Impact Factors of Blood Copeptin Levels in Health and Disease States.

ABSTRACT

OBJECTIVE: Copeptin, which is the C-terminal glycopeptide of the provasopressin (pro-AVP), is released into the circulation in an equimolar manner with arginine vasopressin (AVP) when fluid homeostasis changes or have somatic stress. Copeptin is considered to be a potential alternative to AVP due to its advantages in facilitating assays. Although there have been a number of studies and reviews that have focused on marker potential of copeptin in diseases involving changes in AVP, the study of its characteristics and factors that may influence its secretion have not been reviewed before. METHODS: We summarized the influencing factors associated with copeptin levels in healthy and disease states, showed the changes in copeptin levels under different physiologic and pathophysiologic conditions, calculated the changes in copeptin levels under different physiologic and pathophysiologic conditions and compared them according to the type of stimuli. We also report research advances in copeptin changes in the diagnosis and prognosis of endocrine-related diseases. RESULTS: Males have higher copeptin levels. Decreased copeptin levels are mainly caused by reduced blood decrease and some diseases (e.g. obesity). In normal physiological conditions, the effect of stress, endocrine axis stimulation and blood volume increase on copeptin levels gradually increased. In severe disease conditions (e.g. sepsis), copeptin would remain at consistently high levels under compound stimuli and these elevated levels are associated with poor prognosis of disease. CONCLUSIONS: Summarizing the influencing factors of copeptin can help us better understand the biological features of copeptin and the similarities and differences between AVP and copeptin.