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. 2015 Apr 10:11:589-94.
doi: 10.2147/TCRM.S80779. eCollection 2015.

Copeptin: a new predictor for severe obstructive sleep apnea

Halit Çınarka  1 , Servet Kayhan  1 , Mevlüt Karataş  1 , Asiye Yavuz  1 , Aziz Gümüş  1 , Songül Özyurt  1 , Medine Cumhur Cüre  2 , Ünal Şahin  1
Affiliations

Copeptin: a new predictor for severe obstructive sleep apnea

Halit Çınarka et al. Ther Clin Risk Manag. .

Abstract

Introduction: Copeptin which is the C-terminal fragment of antidiuretic hormone (ADH), is a biomarker that has been reported to be increased in various cardiovascular disorders, cerebrovascular diseases and associated with prognosis. Patients with obstructive sleep apnea syndrome (OSAS) have a tendency to develop coronary and cerebral atherosclerotic diseases.

Objectives: The aim of the present study was to study copeptin levels in patients with obstructive sleep apnea and in a control group in order to determine whether copeptin could be used as a biomarker predicting the severity of OSAS and possible complications in this group.

Methods: A total of 116 patients with OSAS, diagnosed by polysomnography, and 27 controls were included in the study. Blood samples were collected after overnight fasting, and copeptin levels were measured with enzyme-linked immunosorbent assay.

Results: Copeptin levels were significantly higher in the OSAS group compared to control group (2,156±502; 1,845±500 pg/mL, respectively, P=0.004). Mean copeptin level of the patients having apnea-hypopnea index (AHI) ≥30 was significantly higher than that of the patients having AHI <30 (2,392±415; 2,017±500 pg/mL, respectively, P<0.001). A multivariate regression analysis showed that copeptin level, (hazard ratio: 1.58; 95% confidence interval: 1.09-2.30) was a predictor of severe OSAS (P=0.016). Copeptin levels showed significant positive correlation with AHI (r=0.32; P<0.001), desaturation index (r=0.23; P=0.012), arousal index (r=0.24; P=0.010) and CRP (r=0.26; P=0.011) respectively.

Conclusion: Copeptin levels are high in OSAS patients and copeptin is a potential marker for identifying patients with a high risk of early cardiovascular complications of OSAS. Copeptin has modest sensitivity (84%) for discriminating severe OSAS patients who are candidates for severe cardiovascular complications.

Keywords: copeptin; inflammation; obstructive sleep apnea; predictor.

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Figures

Figure 1
Figure 1
Comparison of copeptin levels between patients with obstructive sleep apnea and healthy control group. Abbreviation: OSAS, obstructive sleep apnea syndrome.
Figure 2
Figure 2
Comparison of copeptin levels between the patients with apnea-hypopnea index (AHI) ≥30 and the patients with AHI <30.
Figure 3
Figure 3
Receiver operating characteristic curve analysis of copeptin levels in predicting severe OSAS (the area under the curve of copeptin for prediction of severe OSAS was 0.736 with the optimal cut-off copeptin level of 2,044 pg/mL; the specificity and sensitivity for severe OSAS were found as 58% and 84% respectively). Abbreviations: OSAS, obstructive sleep apnea syndrome; ROC, receiver operating characteristic; AUC, area under the curve.
Figure 4
Figure 4
Correlation analysis by Spearman test between copeptin levels and apnea-hypopnea index (r=0.32; P<0.001).
Figure 5
Figure 5
Correlation analysis by Spearman test between copeptin levels and desaturation index (r=0.23; P=0.012).
Figure 6
Figure 6
Correlation analysis by the Spearman test between copeptin levels and arousal index (r=0.24; P=0.010).
Figure 7
Figure 7
Correlation analysis by the Spearman test between copeptin levels and C-reactive protein level (r=0.26; P=0.011).
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