Copeptin, a marker of vasopressin, in abdominal obesity, diabetes and microalbuminuria: the prospective Malmö Diet and Cancer Study cardiovascular cohort.
Level 3 - non-randomized controlled study
Prospective observational cohort study with 15.8-year follow-up
PubMed 22614056 · doi:10.1038/ijo.2012.88
What was done
Plasma copeptin levels were measured at baseline (1991-1994) in the population-based Malmö Diet and Cancer Study cardiovascular cohort. A total of 2,064 participants (mean age 72.8 years, 59% women) were re-examined 15.8 years later with an oral glucose tolerance test and clinical assessments to evaluate incident metabolic syndrome (MetS), individual MetS components, and microalbuminuria.
What was found
After age and sex adjustment, increasing baseline copeptin quartiles were associated with MetS (P for trend = 0.008), incident abdominal obesity (P for trend = 0.002), diabetes mellitus (DM, P for trend = 0.001), and microalbuminuria (P for trend = 0.002). After adjusting for baseline MetS components, higher copeptin quartiles predicted incident abdominal obesity (odds ratios 1.55, 1.30, and 1.59; P for trend = 0.04), incident DM (odds ratios 1.18, 1.32, and 1.46; P for trend = 0.04), and microalbuminuria (odds ratios 1.05, 1.08, and 1.65; P for trend = 0.02), but not composite MetS (P for trend = 0.19). The microalbuminuria association was independent of baseline C-reactive protein, incident DM, and incident hypertension.
Why it matters
Elevated vasopressin system activity, measured via plasma copeptin, long precedes the onset of abdominal obesity, diabetes, and microalbuminuria independently of baseline metabolic risk factors.
Limits
The observational cohort design cannot establish causation or rule out residual confounding. The study relied on participants surviving to re-examination at a mean age of ~73 years, introducing potential survivor or attrition bias. Confidence intervals for odds ratios were not reported in the abstract.
Cited by
- supports Circulating vasopressin, measured via copeptin, is elevated in people with obesity.