Mellor A J, Boos C J, Ball S, Burnett A, Pattman S, Redpath M, Woods D R
Defence Medical Services, Lichfield, UK,
Eur J Appl Physiol. 2015 Jan;115(1):91-8. doi: 10.1007/s00421-014-2994-7. Epub 2014 Sep 12.
A diuresis is a key part of acclimatisation to high altitude (HA). Arginine vasopressin (AVP) is a hormone involved in salt and water balance and may potentially have a role in the development of altitude illness. ProAVP (copeptin) is more stable than AVP and is assayed by a straightforward, automated method. We investigated the relationship of AVP to copeptin and the copeptin response to exercise and altitude illness in a large cohort during a field study at HA.
48 subjects took part in a 10-day trek at HA. Venous blood samples were taken at 3,833, 4,450 and 5,129 m post-trek (exercise) and the following day at rest. Daily recordings of symptoms of altitude illness, oxygen saturations and perceived exertion were carried out.
AVP and copeptin levels increased with exercise and correlated closely (ρ 0.621 p < 0.001), this was strongest in the stressed state when AVP secretion was highest, at 5,129 m post-exercise (ρ 0.834 p < 0.001). On two-way ANOVA, both altitude (F = 3.5; p = 0.015) and exercise (F = 10.2; p = 0.002) influenced copeptin levels (interaction F = 2.2; p = 0.08). AVP levels were influenced by exercise (F = 14.4; p = 0.0002) but not altitude (F = 2.0; p = 0.12) with no overall group interactions (F = 1.92.6; p = 0.06). There was no association between copeptin or arginine vasopressin and altitude illness. Copeptin correlated with the Borg RPE score and was significantly higher in the group with a Borg score ≥15 (7.9 vs. 3.7 p < 0.001).
We have shown that arginine vasopressin and copeptin levels correlate and are suppressed below 5,129 m. Furthermore, we have demonstrated that exertion, rather than altitude illness or increasing osmolality, is the stimulus for increases in copeptin.
利尿是高原适应的关键部分。精氨酸加压素（AVP）是一种参与盐和水平衡的激素，可能在高原病的发生中起作用。前体AVP（ copeptin）比AVP更稳定，可通过一种简单的自动化方法进行检测。我们在高原实地研究中调查了一个大型队列中AVP与copeptin的关系以及copeptin对运动和高原病的反应。
48名受试者参加了在高原进行的为期10天的徒步旅行。在徒步旅行后（运动后）海拔3833米、4450米和5129米处以及第二天休息时采集静脉血样。每天记录高原病症状、血氧饱和度和自觉运动强度。
AVP和copeptin水平随运动增加而升高且密切相关（ρ 0.621，p < 0.001），在运动后5129米AVP分泌最高的应激状态下这种相关性最强（ρ 0.834，p < 0.001）。在双向方差分析中，海拔（F = 3.5；p = 0.015）和运动（F = 10.2；p = 0.002）均影响copeptin水平（交互作用F = 2.2；p = 0.08）。AVP水平受运动影响（F = 14.4；p = 0.0002）但不受海拔影响（F = 2.0；p = 0.12），且无总体组间交互作用（F = 1.92.6；p = 0.06）。copeptin或精氨酸加压素与高原病之间无关联。copeptin与Borg主观用力评分相关，在Borg评分≥15的组中显著更高（7.9对3.7，p < 0.001）。
我们已表明精氨酸加压素和copeptin水平相关且在海拔5129米以下受到抑制。此外，我们已证明是运动而非高原病或渗透压升高刺激了copeptin的增加。
