Comparison Between Copeptin and Vasopressin in a Population From the Community and in People With Chronic Kidney Disease

The Journal of Clinical Endocrinology & Metabolism, Dec 2014

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.

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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) - 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)


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Roussel, Ronan, Fezeu, Léopold, Marre, Michel, Velho, Gilberto, Fumeron, Frédéric, Jungers, Paul, Lantieri, Olivier, Balkau, Beverley, Bouby, Nadine, Bankir, Lise, Bichet, Daniel G.. Comparison Between Copeptin and Vasopressin in a Population From the Community and in People With Chronic Kidney Disease, The Journal of Clinical Endocrinology & Metabolism, 2014, pp. 4656-4663, Volume 99, Issue 12, DOI: 10.1210/jc.2014-2295