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Plasma Copeptin and Risk of Lower-Extremity Amputation in Type 1 and Type 2 Diabetes

Louis Potier1,2,3, Ronan Roussel4,2,3, Michel Marre4,2,3,5

  • 1Department of Diabetology, Endocrinology and Nutrition, DHU FIRE, Bichat Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France louis.potier@gmail.com.

Diabetes Care
|October 5, 2019
PubMed

Insights

Elevated plasma copeptin levels in individuals with diabetes are linked to an increased risk of lower-extremity amputations (LEAs). This finding may help identify at-risk patients for proactive intervention.

Area of Science:

  • Endocrinology
  • Cardiovascular Medicine
  • Diabetology

Background:

  • Diabetes mellitus is a primary driver of nontraumatic lower-extremity amputations (LEAs).
  • Identifying diabetic patients with foot ulcers at high risk for LEA presents a significant clinical challenge.
  • Plasma copeptin, a vasopressin biomarker, correlates with cardiovascular and renal complications in diabetes.

Purpose of the Study:

  • To investigate the association between baseline plasma copeptin levels and the risk of LEA.
  • To evaluate copeptin's predictive value in both type 1 and type 2 diabetes populations.
  • To explore copeptin's association with lower-limb revascularization procedures in type 2 diabetes.

Main Methods:

  • Analysis of four independent cohorts: GENESIS (T1D), GENEDIAB (T1D), DIABHYCAR (T2D), and SURDIAGENE (T2D).
  • Measurement of baseline plasma copeptin using an immunoluminometric assay.
  • Longitudinal follow-up (5-10 years) with Cox regression analysis to assess LEA risk.

Main Results:

  • In type 1 diabetes cohorts (n=710), higher copeptin tertiles correlated with increased LEA incidence (3.9% to 10.0%, P=0.002).
  • In type 2 diabetes cohorts (n=4,553), higher copeptin tertiles showed increased LEA incidence (1.1% to 3.6%, P<0.0001).
  • Elevated copeptin was significantly associated with LEA risk in both diabetes types (HR 1.89 for T1D, HR 1.42 for T2D) and revascularization in T2D (HR 1.20).

Conclusions:

  • Baseline plasma copeptin is a significant predictor of LEA risk in patients with type 1 and type 2 diabetes.
  • Plasma copeptin measurement may aid in identifying diabetic individuals at elevated risk for LEA.
  • These findings support the utility of copeptin as a biomarker for predicting adverse lower-extremity outcomes in diabetes.
Abstract

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