Plasma Copeptin Levels may predict Arterial Disorder in Type 2 Diabetes Patients: Study

The CARDIPP study, published in Cardiovascular Diabetology, revealed that plasma copeptin may be a helpful surrogate for identifying individuals at higher risk for arterial disorders.

"Findings revealed that higher copeptin levels were linked to lower toe brachial index (TBI) and increased aortic pulse wave velocity in 519 patients aged 55–65," the researchers reported. "These associations remained robust regardless of key risk factors such as sex, age, diabetes duration, and HbA1c levels."

Arterial stiffness, characterized by reduced arterial compliance, is a hallmark of vascular aging and is closely linked to the development of cardiovascular events in diabetic individuals. Endothelial dysfunction, on the other hand, refers to impaired endothelial function, which plays a pivotal role in the initiation and progression of atherosclerosis.

Currently, there is a limited understanding of the relationship between copeptin, the mid-regional portion of proadrenomedullin (MRproADM) and the midregional fragment of the N-terminal of proatrial natriuretic peptide (MRproANP), and arterial disorders. Aortic pulse wave velocity (aPWV) and toe brachial index (TBI) are established parameters for detecting arterial disorders.

Against the above background, Lee Ti Davidson, Linköping University, Linköping, Sweden, and colleagues evaluated whether copeptin, MRproADM, and MRproANP were associated with TBI and aPWV in T2D patients with no history of cardiovascular disease (CVD).

For this purpose, the researchers conducted a cross-sectional analysis of 519 type 2 diabetes patients aged 55–65 years with no history of CVD at baseline, had complete data on copeptin, MRproANP, MRproADM, aPWV, and TBI was performed. The associations between conventional CVD risk factors, copeptin, MRproADM, MRproANP, TBI, and aPWV, were investigated using Linear regression analysis.

The study led to the following findings:

· Copeptin was associated with TBI (β–0.0020) and aPWV (β 0.023).

· These associations were independent of age, sex, diabetes duration, mean 24-hour ambulatory systolic blood pressure, glycated hemoglobin A1c, estimated glomerular filtration rate, total cholesterol, body mass index, and active smoking.

Copeptin, a biomarker of various stresses, is associated with TBI, and aPWV, a marker of arterial disorders, independently of age, sex, diabetes duration, smoking status, BMI, HbA1c, eGFR, total cholesterol, and mean 24-hour ambulatory SBP. Measuring copeptin levels may make identifying individuals at risk for arterial disorders simpler than current methods, such as TBI or aPWV.

"There is a need to conduct further studies to evaluate the predictive value of copeptin levels in identifying patients at increased risk of arterial disorders in primary care," the researchers concluded.

Reference:

Davidson, L.T., Engvall, J., Chisalita, S.I. et al. Plasma copeptin and markers of arterial disorder in patients with type 2 diabetes, a cross-sectional study. Cardiovasc Diabetol 23, 200 (2024). https://doi.org/10.1186/s12933-024-02291-2