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. 2019 Dec;20(8):1110-1117.
doi: 10.1111/pedi.12909. Epub 2019 Aug 29.

Elevated copeptin, arterial stiffness, and elevated albumin excretion in adolescents with type 1 diabetes

Pattara Wiromrat  1 , Petter Bjornstad  1   2 , Carissa Vinovskis  1 , Linh T Chung  1 , Carlos Roncal  2 , Laura Pyle  1   3 , Miguel A Lanaspa  2 , Richard J Johnson  2 , David Z Cherney  4 , Tyler K Reznick-Lipina  5 , Franziska Bishop  5 , David M Maahs  6   7 , Raj Paul Wadwa  5
Affiliations

Elevated copeptin, arterial stiffness, and elevated albumin excretion in adolescents with type 1 diabetes

Pattara Wiromrat et al. Pediatr Diabetes. 2019 Dec.

Abstract

Objective: We sought to evaluate copeptin concentrations in adolescents with and without type 1 diabetes (T1D) and examine the associations between copeptin and measures of arterial stiffness and kidney dysfunction.

Research design and methods: This analysis included 169 adolescents with T1D (12-19 years of age, 59% girls, mean HbA1c 9.0 ± 1.5% and diabetes duration of 8.6 ± 2.9 years), in addition to 61 controls without T1D. Arterial stiffness including carotid-femoral pulse wave velocity (CF-PWV), carotid-radial PWV (CR-PWV), augmentation index normalized to heart rate of 75 bpm (AIx@HR75), and brachial artery distensibility (BAD). Serum copeptin, urinary albumin-to-creatinine ratio (UACR), and estimated glomerular filtration rate (eGFR) by serum creatinine and cystatin C were also assessed.

Results: Compared to controls, adolescents with T1D had higher median (Q1-Q3) copeptin (7.5 [5.2-11.3] vs 6.4 [4.8-8.3] pmol/L, P = .01), mean ± SD eGFR (121 ± 23 vs 112 ± 16 mL/min/1.73m2 , P = .002) and lower BAD (7.1 ± 1.3 vs 7.2 ± 1.2%, P = .02). Adolescents with T1D in the in high tertile copeptin group (>9.1 pmol/L) had higher AIx@HR75 (10.7 ± 1.2 vs 5 ± 1.2, P = .001), CR-PWV (5.30 ± 1.0 vs 5.18 ± 1.0 m/s, P = .04), and UACR (12 ± 1 vs 8 ± 1 mg/g, P = .025) compared to those in low tertile (<5.8 pmol/L) after adjusting for age, sex, and eGFR. Copeptin inversely associated with CF-PWV independent of age, sex, eGFR, SBP, and HbA1c in T1D adolescents.

Conclusions: Our data demonstrate that elevated copeptin was associated with worse arterial stiffness in adolescents with T1D. These findings suggest that copeptin could improve CVD risk stratification in adolescents with T1D.

Keywords: adolescents; arterial stiffness; copeptin; diabetic kidney disease; pulse wave velocity; type 1 diabetes.

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Figures

Figure 1:
Figure 1:. Measures of vascular stiffness and urinary albumin excretion in adolescents with type 1 diabetes regarding tertiles of copeptin concentrations
Data are shown by groups according to tertiles of copeptin concentrations. Bar graphs and whiskers indicate least-square means (adjusting for age, sex and eGFR) and standard errors of the mean, respectively. CF-PWV, carotid-femoral pulse wave velocity; CR-PWV, carotid-radial pulse wave velocity; BAD, brachial artery distensibility; AIx@HR75, augmentation index at heart rate of 75 beats per minute; UACR, urinary albumin to creatinine ratio
Figure 2:
Figure 2:. Logistic regression model predicting elevated albumin excretion in T1D adolescents in high vs. low copeptin tertile groups
Data are presented as forest plots. Black box indicates reference odds ratio of low copeptin tertile group. Black circle and lines indicate odds ratio and 95% confidence interval of elevated albuminuria in high vs. with low copeptin tertile group.
See this image and copyright information in PMC

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