Copeptin, Waist Circumference, and Insulin Sensitivity in Type 1 Diabetes

Presentation Number: SUN 597
Date of Presentation: April 2nd, 2017

Thomas Jensen1, Petter Bjornstad*2 and Janet K Snell-Bergeon3
1University of Colorado School of Medicine, CO, 2University of Colorado School of Medicine, Aurora, CO, 3Barbara Davis Center for Diabetes, Aurora, CO

Abstract

Plasma copeptin is associated with Insulin Sensitivity and Waist Circumference in Adults with and without Type 1 Diabetes

Jensen, T.; Bjornstad, P.; Snell-Bergeon, J.K.

 

BACKGROUND: Insulin resistance is a growing issue in patients with Type 1 Diabetes, but it is difficult in the clinical setting to identify patients who might benefit insulin sensitizing therapies. The glucose disposal rate (GDR) from a hyperinsulinemic-euglycemic clamp is considered gold standard for measuring insulin resistance, but is too cumbersome of a procedure to make use routinely in clinic. Insulin sensitivity equations have been developed and validated and adult and adolescent populations, such as the Coronary Artery Calcification in Type 1 diabetes study (eIS-CACTI) equation, but is complex and therefore not always practical to calculate in a busy clinical environment. Hence finding biomarkers that might help to identify patients with greater insulin resistance could offer a simpler option for. Copeptin, a surrogate marker for vasopression, has been identified a marker both associated with metabolic syndrome and predictive of new onset type 2 diabetes, obesity, and microalbuminuria.

OBJECTIVE: To determine whether plasma copeptin is associated with insulin sensitivity and waist circumference in adults with and without Type 1 Diabetes

METHODS: Participants ages 19-56 with (n=209, 55% female) and without T1D (n=244, 52% female) in the Coronary Artery Calcification in Type 1 Diabetes (CACTI) study were assessed for ultrasensitive serum copeptin, waist circumference and eIS-CACTI equation to assess insulin sensitivity . Copeptin was measured by standard and ultrasensitive assays on KRYPTOR and KRYPTOR Compact Plus analyzers using the commercial sandwich immunoluminometric assays (Thermo Fisher Scientific, Waltham, MA). The eIS-CACTI model includes waist circumference, daily insulin dose per kg body weight, triglycerides and DBP: exp(4.1075 - 0.01299*waist(cm) - 1.05819 *insulin dose [daily units per kg) - 0.00354*triglycerides (mg/dL) - 0.00802*DBP (mm Hg)]. Pearson’s Correlation coefficients were then determined between copeptin and eIS along with copeptin and waist circumference.

RESULTS: In adults without diabetes, copeptin strongly correlated with waist circumference (r=0.41, P<0.0001) and insulin sensitivity (eIS) (r-0.39, p<0.001). In patients with Type 1 Diabetes, correlated with waist circumference (r=0.22, p=0.0018) and eIS (r-0.16, p=0.02) though these associations were not as strong in patients without diabetes.

CONCLUSIONS: Copeptin correlates with insulin sensitivity and waist circumference in adult patients with Type 1 diabetes and without diabetes.

Nothing to Disclose: JT, BP, JKSB

Sources of Research Support: NHLBI grants R01 HL113029, HL61753, HL79611, and HL113029, DERC Clinical Investigation Core P30 DK57516 and JDRF grant 17-2013-313.

 

Nothing to Disclose: TJ, PB, JKS