Copeptin, a stable peptide derived from the vasopressin precursor, correlates with the individual stress level

Neuro Endocrinol Lett. 2008 Jun;29(3):341-6.


Background: During stress, vasopressin is a potent synergistic factor of CRH as a hypothalamic stimulator of the HPA axis. The measurements of CRH and vasopressin levels are cumbersome because of their instability and short half-life. Copeptin is a more stable peptide stoichiometrically released from the same precursor molecule. The aim of our study was to compare copeptin and cortisol levels in different stress situations.

Methods: Three groups of patients with increasing stress levels were investigated: a) healthy controls without apparent stress (n=20), b) hospitalized medical patients with moderate stress (n=25) and c) surgical patients 30 minutes after extubation, with maximal stress (n=29). In all patients we assessed cortisol and copeptin levels. Copeptin levels were measured with a new sandwich immunoassay.

Results: Cortisol levels in controls were (median, IQ range, 486 [397-588] nmol/L), not significantly different as compared to medical patients (438 [371-612] nmol/L, p=0.69). Cortisol levels in surgical patients after extubation were higher (744 [645-1062] nmol/L p<0.01 vs controls and medical patients). Copeptin levels in controls were 4.3 [3.2-5.5] pmol/L, which was lower as compared to medical patients (17.5 [6.4-24.1], p<0.001) and surgical patients after extubation (67.5 [37.8-110.0] pmol/L, p<0.001). The correlation between copeptin levels and cortisol was r=0.46, p<0.001.

Conclusion: Copeptin is a novel marker of the individual stress level. It more subtly mirrors moderate stress as compared to cortisol values.

MeSH terms

  • Adrenocorticotropic Hormone / blood
  • Adult
  • Biomarkers
  • Body Mass Index
  • Cohort Studies
  • Female
  • Glycopeptides / analysis
  • Glycopeptides / metabolism*
  • Humans
  • Hydrocortisone / blood
  • Hypothalamus / metabolism
  • Male
  • Middle Aged
  • Sex Characteristics
  • Stress, Psychological / metabolism*
  • Vasopressins / analysis
  • Vasopressins / metabolism*


  • Biomarkers
  • Glycopeptides
  • copeptins
  • Vasopressins
  • Adrenocorticotropic Hormone
  • Hydrocortisone