Increased Levels of Copeptin Before Clinical Diagnosis of Preeclampsia

Abstract

Copeptin, a surrogate biomarker of vasopressin, has been associated with renal function decline and may serve as a useful early biomarker for preeclampsia. We measured serum copeptin using samples collected longitudinally during pregnancy among unaffected controls (n=136) and cases of preeclampsia (n=169), gestational diabetes (n=92), gestational hypertension (n=101) and preterm birth (n=86) in the Calcium for Preeclampsia Prevention trial (1992–1995). Preeclampsia and gestational hypertension were defined as having a diastolic blood pressure greater than or equal to 90 millimeters of mercury on two occasions with and without proteinuria, respectively. The risk of pregnancy complications associated with copeptin was estimated by logistic regression adjusting for maternal age, race, body-mass index, insurance status, marital status, current smoking, and clinical site. Baseline copeptin levels, at mean 16 weeks of gestation, were associated with increased preeclampsia risk (adjusted odds ratios and 95% confidence interval being 1.55 per log unit; 1.03–2.31) compared to controls (p=0.03). The association was stronger among cases diagnosed before 37 weeks (1.86; 1.08–3.20) than those diagnosed later (1.45; 0.91–2.32). Copeptin levels rose with increasing gestational age in both cases and controls but remained significantly higher among those who were diagnosed with preeclampsia. Differences in levels of copeptin between cases and controls became more apparent closer to time of diagnosis. No significant associations were found for gestational hypertension without proteinuria, gestational diabetes, or preterm birth without preeclampsia. Copeptin levels are elevated in pregnant women prior to diagnosis of preeclampsia with elevation specific to this pregnancy complication rather than hypertension alone.

First and third trimester serum concentrations of adropin and copeptin in gestational diabetes mellitus and normal pregnancy

“…However, a recent study of Yeung and coauthors (2014) investigates serum copeptin levels during pregnancy in relation to multiple pregnancy complications risk. There, in one of the largest reports, association between increased copeptin concentration and occurrence of preeclampsia were confirmed and no correlation to gestational diabetes was found [24]. Likewise in our study, an elevated serum concentration of copeptin in GDM patients, both in the first and in the third trimester, was not statistically significant.…”

Shifting Focus: From Hydration for Performance to Hydration for Health

“…Finally, there is a paucity of research regarding ways that hydration and copeptin may impact specific segments of the population. In pregnant women, limited research suggests that plasma copeptin as early as the first trimester may be predictive of preeclampsia [71,72] ; in children, research regarding water intake, hydration, and vasopressin is virtually nonexistent outside of enuresis. Today, the field is wide open and, for young researchers in particular, represents a huge opportunity for novel research.…”

Use of Biomarkers in the Evaluation and Treatment of Hypertensive Patients

“…Without going into any detail we would like to highlight that advances in technology and especially in mass spectrometry have made it possible to screen for and detect such novel substances and have led to the identification of Angiotensin A [53] and more recently of Vasoconstriction-Inhibiting Factor [54] as novel players in the balance between vasoconstriction and vasorelaxation. Other factors including arginine vasopressin and its inert prosegment copeptin have been found to be associated with essential hypertension [55] and pre-eclampsia [56,57] but the clinical relevance remains to be determined.…”