title: Copeptin, a marker of vasopressin, in abdominal obesity, diabetes and microalbuminuria: the prospective Malmö Diet and Cancer Study cardiovascular cohort.
abstract: BACKGROUND
  High plasma copeptin (copeptin), the C-terminal fragment of arginine vasopressin pro-hormone, has been associated with the metabolic syndrome (MetS), diabetes mellitus (DM) development and nephropathy. Here we tested whether elevated copeptin level is associated with later development of the MetS, its individual components and microalbuminuria.
  
  
  METHODS
  We analysed copeptin at baseline (1991-1994) in the population-based Malmö Diet and Cancer Study cardiovasular cohort and re-examined 2064 subjects 15.8 years later (mean age 72.8 years, 59% women) with oral glucose tolerance test and measurement of MetS and its individual components.
  
  
  RESULTS
  After age and sex adjustment, increasing quartiles of copeptin at baseline (the lowest quartile as reference) were associated with MetS (P for trend=0.008), incident abdominal obesity (P for trend=0.002), DM (P for trend=0.001) and microalbuminuria (P for trend=0.002). After additional adjustment for all the MetS components at baseline, increasing copeptin quartiles predicted incident abdominal obesity (odds ratios 1.55, 1.30 and 1.59; P for trend=0.04), DM (odds ratios 1.18, 1.32 and 1.46; P for trend=0.04) and microalbuminuria (odds ratios 1.05, 1.08 and 1.65; P for trend=0.02) but not MetS (P for trend=0.19) at the reexamination. Further, the relationship between copeptin and microalbuminuria was independent of baseline C-reactive protein, incident DM and incident hypertension.
  
  
  CONCLUSIONS
  Copeptin independently predicts DM and abdominal obesity but not the cluster of MetS. Apart from predicting DM and abdominal obesity, elevated copeptin signals increased risk of microalbuminuria. Interestingly, the association between copeptin and later microalbuminuria was independent of both prevalent and incident DM and hypertension. Our findings suggest a relationship between a dysregulated vasopressin system and cardiometabolic risk, which could have implications for risk assessment and novel preventive treatments.
authors.affiliation: Department of Clinical Sciences, Lund University, Clinical Research Center (CRC), Malmö University Hospital, Malmö, Sweden.
authors.forename: S
authors.initials: S
authors.lastname: Enhörning
authors.forename: L
authors.initials: L
authors.lastname: Bankir
authors.forename: N
authors.initials: N
authors.lastname: Bouby
authors.forename: J
authors.initials: J
authors.lastname: Struck
authors.forename: B
authors.initials: B
authors.lastname: Hedblad
authors.forename: M
authors.initials: M
authors.lastname: Persson
authors.forename: N G
authors.initials: NG
authors.lastname: Morgenthaler
authors.forename: P M
authors.initials: PM
authors.lastname: Nilsson
authors.forename: O
authors.initials: O
authors.lastname: Melander
mesh_terms: D017677:Age Distribution; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000419:Albuminuria / Q000453:epidemiology / Q000378:metabolism*; D001127:Arginine Vasopressin / Q000378:metabolism*; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000378:metabolism*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000378:metabolism*; D005260:Female; D006020:Glycopeptides / Q000378:metabolism*; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D024821:Metabolic Syndrome / Q000453:epidemiology / Q000378:metabolism*; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000378:metabolism*; D056128:Obesity, Abdominal / Q000453:epidemiology / Q000378:metabolism*; D011237:Predictive Value of Tests; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013548:Sweden / Q000453:epidemiology; D013997:Time Factors
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins; D001127:Arginine Vasopressin; D002097:C-Reactive Protein