Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031 Basel, Switzerland.
Department of Clinical Research, University Hospital Basel, 4031 Basel, Switzerland.
J Clin Endocrinol Metab. 2022 May 17;107(6):1727-1738. doi: 10.1210/clinem/dgac070.
Copeptin derives from the same precursor peptide preprovasopressin as arginine vasopressin (AVP). The secretion of both peptides is stimulated by similar physiological processes, such as osmotic stimulation, hypovolemia, or stress. AVP is difficult to measure due to complex preanalytical requirements and due to technical difficulties. In the last years, copeptin was found to be a stable, sensitive, and simple to measure surrogate marker of AVP release. Different immunoassays exist to measure copeptin. The 2 assays which have most often be used in clinical studies are the original sandwich immunoluminometric assay and its automated immunofluorescent successor. In addition, various enzyme-linked immunosorbent assay have been developed. With the availability of the copeptin assay, the differential diagnosis of diabetes insipidus was recently revisited. The goal for this article is therefore to first review the physiology of copeptin, and second to describe its use as marker for the differential diagnosis of vasopressin-dependent fluid disorders, mainly diabetes insipidus but also hyper- and hyponatremia. Furthermore, we highlight the role of copeptin as prognostic marker in other acute and chronic diseases.
copeptin 源自与精氨酸加压素 (AVP) 相同的前体肽加压素原。这两种肽的分泌都受到类似的生理过程的刺激，如渗透刺激、低血容量或应激。由于分析前的复杂要求和技术困难，AVP 难以测量。在过去的几年中，copeptin 被发现是 AVP 释放的一种稳定、敏感且易于测量的替代标志物。存在多种用于测量 copeptin 的免疫测定法。在临床研究中最常使用的 2 种测定法是原始的夹心免疫发光测定法及其自动化免疫荧光后继者。此外，还开发了各种酶联免疫吸附测定法。随着 copeptin 测定法的出现，最近重新审视了尿崩症的鉴别诊断。本文的目的首先是回顾 copeptin 的生理学，其次是描述其作为血管加压素依赖性液体紊乱（主要是尿崩症，但也包括高钠血症和低钠血症）鉴别诊断标志物的用途。此外，我们强调了 copeptin 作为其他急性和慢性疾病预后标志物的作用。
