Vasopressin marker copeptin and the development of renal and metabolic disorders in patients with type 2 diabetes

The aim of the study was to evaluate the possibility of using copeptin as a marker of renal and metabolic dysfunction in patients with type 2 diabetes. Methods: In this cross-sectional, observational study included 78 patients with type 2 diabetes mellitus complicated by diabetic nephropathy (DN) were examined. Patients were divided into 4 groups according to the stage of chronic kidney disease. Control group - 15 healthy subjects. Serum levels of copeptin and insulin were determined by enzyme-linked immunosorbent assay. Results: our studies have shown that the development of DN in type 2 diabetes is accompanied by a significant increase of copeptin concentration in blood plasma compared with controls and with diabetic patients without signs of nephropathy. The highest values of copeptin were found in the later stages of DN - in patients with albuminuria and impaired kidney filtration function. In patients with type 2 diabetes, a significant direct correlation was found between copeptin level and serum creatinine (r = 0.247, p <0.03). We found more significant violations of glucose metabolism in DN patients with high serum levels of copeptin compared with patients with normal values of this factor. In particular, an increase in serum copeptin was accompanied by a significant increase in the HOMA index and insulin concentration. Conclusions. Our data indicate that the copeptin level reflects the functional state of the kidneys and can be considered a diagnostic marker of renal and cardiovascular lesions in type 2 diabetes.