title: Plasma copeptin as a predictor of intoxication severity and delayed neurological sequelae in acute carbon monoxide poisoning.
abstract: The present study was designed to assess the usefulness of measuring plasma levels of copeptin (a peptide co-released with the hypothalamic stress hormone vasopressin) as a biomarker for the severity of carbon monoxide (CO) poisoning and for predicting delayed neurological sequelae (DNS). Seventy-two patients with CO poisoning and 72 sex and age matched healthy individuals were recruited. Plasma copeptin levels were measured on admission from CO poisoning patients and for healthy individuals at study entry by using a sandwich immunoassay. The CO poisoning patients were divided into two groups according to severity (unconscious and conscious) and occurrence of DNS. The mean plasma copeptin levels (52.5±18.5 pmol/L) in the unconscious group were significantly higher than in the conscious group (26.3±12.7 pmol/L) (P<0.001). Plasma copeptin levels of more than 39.0 pmol/L detected CO poisoning with severe neurological symptoms e.g. unconsciousness (sensitivity 84.6% and specificity 81.4%). The plasma copeptin levels were higher in patients with DNS compared to patients without DNS (52.2±20.6 pmol/L vs. 27.9±14.8 pmol/L, P<0.001). Plasma copeptin levels higher than 40.5 pmol/L predicted the development of DNS (sensitivity 77.8%, specificity 82.1%). Plasma copeptin levels were identified as an independent predictor for intoxication severity [odds ratio (OR) 1.261, 95% confidence interval (CI) 1.112-1.638, P=0.002] and DNS (OR 1.313, 95% CI 1.106-1.859, P=0.001). Thus, plasma copeptin levels independently related to intoxication severity and were identified as a novel biomarker for predicting DNS after acute CO poisoning.
authors.affiliation: Department of Emergency, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China.
authors.forename: Li
authors.initials: L
authors.lastname: Pang
authors.affiliation: Department of Gastrointestinal Surgery, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China.
authors.forename: He-Lei
authors.initials: HL
authors.lastname: Wang
authors.affiliation: Department of Emergency, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China.
authors.forename: Zhi-Hao
authors.initials: ZH
authors.lastname: Wang
authors.affiliation: Department of Emergency, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wu
authors.affiliation: Department of Emergency, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China.
authors.forename: Ning
authors.initials: N
authors.lastname: Dong
authors.affiliation: Department of Emergency, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China.
authors.forename: Da-Hai
authors.initials: DH
authors.lastname: Xu
authors.affiliation: Department of Emergency, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China.
authors.forename: Da-Wei
authors.initials: DW
authors.lastname: Wang
authors.affiliation: Department of Gastrointestinal Surgery, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China. Electronic address: 187211618@qq.com.
authors.forename: Hong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Emergency, The First Hospital of Jilin University, 71 Xinmin Road, Changchun 130021, China. Electronic address: 466634002@qq.com.
authors.forename: Nan
authors.initials: N
authors.lastname: Zhang
mesh_terms: D000208:Acute Disease; D000328:Adult; D015415:Biomarkers / Q000097:blood; D002249:Carbon Monoxide Poisoning / Q000097:blood*; D005260:Female; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000097:blood*; D012720:Severity of Illness Index
chemical_list: D015415:Biomarkers; D006020:Glycopeptides; C048197:copeptins
keywords: Biomarker; Carbon monoxide poisoning; Copeptin; Delayed neurological sequelae; Severity