Elevated Copeptin, Arterial Stiffness and Elevated Albumin Excretion in Adolescents with Type 1 Diabetes

Abstract

Objective:

We sought to evaluate copeptin concentrations in adolescents with and without type 1 diabetes (T1D) and examine the associations between copeptin and measures of arterial stiffness and kidney dysfunction.

Research Design and Methods:

This analysis included 169 adolescents with T1D (12-19 years of age, 59% girls, mean HbA1c 9.0±1.5% and diabetes duration of 8.6±2.9 years), in addition to 61 controls without T1D. Arterial stiffness including carotid-femoral pulse wave velocity (CF-PWV), carotid-radial PWV (CR-PWV), augmentation index normalized to heart rate of 75bpm (AIx@HR75) and brachial artery distensibility (BAD). Serum copeptin, urinary albumin-to-creatinine ratio (UACR) and estimated glomerular filtration rate (eGFR) by serum creatinine and cystatin C were also assessed.

Results:

Compared to controls, adolescents with T1D had higher median (Q1-Q3) copeptin (7.5 [5.2-11.3] vs. 6.4 [4.8-8.3] pmol/l, p=0.01), mean±SD eGFR (121±23 vs. 112±16 ml/min/1.73m ², p=0.002) and lower BAD (7.1±1.3 vs. 7.2±1.2%, p=0.02). Adolescents with T1D in the in high tertile copeptin group (>9.1 pmol/l) had higher AIx@HR75 (10.7±1.2 vs. 5±1.2, p=0.001), CR-PWV (5.30±1.0 vs. 5.18±1.0 m/s, p=0.04) and UACR (12±1 vs. 8±1 mg/g, p=0.025) compared to those in low tertile (<5.8 pmol/l) after adjusting for age, sex and eGFR. Copeptin inversely associated with CF-PWV independent of age, sex, eGFR, SBP and HbA1c in T1D adolescents.

Conclusions:

Our data demonstrate that elevated copeptin was associated with worse arterial stiffness in adolescents with T1D. These findings suggest that copeptin could improve CVD risk stratification in adolescents with T1D.