Original Article
Clinical
Copeptin Plasma Levels are Associated with Decline of Renal Function in Patients with Type 2 Diabetes Mellitus

https://doi.org/10.1016/j.arcmed.2018.04.002Get rights and content

Background

Chronic kidney disease (CKD) is a leading complication of type 2 diabetes mellitus (T2DM) and is considered as a public health problem. Copeptin is a surrogate marker of arginine vasopressin (AVP) system and is proposed as a biomarker of decline renal function.

Objective

Evaluate whether plasma copeptin levels may be used as a biomarker of decline renal function in patients with T2DM.

Research Design and Methods

A total of 480 patients with T2DM and different stages of CKD were included. Plasma levels of copeptin, cystatin-C, and other biochemical parameters were measured. The correlation between copeptin and glomerular filtration rate (GFR), estimated based on plasma cystatin-C levels, was investigated.

Results

Plasma copeptin levels were gradually increased from the stage 1–5 of CKD in the patients with T2DM. In univariate linear regression analysis, high plasma levels of copeptin were associated with lower GFR (Standardized β = −0.535, R2 = 0.287, p <0.0001). This association remained significant even after being adjusted for glucose levels and years of T2DM diagnosis, mean blood pressure, pharmacological treatment, gender, and age.

Conclusions

The results show that high plasma copeptin levels are associated with the decline of renal function in patients with T2DM and, therefore, copeptin may be considered as a biomarker of renal function. Further evaluation of plasma copeptin levels to predict morbidity and mortality of T2DM patients, with or without CKD, has been taken into our consideration.

Section snippets

Study Design and Participants

In a cross-sectional study, patients with T2DM were recruited from the Medical Care Ambulatory Unit/Family Medicine Unit #75 (UMAA/UMF #75) and the Regional General Hospital # 1 (HGR #1), both from the Mexican Social Security Institute (IMSS) in Morelia, Michoacan, Mexico. The study was approved by the Local Research Committee of the HGR #1, IMSS, Morelia, Michoacan, Mexico. All patients signed an informed consent to participate in the study. Inclusion criteria of the patients were: at least

Results

A total of 480 (41% males) patients with T2DM were analyzed. Sixty-seven (14.0%) patients were classified as stage 1 CKD, 142 (29.5%) as stage 2, 97 (20.2%) as stage 3, 31 (6.5%) as stage 4 and 143 (29.8%) as stage 5 CKD, according the K/DOQI Guidelines. The cardiovascular morbidities found were: hypertension in 215 (44.8%) patients, ischemic heart disease in 20 (4.2%), heart failure in 22 (4.6%), peripheral arterial disease in 11 (2.3%), and stroke in 6 (1.3%) patients. Of the studied

Conclusions

In the present study we investigated the effect of renal function and its association with plasma copeptin levels in a sample of Mexican patients with T2DM. We showed that plasma copeptin levels were strongly associated with the eGFR. Plasma copeptin levels progressively increased, while renal function was declined, reaching the highest values in patients with stage 5 CKD. Interestingly, in patients with stage 5 CKD undergoing hemodialysis, there was a trend toward a reduction in plasma

Acknowledgments

M.L.V.T. researched data. A.E.H.M. researched data. A.G.G. reviewed/edited manuscript and researched data. A.R.A.P. researched data. E.G.L. researched data. P.S. contributed to discussion. H.F.G. contributed to discussion. D.R. contributed to discussion. B.L. reviewed/edited manuscript and contributed to discussion. C.A.A. wrote the manuscript.

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    • Relation of Copeptin with Diabetic and Renal Function Markers Among Patients with Diabetes Mellitus Progressing Towards Diabetic Nephropathy

      2020, Archives of Medical Research
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      The present study is the only available study reporting the correlation of UACR not only in patients with DM but also with different stages from initiation of diabetes to the onset of its complications (controls, pre diabetes, DM and DM with nephropathy). Although several studies with variable ethnicity and study parameters are available that have reported significant association of copeptin with DM and renal outcomes with few biomarkers of renal function (1,5,27,29–32). According to best of our knowledge this is the first study reporting copeptin levels from healthy controls to pre diabetic stage to the development of DM and then the onset of renal complications.

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