Center for Health, Work, and Environment, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA,
Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado, Aurora, Colorado, USA,
Ann Nutr Metab. 2020;76(1):30-36. doi: 10.1159/000506619. Epub 2020 Mar 13.
Vasopressin is elevated in response to heat and dehydration and has been postulated to have a role in the chronic kidney disease of unknown origin being observed in Central America. The aims of this study were to examine whether the vasopressin pathway, as measured by copeptin, is associated with the presence of kidney dysfunction, and to examine whether higher fluid intake is associated with lower circulating copeptin and thereby preserves kidney health among sugarcane workers exposed to hot conditions.
Utilizing a longitudinal study of 105 workers in Guatemala, we examined relationships between hydration indices, plasma copeptin concentrations, and kidney function markers at 3 times during the 6-month harvest. We also examined whether baseline copeptin concentrations increased the odds of developing an estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2.
Copeptin concentrations were positively associated with serum creatinine (β 1.41, 95% CI 0.88-2.03) and negatively associated with eGFR (β -1.07, 95% CI -1.43 to -0.70). In addition, as workers improved their hydration (measured by increases in fluid balance), copeptin concentrations were reduced, and this reduction was associated with an improvement in kidney function.
Results suggest that copeptin should be studied as a potential prognostic biomarker.
加压素在受热和脱水时会升高，据推测它在中美洲观察到的不明原因的慢性肾脏病中发挥作用。本研究的目的是检验加压素途径（以 copeptin 衡量）是否与肾功能障碍的存在相关，以及更高的液体摄入量是否与循环 copeptin 降低相关，从而保护暴露于高温环境下的甘蔗工人的肾脏健康。
我们利用危地马拉的一项 105 名工人的纵向研究，在 6 个月的收获期内的 3 个时间点检查了水合指数、血浆 copeptin 浓度和肾功能标志物之间的关系。我们还检验了基线 copeptin 浓度是否会增加估算肾小球滤过率（eGFR）<60 mL/min/1.73 m2 的几率。
copeptin 浓度与血清肌酐呈正相关（β 1.41，95%置信区间 0.88-2.03），与 eGFR 呈负相关（β-1.07，95%置信区间-1.43 至-0.70）。此外，随着工人的水合作用（通过液体平衡的增加来衡量）得到改善，copeptin 浓度降低，这种降低与肾功能的改善相关。
结果表明，copeptin 应该作为一种潜在的预后生物标志物进行研究。
