Copeptin as a dual biomarker in type 2 diabetes: association with glycemic control and diabetic kidney disease

Abstract

Chronic kidney disease and end-stage renal disease are significantly contributed by diabetes mellitus (DM), especially diabetes mellitus type 2 (T2DM). A stable surrogate marker of vasopressin, the serum copeptin, has become a potential biomarker of poor glycemic control and diabetic kidney disease (DKD). The research objective is to estimate the usefulness of the serum copeptin as a marker of glycemic status and its correlation with DKD in patients with T2DM. This cross-sectional study was conducted on 60 participants at Cairo University Hospital between 2021 and 2022. Participants were divided into 40 T2DM patients (26 males, 14 females; mean age 52.62 ± 9.7 years) and 20 healthy controls. Diabetic patients were further categorized into controlled (HbA1c ≤ 7%, n = 18) and uncontrolled (HbA1c > 7%, n = 22) subgroups. Clinical evaluation, biochemical tests, and serum copeptin levels (measured via ELISA) were analyzed. Cairo university, Faculty of Medicine, Ethical approval: N-247-2023. Serum copeptin levels were significantly higher in diabetic patients compared to controls (p < 0.001), and in uncontrolled vs. controlled diabetics (p < 0.001). Copeptin positively correlated with fasting glucose, HbA1c, serum creatinine, and urinary protein, and negatively with eGFR. ROC analysis identified copeptin as a sensitive marker for both poor glycemic control at a cut off value > 3452 pg/mL (AUC 0.925) and DKD at a cut off vlue > 370 pg/mL (AUC 0.94), both with high sensitivity and specificity. The level of serum copeptin correlates positively with poor glycemic status as well as DKD among T2DM patients. It can be an effective, non-invasive biomarker used in early diagnosis and risk stratification of diabetic complications. Not applicable.