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Clin J Sport Med. 2011 May;21(3):211-7. doi: 10.1097/JSM.0b013e31821a62c2.

Changes in copeptin and bioactive vasopressin in runners with and without hyponatremia.

Author information

1
Exercise Science Program, School of Health Sciences, Oakland University, Rochester, Michigan. USA. hew@oakland.edu

Abstract

OBJECTIVE:

To evaluate changes in both the N-terminal (arginine vasopressin; AVP) and C-terminal (copeptin) fragments of the vasopressin prohormone before, during, and after an ultramarathon race and to assess vasopressin and copeptin concentrations in runners with and without hyponatremia.

DESIGN:

Observational study.

SETTING:

Three trials (2 sodium balance and 1 hyponatremia treatment) in 2 separate approximately 160-km footraces [Western States Endurance Run (WSER) and Javelina Jundred (JJ100)].

PARTICIPANTS:

Six hyponatremic and 20 normonatremic runners; 19 finishers with 7 completing 100 km.

MAIN OUTCOME MEASURES:

Plasma AVP ([AVP]p), copeptin ([copeptin]p), sodium ([Na]p), and protein (%plasma volume change; %PV) concentrations.

RESULTS:

In the WSER Sodium Trial, a 3-fold prerace to postrace increase in both [AVP]p (0.7 ± 0.4 to 2.7 ± 1.9 pg/mL; P < 0.05) and [copeptin]p (10.3 ± 12.5 to 28.2 ± 16.3 pmol/L; nonsignificant) occurred, despite a 2 mEq/L decrease in [Na]p (138.7 ± 2.3 to 136.7 ± 1.6 mEq/L; NS). A significant correlation was noted between [AVP]p and [copeptin]p postrace (r = 0.82; P < 0.05). In the WSER Treatment Trial, despite the presence of hyponatremia pretreatment versus posttreatment ([Na]p = 130.3 vs 133.5 mEq/L, respectively), both [AVP]p (3.2 vs 2.1 pg/mL) and [copeptin]p (22.5 vs 24.9 pmol/L) were well above the detectable levels. A significant correlation was noted between [AVP]p and [copeptin]p 60 minutes after treatment (r = 0.94; P < 0.05). In the JJ100 Sodium Trial, significant correlations were found between [copeptin]p change and %PV change (r = -0.34; P < 0.05) and between [AVP]p change and [Na]p change (r = 0.39; P < 0.05) but not vice-versa.

CONCLUSIONS:

[Copeptin]p seems to be a reliable surrogate of stimulated [AVP]p during exercise. Nonosmotic vasopressin stimulation occurs during ultradistance running. [Copeptin]p may better reflect chronic (%PV) vasopressin secretion under conditions of endurance exercise.

PMID:
21519298
PMCID:
PMC3690462
DOI:
10.1097/JSM.0b013e31821a62c2
[Indexed for MEDLINE]
Free PMC Article
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