Serum copeptin and NT-proBNP is associated with central aortic stiffness and flow hemodynamics in adolescents with type 1 diabetes: A pilot study

J Diabetes Complications. 2021 May;35(5):107883. doi: 10.1016/j.jdiacomp.2021.107883. Epub 2021 Feb 6.


Aims: Cardiovascular disease (CVD) is the major cause of mortality in type 1 diabetes (T1D). Biomarkers, N-terminal pro-brain natriuretic peptide (NT-proBNP) and copeptin have been linked with measures of CVD, but their relationship in adolescents with T1D remains incompletely understood. Accordingly, we examined the associations between NT-proBNP and copeptin and hemodynamic markers of central aortic stiffness in adolescents with T1D.

Methods: In this pilot study, forty-nine pubertal adolescents with T1D (mean age 17 ± 2 years, median [Q1-Q3] Tanner Stage 5 [5, 5] and HbA1c 8.5 ± 1.5%), from the EMERALD study, were assessed for copeptin and NT-proBNP, and indices of central aortic stiffness non-invasively assessed by MRI. Pearson correlations and generalized linear regression models, adjusting for confounders, were applied to examine the relationships between biomarkers and vascular measures.

Results: Copeptin correlated independently with both ascending aortic (AA) (β ± SE: -4.28 ± 1.87, p = 0.03) and descending aortic (DA) relative area change (RAC) (-3.41 ± 1.55, p = 0.04). NT-proBNP was independently associated with DA time-averaged wall shear stress (WSSTA) (0.87 ± 0.25, p = 0.001) and DA maximum wall shear stress (WSSmax) (2.45 ± 1.00, p = 0.02).

Conclusions: Serum copeptin and NT-proBNP may be associated with central aortic stiffness and elevated WSS in youth with T1D, potentially offering a non-invasive way to identify and monitor the development of early CVD in an at-risk population.

Keywords: Biomarkers; Copeptin; NT-proBNP; Type 1 diabetes; Vascular stiffness.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Biomarkers / blood
  • Cardiovascular Diseases*
  • Diabetes Mellitus, Type 1* / complications
  • Glycopeptides / blood*
  • Hemodynamics
  • Humans
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Pilot Projects
  • Vascular Stiffness*
  • Young Adult


  • Biomarkers
  • Glycopeptides
  • Peptide Fragments
  • copeptins
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain