title: Modifiable factors associated with copeptin concentration: a general population cohort.
abstract: BACKGROUND
  Vasopressin plays an important role in maintaining volume homeostasis. However, recent studies suggest that vasopressin also may play a detrimental role in the progression of chronic kidney disease. It therefore is of interest to identify factors that influence vasopressin concentration, particularly modifiable ones.
  
  
  METHODS
  Cross-sectional analyses.
  
  
  METHODS
  Data used are from participants in a large general-population cohort study (Prevention of Renal and Vascular Endstage Disease [PREVEND]). Patients with a missing copeptin value (n=888), nonfasting blood sample (n=495), missing or assumed incorrect 24-hour urine collection (n=388), or heart failure (n=20) were excluded, leaving 6,801 participants for analysis.
  
  
  METHODS
  Identification of lifestyle- and diet-related factors that are associated with copeptin concentration.
  
  
  RESULTS
  Copeptin concentration as surrogate for vasopressin.
  
  
  METHODS
  Copeptin was measured by an immunoluminometric assay as a surrogate for vasopressin. Associations were assessed in uni- and multivariable linear regression analyses.
  
  
  RESULTS
  Median copeptin concentration was 4.7 (IQR, 2.9-7.6) pmol/L. When copeptin was studied as a dependent variable, the final stepwise backward model revealed associations with higher copeptin concentrations for lower 24-hour urine volume (P < 0.001), higher sodium excretion (P < 0.001), higher systolic blood pressure (P < 0.001), current smoking (P < 0.001), higher alcohol use (P < 0.001), higher urea excretion (P = 0.003), lower potassium excretion (P = 0.002), use of glucose-lowering drugs (P = 0.02), higher body mass index (P < 0.001), and higher plasma glucose level (P < 0.001). No associations with copeptin concentration were found for C-reactive protein or use of diuretics or nondiuretic antihypertensives.
  
  
  CONCLUSIONS
  The cross-sectional study design does not allow firm conclusions on cause-effect relationships.
  
  
  CONCLUSIONS
  Important lifestyle- and diet-related factors associated with copeptin concentration are current smoking, alcohol use, protein and potassium intake, and particularly fluid and sodium intake. These data form a rationale to investigate whether intervening on these factors results in a lower vasopressin concentration with concomitant beneficial renal effects.
authors.affiliation: Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Maatje D A
authors.initials: MD
authors.lastname: van Gastel
authors.affiliation: Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Esther
authors.initials: E
authors.lastname: Meijer
authors.affiliation: Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Lieneke E
authors.initials: LE
authors.lastname: Scheven
authors.affiliation: ThermoFisher Scientific, Clinical Diagnostics, Hennigsdorf, Germany.
authors.forename: Joachim
authors.initials: J
authors.lastname: Struck
authors.affiliation: Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
authors.forename: Stephan J L
authors.initials: SJ
authors.lastname: Bakker
authors.affiliation: Department of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: r.t.gansevoort@umcg.nl.
authors.forename: Ron T
authors.initials: RT
authors.lastname: Gansevoort
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D004044:Dietary Proteins / Q000008:administration & dosage; D018450:Disease Progression; D006020:Glycopeptides / Q000097:blood*; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D011498:Protein Precursors / Q000097:blood*; D051436:Renal Insufficiency, Chronic / Q000097:blood*; D012907:Smoking / Q000453:epidemiology; D012982:Sodium, Dietary / Q000008:administration & dosage; D014508:Urea / Q000378:metabolism
chemical_list: D004044:Dietary Proteins; D006020:Glycopeptides; D011498:Protein Precursors; D012982:Sodium, Dietary; C048197:copeptins; D014508:Urea
keywords: Copeptin; diet; fluid intake; general population cohort; kidney disease progression; lifestyle; modifiable factor; sodium intake; vasopressin