Seasonal variation of vasopressin and its relevance for the winter peak of cardiometabolic disease: A pooled analysis of five cohorts

Abstract

Background Vasopressin concentration is typically higher at night, during stress, and in males, but readily lowered by water intake. Vasopressin is also a causal candidate for cardiometabolic disease, which shows seasonal variation. Objective To study whether vasopressin concentration varies by season in a temperate climate. Methods The vasopressin surrogate marker copeptin was analyzed in fasting plasma samples from five population‐based cohorts in Malmö, Sweden (n = 25,907, 50.4% women, age 18–86 years). We investigated seasonal variation of copeptin concentration and adjusted for confounders in sinusoidal models. Results The predicted median copeptin level was 5.81 pmol/L (7.18 pmol/L for men and 4.44 pmol/L for women). Copeptin exhibited a distinct seasonal pattern with a peak in winter (mid‐February to mid‐March) and nadir in late summer (mid‐August to mid‐September). The adjusted absolute seasonal variation in median copeptin was 0.62 pmol/L (95% confidence interval [CI] 0.50; 0.74, 0.98 pmol/L [95% CI 0.73; 1.23] for men and 0.46 pmol/L [95% CI 0.33; 0.59] for women). The adjusted relative seasonal variation in mean log copeptin z‐score was 0.20 (95% CI 0.17; 0.24, 0.18 [95% CI 0.14; 0.23] in men and 0.24 [95% CI 0.19; 0.29] in women). The observed seasonal variation of copeptin corresponded to a risk increase of 4% for incident diabetes mellitus and 2% for incident coronary artery disease. Conclusion The seasonal variation of the vasopressin marker copeptin corresponds to increased disease risk and mirrors the known variation in cardiometabolic status across the year. Moderately increased water intake might mitigate the winter peak of cardiometabolic disease.

Short-term association between outdoor temperature and the hydration-marker copeptin: a pooled analysis in five cohorts

“…We have previously reported a winter peak of copeptin and hypothesized that it could be explained by a J-shaped association between temperature and copeptin concentration. 16 The results of the current study supports this hypothesis. While we do not present data on other biochemical markers of hydration, previous evidence support our findings by suggesting a less hydrated state (underhydration) at both high and low temperatures, thereby providing a plausible explanation to the elevated vasopressin concentrations seen during winter.…”

“…While the water reabsorption in the renal collecting ducts are mediated mainly by the V2 receptor, 22 the metabolic and cardiovascular effects of vasopressin are also mediated via V1a and V1b receptors. 23 As we have previously summarized, 16 these include, but are not limited to, gluconeogenesis, anti-lipolysis, and platelet aggregation. In contrast to the effects of heat, cold appears to have effects on mortality over longer periods.…”

“…We addressed this issue by expanding the model in the main analysis to include a cubic spline with 10 degrees of freedom of date. Furthermore, we adjusted our main model for seasonality by following the analysis in 16 and updating the main model to include date through a sine and a cosine term with period one year.…”

“… 13 , 14 , 15 We have recently shown that copeptin has a distinct seasonal pattern in a temperate climate, with higher plasma concentration in winter of a magnitude corresponding to a relevant disease risk on the population level. 16 However, the extent to which the outdoor temperature is associated with copeptin in a population-based setting is unknown.…”

Seasonal Variation of Glucose Variability in Rather Elderly Patients with Type 2 Diabetes (T2D) Treated by Vildagliptin and Metformin (EquMet)

“…Concerning seasonal variations, systolic BP was mainly responsible for the changed risk for UKPDS-Stroke and ASCVD scores. Seasonal changes in diabetes mellitus (DM) and coronary artery disease (CHD) have been reported, which may be related to vasopressin (VP) concentration [18]. VP is known to show seasonal variation, and then these relationships were studied.…”