Comparison Between Copeptin and Vasopressin in a Population From the Community and in People With Chronic Kidney Disease
Endocrine Society
Received May
Comparison Between Copeptin and Vasopressin in a Population From the Community and in People With Chronic Kidney Disease
Ronan Roussel 0
Léopold Fezeu 0
Michel Marre 0
Gilberto Velho 0
Frédéric Fumeron 0
Paul Jungers 0
Olivier Lantieri 0
Beverley Balkau 0
Nadine Bouby 0
Lise Bankir 0
Daniel G. Bichet 0
0 Centre de Recherche des Cordeliers , (R.R., L.F., N.B., F.F., G.V., M.M., L.B.) INSERM, 75005 Paris , France; Service d'Endocrinologie (R.R., M.M), Diabétologie et Nutrition, DHU FIRE, Hôpital Bichat Assistance Publique-Hôpitaux de Paris, 75018 Paris, France; Université Pierre et Marie Curie (N.B., L.B.) , 75005 Paris , France; Université Paris Diderot (R.R., F.F., M.M.), 75013 Paris , France; Service de Néphrologie (P.J.), Hôpital Necker , 75015 Paris, France; IRSA (O.L.), LA Riche , France; INSERM Center for Research in Epidemiology and Population Health (B.B.), Epidemiology of Diabetes, Obesity and Chronic Kidney Disease Over the Life course , 94805 Villejuif , France; Université Paris Sud (B.B.) , 91400 Villejuif , France; and Service de Néphrologie (D.G.B.), Hôpital du Sacré-Coeur, Université de Montréal , QC H3T 1J4 Montreal , Canada
Context: Vasopressin plays a central role in water homeostasis but it has also been recognized to be associated with adverse effects in several chronic diseases. Recently, copeptin has been increasingly used as a surrogate for vasopressin, as they are co-secreted, and copeptin is easier to measure. However, the relationship between plasma concentrations of copeptin (Pcop) and vasopressin (Pvp) has only been studied in relatively small numbers of selected people. Objective: This study sought to evaluate the relationship between Pvp and Pcop in a communitybased population and in people with chronic kidney disease (CKD). Design, Setting, and Participants: Pvp, Pcop, and urinary osmolarity (Uosm) were compared in 500 participants of the DESIR study, and in 83 ambulatory people with CKD. Results: Median [interquartile range] of Pcop and Pvp in the DESIR study were 4.13 [3.58] pmol/L and 0.92 [1.93] pmol/L, respectively. Log-transformed Pcop and Pvp concentrations correlated significantly and positively (r 0.686, P .001) and they correlated inversely with estimated Uosm (P .001). Copeptin explained only approximately half of the vasopressin variation. In CKD, Pcop and Pvp both increased with decreasing estimated glomerular filtration rate (eGFR), but Pcop increased much faster than Pvp. The Pcop/Pvp ratios in the lower and upper quintile groups of eGFR were 14.3 [18.3] and 5.3 [4.5], P .001, respectively. Conclusions: This study in a normal population, the largest ever with measurements of both peptides, shows that copeptin and vasopressin concentrations correlated well. But their relationship is distorted in CKD, suggesting that the peptide clearances differ when the renal function is impaired. (J Clin Endocrinol Metab 99: 4656 - 4663, 2014)
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E n d o c r i n e
R e s e a r c h
* R.R. and L.F. contributed equally to the study.
** D.B. and L.B. contributed equally to the study.
Abbreviations: AVP, vasopressin; BMI, body mass index; CKD, chronic kidney disease;
DESIR, Data from Epidemiological Study on Insulin Resistance Syndrome ; eGFR, estimated
glomerular filtration rate; eUosm, estimated urine osmolarity; GFR, glomerular filtration
rate; IQR, interquartile range; Pcop, plasma concentration of copeptin; Pvp, plasma
concentration of vasopressin; Ucreat, concentration of creatinine; UK, concentration of
potassium; UNa, concentration of sodium; Uurea, concentration of urea; Uosm, urinary osmolality.
V mone, very ancient and phylogenetically well
conasopressin (AVP) is a small, nine-amino-acid
horserved. It plays a crucial role in water conservation that is
not duplicated by any other hormone (
1
). The major
stimulus for its secretion is an increase in plasma osmolality. In
normal conditions, plasma vasopressin concentration
ranges from an undetectable level to approximately 5
pmol/L, a range of values one order of magnitude lower
than that of most other peptidic hormones. Despite its
implication in various pathological states (
2
), vasopressin
was rarely measured, mainly because the available assays
were time consuming and had limited sensitivity (lower
limit of detection 0.3– 0.5 pmol/L).
In recent years, a renewed interest in vasopressin has
emerged in research. This is due, at least in part, to the
development of new biochemical and pharmacological
tools. First, the cloning of the different vasopressin
receptors and the subsequent availability of antibodies against
them have shown that there are vasopressin receptors in
many organs in which vasopressin action had not been
suspected before (
2, 3
). Second, the availability of new
selective nonpeptidic antagonists of the different
vasopressin receptors has allowed new physiological effects of
vasopressin in these organs to be detected. Finally, a
relatively simple and s (...truncated)