Ozben Serkan, Guvenc Tolga Sinan, Huseyinoglu Nergiz, Sanivar Hilal Safak, Hanikoglu Ferhat, Cort Aysegul, Ozben Tomris
Department of Neurology, Medical Faculty, Kafkas University, 36100, Kars, Turkey,
Sleep Breath. 2013 Dec;17(4):1187-92. doi: 10.1007/s11325-013-0822-7. Epub 2013 Feb 14.
Copeptin, the C-terminal fragment of antidiuretic hormone (ADH), is a new biomarker that has been found to be elevated in several cardiovascular disorders and is related with prognosis. Patients with obstructive sleep apnea demonstrate a tendency to develop coronary and cerebral atherosclerotic disease. Our aim was to investigate copeptin levels in untreated new diagnosed obstructive sleep apnea patients without manifest cardiovascular disorders in order to determine whether copeptin could be used as a biomarker in this group.
A total of 60 patients with obstructive sleep apnea, diagnosed with polysomnography, and 23 healthy volunteers were enrolled into this study. Blood samples were collected after overnight fasting, and copeptin level was measured with an enzyme immunoassay method.
Patients with obstructive sleep apnea had a higher incidence of hypertension and body mass index but lower serum copeptin level (0.48 ± 0.24. vs. 0.64 ± 0.28 ng/ml, p = 0.007) compared with the healthy controls. There was no significant difference regarding to serum copeptin levels between the moderate (n = 13) and severe (n = 47) obstructive sleep apnea patients (0.42 ± 0.18 vs. 0.49 ± 0.26 ng/ml, p = 0.409).
Rather than reflecting a reduced risk for cardiovascular disorders, we consider that reduced copeptin level is related with disturbed ADH secretion in obstructive sleep apnea patients. Therefore, it would not be advisable to measure copeptin levels in obstructive sleep apnea patients to determine cardiovascular risk, while this marker could be valuable to demonstrate impairment in ADH regulation in this patient group.
copeptin是抗利尿激素（ADH）的C末端片段，是一种新的生物标志物，已发现在几种心血管疾病中升高且与预后相关。阻塞性睡眠呼吸暂停患者有发生冠状动脉和脑动脉粥样硬化疾病的倾向。我们的目的是研究未经治疗的新诊断阻塞性睡眠呼吸暂停患者（无明显心血管疾病）的copeptin水平，以确定copeptin是否可作为该组患者的生物标志物。
共有60例经多导睡眠图诊断为阻塞性睡眠呼吸暂停的患者和23名健康志愿者纳入本研究。过夜禁食后采集血样，采用酶免疫测定法测量copeptin水平。
与健康对照组相比，阻塞性睡眠呼吸暂停患者高血压发病率和体重指数较高，但血清copeptin水平较低（0.48±0.24 vs. 0.64±0.28 ng/ml，p = 0.007）。中度（n = 13）和重度（n = 47）阻塞性睡眠呼吸暂停患者之间血清copeptin水平无显著差异（0.42±0.18 vs. 0.49±0.26 ng/ml，p = 0.409）。
我们认为，copeptin水平降低与阻塞性睡眠呼吸暂停患者抗利尿激素分泌紊乱有关，而不是反映心血管疾病风险降低。因此，测量阻塞性睡眠呼吸暂停患者的copeptin水平以确定心血管风险是不可取的，而该标志物对于证明该患者组抗利尿激素调节受损可能有价值。
