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Copeptin serves as marker for renal function in children with type 1 diabetes
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In children and adolescents with type 1 diabetes, serum copeptin levels are associated with renal function, recent study findings show.
Ralf Schiel, MD, of the department of diabetes and metabolic diseases at Osteebad Heringsdorf, Germany, and colleagues analyzed data from 80 children with type 1 diabetes (mean age, 13 years; 37 girls; mean HbA1c, 7.85%; mean diabetes duration, 7.3 years) and 61 healthy controls (mean age, 12.4 years; 38 girls), both admitted to an in-house rehabilitation in a specialized hospital in 2014. Researchers measured serum copeptin levels and lipid profiles, as well as clinical and socioeconomic data for the cohort. In patients with diabetes, researchers also measured HbA1c and blood glucose and assessed for microalbuminuria. Researchers used a sandwich immunoassay to measure plasma copeptin levels.
In the diabetes group, mean concentration of serum copeptin was 4.75 pmol/L vs. a mean of 5.56 pmol/L in controls. Researchers found an inverse correlation between copeptin levels and glomerular filtration rate in children with type 1 diabetes (r = 0.23; P = .041) and controls (r = 0.61; P = .034). In the diabetes group, serum copeptin levels also inversely correlated with total cholesterol (r=-0.23, P = .041) and LDL cholesterol (r=-0.24, P = .036) levels, but not with other factors. In controls, researchers found no other associations.
Researchers found that children with a longer diabetes duration (at least 7 years; n = 45) had higher serum copeptin levels vs. those with a shorter diabetes duration (n = 35; mean 5.24 pmol/L vs. 4.13 pmol/L). In multivariate analyses, only GFR could be identified as a parameter associated with copeptin (P = .032).
In comparing patients with type 1 diabetes and controls, researchers found no between-group differences with respect to copeptin (P = .24), serum creatinine (49.8 vs. 50.4 mol/L; P = .53) or GFR (102.4 vs. 104.5 mL/min; P = 0.47). However, children with type 1 diabetes had lower concentrations of C-reactive protein (1.66 vs 3.21 g/mL; P = .013) and triglycerides (0.88 vs. 1.13 mmol/L; P = .010), and a lower ratio of LDL/HDL cholesterol (1.73 vs. 2.32; P < .001), as well as lower body weight (51.3 kg vs. 60.3 kg; P = .002) and BMI (19.7 kg/m² vs. 23.2 kg/m²; P < .001).
Children with type 1 diabetes also had higher blood glucose, HDL cholesterol, higher education and maternal education levels vs. controls.
“In the total group and both subgroups, there were significant inverse correlations between copeptin and GFR,” the researchers wrote. “These findings are in agreement with previously published data. This suggests that the copeptin concentration is also a surrogate parameter for kidney function and a decline of GFR in children and adolescents.”
The researchers noted that the higher BMI and body weight and less-favorable lipid profiles in the control group may reflect a less healthy nutritional intake and lifestyle, as the cohort was recruited from a mother-child rehabilitation group.
“Although the groups studied in the present trial were comparable with respect to sex and age, it is possible that the differences found have to be regarded as a bias with relation to a social class effect resulting in the differences found,” the researchers wrote.” – by Regina Schaffer
Disclosure: The researchers report no relevant financial disclosures.
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