The Relation between Microvascular Complications of Type 2 Diabetic Patients and Plasma Copeptin Levels

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Confidentiality was guaranteed on handling the data base.This table showed that there a weak negative correlation between copeptin and (urea, creatinine, HbA1C and A/C ratio) and weak positive correlation between copeptin and GFR but P-value were not significant.But there was a positive weak correlation between copeptin and albumin and p-value was significant (P-value 0.014).In our study we found that there was a weak positive correlation between copeptin and GFR but P -value was not significant.

Results:
In

Conclusion:
It was shown that serum copeptin level was significantly lower in diabetic patients with macroalbuminuria than in normal healthy control.There was no significant association was found

The ( 60 )
Diabetic patients were divided into three subgroups according to albuminuria: a normoalbuminuric diabetic group with 24-hr urinary albumin excretion (UAE) < 30mg, (20 patients), a microalbuminuric diabetic group with a 24-hr UAE in the range 30-299mg, (20 patients) and an overt proteinuria group with proteinuric diabetic patients defined as having a 24-hr UAE ≥ 300mg, (20 patients).Inclusion criteria: Diabetic patients according to American diabetic association criteria 2015 as followings: Fasting plasma glucose (FPG) ≥126 mg/dL (7.0 mmol/L) Fasting is defined as no caloric intake for ≥8 hours, 2 Hours plasma glucose (2-hr PG) ≥200 mg/dL (11.1 mmol/L), Hemoglobin A1C ≥6.5% (48 mmol/l) and random plasma glucose (PG) ≥200 mg/dL (11.1 mmol/L) in individuals with symptoms of hyperglycemia.Exclusion criteria: Type 1 DM, patients with malignancy, patients with other endocrine diseases which affect glucose metabolism and lipid metabolism, people with chronic hepatitis, pregnancy, and history of drug abuse and the presence of https://ejmr.journals.ekb.eg/hematuria, renal insufficiency of unexplained origin, Urinary tract infection, history of rapidly progressive renal failure, polycystic kidney disease and glomerulonephritis.Statistical analysis: The collected data were coded then entered and analyzed using the SPSS version 25 (Statistical package for social science) for windows 10.Ethical considerations: The study was approved by the ethical committee of the Faculty of Medicine, Beni-Suef University.Informed written consent was obtained from all participants before recruitment in the study, after explaining the objectives of the work.
, whenever the renal function is impaired.Therefore, copeptin is preferred over AVP (8).This study aimed to inspect the clinical importance of copeptin level in patients with type 2 diabetes mellitus with and without nephropathy and to assess the relation between microvascular complications of type 2 diabetic patients and copeptin plasma levels.This study included 90 participants; 30 healthy control participants, 20 cases of DN with normoalbuminuria, 20 cases of DN with microalbuminuria, and 20 cases of DN with macroalbuminuria.The study was conducted between November 2021 till May 2022.In our study we found that serum copeptin level was lower in diabetic patients with macroalbuminuria than in normal control.The study by Meijer et al., (9) found that vasopressin might contribute to the progression of kidney damage and plasma copeptin could be a good candidate for the identification of subjects at high risk for progression of nephropathy and also found that Vasopressin is elevated in diabetes and associated with albuminuria in a recent, cross-sectional, populationbased study.copeptin was positively associated with urinary albumin/protein excretion Population-based studies have shown copeptin to be strongly associated with microalbuminuria.It was suggested that increased AVP might have albuminuric effect (10) but these findings disagree with our study.Reverse findings that appeared in the our study can be explained by the lack of adjustment of other factors like blood glucose level and history of hypertension and this may highlight the importance of considering such factors when using copeptin as a biomarker for renal affection .Velho and his colleagues found that Copeptin, a surrogate marker for arginine vasopressin, independently associated with progression to ESRD in patients with T2DM and normal renal function, copeptin also predicted an early eGFR decline leading to CKD (7).

In a chinease study by Zhao, et al. ( 13 )
showed that increased plasma copeptin levels were considered as an independent marker of diabetic retinopathy in patients with T2DM, suggesting a possible role of copeptin in the pathogenesis of diabetic retinopathy complications.Increased plasma copeptin concentrations were an independent marker of DR in Chinese patients with T2DM, suggesting a possible role of copeptin in the pathogenesis of DR complications (14) but in our study there was no significant difference in level of serum copeptin in normal or abnormal fundus examination,

Table ( 2): Comparison between different groups regarding kidney functions, albumin level and copeptin level
aThis table showed that level of urea, creatinine, A/C ratio, was significantly higher in group D than other groups.While albumin and GFR was significantly lower in group D than other groups.Copeptin level in group D was significantly lower than group A.

Table ( 5): Analysis of serum Copeptin levels with different demographic and clinical parameters by using univariate linear regression
This table showed that the independent variable (age, BMI, Na, K, urea, create, HbA1C, A/C ratio, albumin and GFR) cannot predict copeptin level.