Copeptin As a Stress Marker during a Written Examination the Coexam Study

Presentation Number: SAT-0861
Date of Presentation: June 21st, 2014

Sandrine Urwyler*1, Clara Sailer2, Philipp Schuetz3 and Mirjam Christ-Crain1
1University Hospital Basel, Basel, Switzerland, 2Faculty of Medicine, University of Basel, Switzerland, 3Kantonsspital Aarau, Aarau, Switzerland


Introduction: The stress hormone copeptin, which is co-secreted with arginine vasopressin, has been shown to reflect individual physical stress levels and to be outcome biomarker in several diseases. Information about the influence of psychological stress on copeptin levels is lacking, but is important for interpretation of copeptin levels in the clinical setting.

Methods: In this prospective observational study we measured copeptin levels in 25 healthy medical students before and after a written medical examination. The primary endpoint was the increase of copeptin levels from immediately prior the examination compared to after the examination. Secondary endpoints were comparison to other stress markers (serum and salivary cortisol).

Results: Of the 25 voluntary medical students (median age 23 years, median BMI 21.9 kg/m2) 15 (60%) were female. The median subjective stress level on the visual analogue scale (VAS) before the examination was 5 (IQR 4, 7) compared to after the examination VAS 3 (2, 3). Median copeptin levels before the examination were significantly higher as compared to copeptin levels after the examination (median (IQR) 3.1 pmol/l (2.4 , 4.3) vs 2.3 pmol/l (2.7, 2.8), p< 0.0001). Also serum cortisol (median (IQR) 561 nmol/l (386, 651) vs 297 nmol/l (235, 327), p< 0.0001) and salivary cortisol levels (median (IQR) 12.5 nmol/l (8.2, 17) vs 6.9 nmol/l (5.7, 8), p<0.0001) were elevated prior the examination compared to after the examination. No correlation between copeptin and cortisol levels could be found.

Conclusion: Psychological stress leads to an increase of copeptin levels although less pronounced than in somatic disease. Psychological stress must therefore be taken into consideration when using copeptin as a biomarker in the clinical setting.


Disclosure: PS: Speaker, Thermo Fisher Scientific BRAHMS GmbH. MC: Speaker, Thermo Fisher AG. Nothing to Disclose: SU, CS