Plasma copeptin, a unifying factor behind the metabolic syndrome.
Level 4 - case-series / case-control
Cross-sectional observational study
PubMed 21490073 · doi:10.1210/jc.2010-2981
What was done
Researchers analyzed a cross-sectional, population-based sample of 4,742 subjects aged 46–68 years (60% women) in Malmö, Sweden. Using multivariable logistic and linear regression, they evaluated associations between plasma copeptin quartiles and components of the metabolic syndrome, adjusting for age, sex, insulin, diabetes mellitus, and environmental factors including fat intake, physical activity, and socioeconomic status.
What was found
Compared to the lowest quartile, increasing copeptin quartiles were significantly associated with hypertension (ORs 1.04, 1.07, 1.31; P = 0.004), abdominal obesity (ORs 1.21, 1.16, 1.57; P = 0.002), obesity (ORs 1.25, 1.15, 1.49; P = 0.01), and top quartile of C-reactive protein (ORs 1.11, 1.13, 1.32; P = 0.007) after adjusting for age, sex, insulin, and diabetes. Copeptin was associated with metabolic syndrome (adjusted for age and sex only: ORs 1.53, 1.77, 1.86; P < 0.001). High copeptin was also associated with high fat intake and low physical activity, but adjusting for these factors did not alter the associations with metabolic syndrome components.
Why it matters
This study links vasopressin system activity to multiple components of metabolic syndrome independently of hyperinsulinemia and lifestyle factors. It suggests the vasopressin pathway may serve as a potential pharmacological target for metabolic syndrome and cardiovascular risk reduction.
Limits
The cross-sectional design cannot establish causality or temporal sequence between copeptin elevation and metabolic abnormalities. The cohort is restricted to middle-aged and older Swedish adults, limiting generalizability to other age groups and ethnicities. Metabolic syndrome overall was only adjusted for age and sex in the reported model.
Cited by
- supports Circulating vasopressin, measured via copeptin, is elevated in people with obesity.