Association of serum copeptin levels with cardiovascular disease among adults with type 2 diabetes mellitus: A comparative cross-sectional study

Abstract

Cardiovascular disease (CVD) remains one of the leading causes of illness and death among individuals with type 2 diabetes mellitus (T2DM), underscoring the need for dependable biomarkers that can improve early cardiovascular risk prediction. Copeptin, the stable C-terminal fragment of the arginine vasopressin prohormone, has recently attracted attention as an indicator of vascular stress and metabolic imbalance; however, its role in predicting cardiovascular complications in diabetic populations remains unclear. This cross-sectional study evaluated 200 adults with T2DM, equally divided based on the presence or absence of CVD, to examine the association between serum copeptin and cardiovascular risk. Serum copeptin concentrations were determined using an enzyme-linked immunosorbent assay, and associations with clinical variables were analyzed through multivariate logistic regression. Participants with CVD demonstrated significantly higher copeptin levels (14.8 ± 4.5 pmol/L) compared with those without CVD (9.2 ± 3.1 pmol/L; P< 0.001). Copeptin correlated positively with HbA1c, diabetes duration, and blood pressure but negatively with renal function. Multivariate analysis identified age, diabetes duration, and serum copeptin as independent predictors of CVD (AUC = 0.85). These findings suggest that elevated copeptin serves as a promising biomarker for cardiovascular risk stratification in T2DM, complementing established clinical and laboratory indicators.