Department of Medical Specialties III, "Grigore T. Popa" University of Medicine and Pharmacy, Universității 16, Iași 700115, Romania; Department of Neurology, Clinical Rehabilitation Hospital, Pantelimon Halipa 14, Iași 700661, Romania.
Faculty of Mathematics, "Alexandru Ioan Cuza" University, Bulevardul Carol I 11, Iași 700506, Romania.
Clin Neurol Neurosurg. 2024 Sep;244:108432. doi: 10.1016/j.clineuro.2024.108432. Epub 2024 Jul 5.
Traumatic brain injury (TBI) necessitates reliable biomarkers to improve patient care. This study explored copeptin as a potential biomarker in TBI and its relation to vasopressin (ADH) in such patients.
A cross-sectional study was conducted on 50 TBI patients. Exclusion criteria included specific medical conditions and recent traumatic events. Copeptin and ADH testing were performed within 30 days post-trauma. Patient data, Glasgow Coma Scale (GCS) scores, imaging results, and the need for surgical intervention were obtained from medical charts.
Copeptin levels negatively correlated with GCS scores (ρ = - 0.313, p = 0.027), indicating a potential association with trauma severity. Copeptin levels (mean: 3.22 pmol/L, median 2.027 pmol/L, SD = 3.15) tended to be lower than those found in the normal population, suggesting possible neuroendocrine dysfunction post-TBI. ADH levels (mean: 67.93 pmol/L, median 56.474 pmol/L SD = 47.67) were higher than the normal range and associated with the need for surgery (p = 0.048). Surprisingly, copeptin and ADH levels negatively correlated (r = - 0.491; p < 0.001), potentially due to differences in degradation processes and physiological variations in TBI patients.
Copeptin shows potential as a predictive biomarker for assessing TBI severity and predicting patient outcome. However, its complex relationship with ADH in TBI requires further investigation. Careful interpretation is needed due to potential variations in excretion dynamics and metabolism. Larger studies on TBI patient cohorts are essential to validate copeptin as a reliable biomarker and improve patient care in TBI.
创伤性脑损伤（TBI）需要可靠的生物标志物来改善患者的治疗效果。本研究探讨了 copeptin 作为 TBI 潜在生物标志物的作用及其与患者中血管加压素（ADH）的关系。
对 50 例 TBI 患者进行了横断面研究。排除标准包括特定的医疗条件和近期创伤事件。copeptin 和 ADH 检测在创伤后 30 天内进行。从病历中获取患者数据、格拉斯哥昏迷量表（GCS）评分、影像学结果以及是否需要手术干预等信息。
copeptin 水平与 GCS 评分呈负相关（r = -0.313，p = 0.027），表明与创伤严重程度有关。copeptin 水平（平均值：3.22 pmol/L，中位数 2.027 pmol/L，标准差=3.15）低于正常人群，提示 TBI 后可能存在神经内分泌功能障碍。ADH 水平（平均值：67.93 pmol/L，中位数 56.474 pmol/L，标准差=47.67）高于正常范围，与手术需求相关（p=0.048）。令人惊讶的是，copeptin 和 ADH 水平呈负相关（r = -0.491；p < 0.001），这可能是由于降解过程和 TBI 患者的生理变化的差异所致。
copeptin 作为评估 TBI 严重程度和预测患者预后的预测性生物标志物具有潜力。然而，它在 TBI 中与 ADH 的复杂关系需要进一步研究。由于排泄动力学和代谢的潜在差异，需要谨慎解释。对 TBI 患者队列进行更大规模的研究对于验证 copeptin 作为可靠的生物标志物并改善 TBI 患者的治疗效果至关重要。
