Skip to main content
The Egyptian Journal of Internal Medicine
Download PDF
  • Original article
  • Open access
  • Published:

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

The Egyptian Journal of Internal Medicine volume 31, pages 696–702 (2019)Cite this article

Abstract

Background

Diabetes 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 methods

The 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.

Results

Patients 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).

Conclusion

The higher serum level of copeptin in patients with T2DM especially in the patient with CAD is strongly correlated with cardiometabolic risk factors.

References

  1. Clark H, Arnett DK, Blaha MJ, Cushman M, et al. NCDs: a challenge to sustainable human development. Lancet. 2013; 381:510–511.

    Article  Google Scholar 

  2. Mozaffarian D, Benjamin EJ, Go AS, et al. Heart disease and stroke statistics-2015 update: a report from the American Heart Association. Circulation 2015; 131:e29–322.

    PubMed  Google Scholar 

  3. Forouzanfar MH, Alexander L, Anderson HR, Bachman VF, Biryukov S, Brauer M. Global, regional, and national comparative risk assessment of 79 behavioral, environmental and occupational, and metabolic risks or clusters of risks in 188 countries, 1990–2013: a systematic analysis for the global burden of disease study2013. Lancet 2015; 386:2287–2323.

    Article  Google Scholar 

  4. Hozawa A, Folsom AR, Sharrett AR, Chambless LE. Absolute and attributable risks of cardio vascular disease incidence in relation to optimal and borderline risk factors: comparison of African American with white subjects – atherosclerosis risk in communities study. Arch Intern Med 2007; 167:573–579.

    Article  Google Scholar 

  5. Barrett LK, Singer M, Clapp LH. Vasopressin: mechanisms of action on the vasculature in health and in septic shock. Crit Care Med 2007; 35:33–40.

    Article  CAS  Google Scholar 

  6. Morgenthaler NG, Struck J, Jochberger S, Dünser MW. Copeptin: clinical use of a new biomarker. Trends Endocrinol Metab 2008; 19:43–49.

    Article  CAS  Google Scholar 

  7. Enhörning S, Bankir L, Bouby N, Struck J, Hedblad B, Persson M, et al. Copeptin, a marker of vasopressin, in abdominal obesity, diabetes and microalbuminuria: the prospective Malmö Diet and Cancer Study cardiovascular cohort. Int J Obes (Lond) 2013; 37:598–603.

    Article  Google Scholar 

  8. Matthews DR, Hosker JP, Rudenski AS, Naylor BA, Treacher DF, Turner RC. Homeostasis model assessment: insulin resistance and β-cell function from fasting plasma glucose and insulin concentrations in man. Diabetologia 1985; 28:412–419.

    Article  CAS  Google Scholar 

  9. Stein JH, Korcarz CE, Hurst RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr 2008; 21:93–111.

    Article  Google Scholar 

  10. Krishnaswamy B, Raja N, Deepa S. A study of peripheral vascular disease in elderly and its association with coronary artery disease. J Indian Acad Geriatr 2006; 2:10–13.

    Google Scholar 

  11. Schink C, Hesse S, Stoppe M, Meyer K, Schmidt E. Post-dexamethasone serum copeptin corresponds to HPA axis responsiveness in human obesity. Psychoneuroendocrinology 2017; 78:39–47.

    Article  Google Scholar 

  12. Enhörning S, Wang TJ, Nilsson PM, Almgren P, Hedblad B, Berglund G. Plasma copeptin and the risk of diabetes mellitus. Circulation 2010; 121:2102–2108.

    Article  Google Scholar 

  13. Spruce BA, McCulloch AJ, Burd J, Orskov H, Heaton A, Baylis PH, Alberti KG. The effect of vasopressin infusion on glucose metabolism in man. Clin Endocrinol (Oxf) 1985; 22:463–468.

    Article  CAS  Google Scholar 

  14. Aoyagi T, Birumachi J, Hiroyama M, Fujiwara Y, Sanbe A, Yamauchi J, Tanoue A. Alteration of glucose homeostasis in V1a vasopressin receptor-deficient mice. Endocrinology 2007; 148:2075–2084.

    Article  CAS  Google Scholar 

  15. Fujiwara Y, Hiroyama M, Sanbe A, Aoyagi T, Birumachi J, Yamauchi J, et al. Insulin hypersensitivity in mice lacking the V1b vasopressin receptor. J Physiol 2007; 584:235–244.

    Article  CAS  Google Scholar 

  16. Mellbin LG, Ryden L, Brismar K. Copeptin, IGFBP-1, and cardiovascular prognosis in patients with type 2 diabetes and acute myocardial infarction: a report from the DIGAMI 2 trial. Diabetes Care 2010; 33:1604–1606.

    Article  CAS  Google Scholar 

  17. Tasevska I, Enhörning S, Persson M, Nilsson PM, Melander O. Copeptin predicts coronary artery disease cardiovascular and total mortality. Heart 2016; 102:127–132.

    Article  CAS  Google Scholar 

  18. Boeckel JN, Oppermann J, Anadol R, Fichtlscherer S, Andreas M, Zeiher AM, Kellera T. Analyzing the release of copeptin from the heart in acute myocardial infarction using a transcoronary gradient model. Sci Rep 2016; 6:20812.

    Article  CAS  Google Scholar 

  19. Wannamethee SG, Welsh P, Lennon L, Papacosta O, Whincup PH, Sattar N. Copeptin and the risk of incident stroke, CHD and cardiovascular mortality in older men with and without diabetes: The British Regional Heart Study. Diabetologia 2016; 59:1904–1912.

    Article  CAS  Google Scholar 

  20. Reichlin T, Hochholzer W, Stelzig C, Laule K, Freidank H, et al. Incremental value of copeptin for rapid rule out of acute myocardial infarction. J Am Coll Cardiol 2009; 54:60–68.

    Article  CAS  Google Scholar 

  21. Keller T, Tzikas S, Zeller T, Czyz E, Lillpopp L, Ojeda FM. Copeptin improves early diagnosis of acute myocardial infarction. J Am Coll Cardiol 2010; 55:2096–2106.

    Article  CAS  Google Scholar 

  22. Gu YL, Voors AA, Zijlstra F, Hillege HL, Struck J, Masson S. Comparison of temporal release pattern of copeptin with conventional biomarkers in acute myocardial infarction. Clin Res Cardiol 2011; 100:1069–1076.

    Article  CAS  Google Scholar 

  23. Khan SQ, Dhillon OS, O’Brien RJ, Struck J, Quinn PA, Morgenthaler NG. C-terminal pro-vasopressin (copeptin) as a novel and prognostic marker in acute myocardial infarction: leicester acute myocardial infarction peptide (LAMP) study. Circulation 2007; 115: 2103–2110.

    Article  CAS  Google Scholar 

  24. Von Haehling S, Papassotiriou J, Morgenthaler NG, Hartmann O, Doehner W, et al. Copeptin as a prognostic factor for major adverse cardiovascular events in patients with coronary artery disease. Int J Cardiol 2012; 162:27–32.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Nearmeen M. Rashad MD, Tamer M. Ezzat & Ayman E. Ali

  2. Department of Clinical Pathology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Reem M. Allam

  3. Department of Physiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Wesam M. R. Ashour

  4. Department of Cardiology, Faculty of Medicine, Zagazig University, Zagazig, Egypt

    Mohamad H. Soliman

Authors
  1. Nearmeen M. Rashad MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Tamer M. Ezzat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Reem M. Allam
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Wesam M. R. Ashour
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ayman E. Ali
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Mohamad H. Soliman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Nearmeen M. Rashad MD.

Additional information

This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Rights and permissions

This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Rashad, N.M., Ezzat, T.M., Allam, R.M. et al. Serum copeptin as a diagnostic and prognostic biomarker of coronary artery disease among patients with type 2 diabetes mellitus. Egypt J Intern Med 31, 696–702 (2019). https://doi.org/10.4103/ejim.ejim_102_19

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.4103/ejim.ejim_102_19

Keywords