Department of Physiology, Dow University of Health Sciences, OJHA Campus, SUPARCO Road, Karachi, Pakistan.
Institute of Biomedical Sciences, Dow University of Health Sciences, OJHA Campus, SUPARCO Road, Karachi, Pakistan.
Arch Med Res. 2020 Aug;51(6):548-555. doi: 10.1016/j.arcmed.2020.05.018. Epub 2020 Jun 3.
Arginine vasopressin (AVP) plays an important role in the pathophysiology of Diabetes Mellitus (DM) and its related complications like diabetic nephropathy. Copeptin is considered as a reliable surrogate biomarker of AVP. If raised levels of copeptin in diabetic patients are detected earlier, prognosis of DM can be improved by timely modulating the treatment strategy.
The study is therefore planned to assess copeptin levels in different groups of DM and in healthy controls to suggest a better and reliable biomarker for progressive stages of DM.
Subjects were recruited as controls, pre diabetes, DM without nephropathy and diabetic nephropathy. Serum copeptin levels were measured by ELISA. While, Blood Urea Nitrogen (BUN), creatinine, Glycosylated Hemoglobin (HbA1c) and spot urinary albumin creatinine ratio (UACR) were done using spectrophotometry. Statistical analysis was done using ANOVA and Pearson's correlation tests on SPSS.
The average copeptin levels were 215.096 pg/mL. Copeptin levels were significantly elevated in subjects with positive family history of DM (p = 0.025), levels were also raised in pre diabetes kpatients (252.85 pg/mL) as compared to other groups. Copeptin levels were also correlated with HbA1c r = 0.171 (p = 0.101), BUN r = 0.244 (p = 0.007), creatinine r = 0.215 (p = 0.018), UACR r = 0.375 (p = <0.001) and GFR r = 0.215 (p = <0.019).
The significant correlation of copeptin with diabetic and renal biomarkers, along with its positive association with family history of DM support its' role as an early and reliable biomarker of DM and its associated nephropathy.
精氨酸加压素（AVP）在糖尿病（DM）及其相关并发症（如糖尿病肾病）的病理生理学中起着重要作用。 copeptin 被认为是 AVP 的可靠替代生物标志物。如果能更早地检测到糖尿病患者 copeptin 水平升高，通过及时调整治疗策略，就可以改善 DM 的预后。
因此，本研究旨在评估不同 DM 组和健康对照组中的 copeptin 水平，以提出一种更好、更可靠的 DM 进展阶段的生物标志物。
受试者被招募为对照组、前驱糖尿病、无肾病的糖尿病和糖尿病肾病。采用 ELISA 法测定血清 copeptin 水平，同时采用分光光度法测定血尿素氮（BUN）、肌酐、糖化血红蛋白（HbA1c）和尿白蛋白肌酐比（UACR）。采用 SPSS 进行方差分析和 Pearson 相关检验进行统计学分析。
平均 copeptin 水平为 215.096pg/ml。有 DM 阳性家族史的受试者 copeptin 水平显著升高（p=0.025），前驱糖尿病患者（252.85pg/ml）的水平也高于其他组。Copeptin 水平与 HbA1c 呈正相关（r=0.171，p=0.101），与 BUN 呈正相关（r=0.244，p=0.007），与肌酐呈正相关（r=0.215，p=0.018），与 UACR 呈正相关（r=0.375，p<0.001），与肾小球滤过率（GFR）呈正相关（r=0.215，p<0.019）。
Copeptin 与糖尿病和肾脏生物标志物显著相关，且与 DM 家族史呈正相关，支持其作为 DM 及其相关肾病的早期可靠生物标志物的作用。
