plasma copeptin with the risk of developing diabetes was stronger in women than in men. Plasma copeptin alone, and along with existing biomarkers (glucose, hs-CRP and UAE), significantly improved the risk prediction for diabetes in women.

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Section: Discussionsupporting

confidence: 90%

“…We and others have shown before that higher plasma copeptin levels are positively associated with the metabolic syndrome, insulin resistance, the inflammatory marker hs-CRP and higher UAE in cross-sectional studies [4,29,30]. Likewise, all these conditions are known to be predictors for the risk of type 2 diabetes [13].…”

Section: Discussionmentioning

confidence: 86%

Sex differences in the association between plasma copeptin and incident type 2 diabetes: the Prevention of Renal and Vascular Endstage Disease (PREVEND) study

et al. 2012

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“…Copeptin is a cleavage product of the C-terminal part of the AVP precursor, stable and with long half-life, which is also known as a surrogate hormone for AVP. In recent studies, the correlation with elevated plasma copeptin and diabetes mellitus has been investigated [13].…”

Section: Introductionmentioning

confidence: 99%

First and third trimester serum concentrations of adropin and copeptin in gestational diabetes mellitus and normal pregnancy

Dąbrowski

Jarmużek²,

Gondek³

et al. 2016

Ginekol Pol

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Objectives: Gestational diabetes mellitus (GDM) is a metabolic disease diagnosed in 1.7% up to 11.6% pregnancies. The prevalence of adverse pregnancy outcome is significantly higher in the case of early onset of diabetes mellitus. Adropin is a hormone promoting carbohydrate oxidation over fat oxidation, and influence nitric oxide synthase. Copeptin is a cleavage product of the vasopressin precursor recently correlated with diabetes mellitus. The aim of the study was to determine maternal serum adropin and copeptin concentrations in women with early and late manifestation of GDM and to discuss their potential role as biochemical markers of insulin resistance. Material and methods:Case-control study on 58 pregnant Caucasian women. Serum levels of adropin and copeptin were assessed in patients with early onset (GDM1) and classical gestational diabetes mellitus (GDM2). Complications such as macrosomia and hypotrophy were evaluated. Results:There was no significant difference between the study and the control group (age, BMI, parity). Fetal growth disturbance rate was 37.5% in GDM1, 11% in GDM2 and 6% in controls. Adropin concentration in GDM patients was significantly higher than in control group (p < 0.001), but there was no difference between GDM1 and GDM2 group. High serum concentration of adropin positively correlated with elevated HbA 1c (p < 0.05). The groups did not differ in terms of copeptin serum concentration. Conclusions:High adropin serum concentration in GDM patients is associated with increased risk of fetal growth disturbances, possibly due to improper placentation. According to our prospective study, neither copeptin nor adropin serum concentration are useful to discriminate between early and late onset of gestational diabetes mellitus.

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“…Secretion of copeptin is prompted by individual stress and seems to mirror moderate levels of stress even more subtly than cortisol (4 ). Copeptin concentrations are associated with measures of insulin resistance and metabolic syndrome in hypertensive adults and have been linked to survival in critically ill patients suffering from hemorrhagic and septic shock (5,6 ). Furthermore, copeptin has prognostic implications in patients with decompensated heart failure, patients with heart failure after acute MI, and post-MI patients (7)(8)(9).…”

mentioning

confidence: 99%

Copeptin Does Not Add Diagnostic Information to High-Sensitivity Troponin T in Low- to Intermediate-Risk Patients with Acute Chest Pain: Results from the Rule Out Myocardial Infarction by Computed Tomography (ROMICAT) Study

Karakas

Januzzi²,

Meyer

et al. 2011

Clinical Chemistry

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PURPOSE:Copeptin, a stable peptide derived from the AVP precursor, has been linked to presence and severity of myocardial ischemia. We sought to evaluate the predictive value of copeptin and its incremental value beyond that of high-sensitivity cardiac troponin T (hscTnT) in patients with acute chest pain and low to intermediate risk for acute coronary syndrome (ACS). METHODS:We recruited patients who presented with acute chest pain to the emergency department and had a negative initial conventional troponin T test (Ͻ0.03 g/L). In all patients, hs-cTnT and copeptin measurements were taken. Each patient also underwent cardiac computed tomography (CT) and coronary angiography. RESULTS:Baseline copeptin concentrations, in contrast to hs-cTnT, were not significantly higher in patients with ACS than in those without (P ϭ 0.24). hs-cTnT showed an earlier rise in patients with ACS than copeptin, when analyses were stratified by time. A copeptin concentration Ն7.38 pmol/L had a negative predictive value (NPV) of 94% and a sensitivity of 51%, whereas hs-cTnT (Ն13.0 pg/mL) had a NPV of 96% and a sensitivity of 63%. The combination of copeptin and hscTnT resulted in a lower diagnostic accuracy than hs-cTnT alone. Finally, on cardiac CT, copeptin concentrations were not associated with coronary artery morphology, although they were related to the presence of left ventricular dysfunction (P ϭ 0.02). CONCLUSIONS:Among patients with acute chest pain and low to intermediate risk for ACS, copeptin concentrations are not independently predictive of ACS and do not add diagnostic value beyond that of hs-cTnT measurements. © 2011 American Association for Clinical ChemistryA substantial proportion of patients presenting to the emergency department (ED) 6 with acute chest discomfort have normal electrocardiograms (ECGs) and initially reassuring conventional cardiac troponin concentrations, but still subsequently develop myocardial infarction (MI) (1 ). Because early-invasive strategies for acute coronary syndrome (ACS) management have been shown to be associated with significantly better patient outcome in higher-risk patients, additional biochemical measures for diagnosis and initial risk stratification of patients presenting with chest pain are needed (2 ).The role of the antidiuretic and vasoconstricting hormone arginine-vasopressin (AVP) in myocardial ischemia is still unclear. Copeptin, the C-terminal part of the AVP prohormone, is a stable peptide derived from the AVP precursor, thereby monitoring AVP levels (3 ). Secretion of copeptin is prompted by individual stress and seems to mirror moderate levels of stress even more subtly than cortisol (4 ). Copeptin concentrations are associated with measures of insulin resistance and metabolic syndrome in hypertensive adults

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Plasma Carboxy-Terminal Provasopressin (Copeptin): A Novel Marker of Insulin Resistance and Metabolic Syndrome

Abstract: Our findings indicate a novel cross-sectional association between plasma copeptin and measures of insulin resistance and MetSyn.

Cited by 141 publications

References 36 publications

Sex differences in the association between plasma copeptin and incident type 2 diabetes: the Prevention of Renal and Vascular Endstage Disease (PREVEND) study

Sex differences in the association between plasma copeptin and incident type 2 diabetes: the Prevention of Renal and Vascular Endstage Disease (PREVEND) study

First and third trimester serum concentrations of adropin and copeptin in gestational diabetes mellitus and normal pregnancy

Copeptin Does Not Add Diagnostic Information to High-Sensitivity Troponin T in Low- to Intermediate-Risk Patients with Acute Chest Pain: Results from the Rule Out Myocardial Infarction by Computed Tomography (ROMICAT) Study

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