Exploring the relationship between serum copeptin levels and other laboratory and radiological investigations in assessing the severity of liver cirrhosis and its complications

Theodor Bilharz Research Institute

Bibliographic Information

Authors: Abdelkhalek Z.S.; Omar A.; Alwaseef M.A.; Abdelbaset N.E.S.; Morsy M.M.; Mekheimar M.A.M.; Ahmed H.A.; Alsayyad M.M.A.A.; Bahgat O.A.; Kotb F.M.; Abdelmageed N.A.; Metwally R.A.; Mahrose H.K.A.; Mosa M.F.I.; Mohamed E.E.; Nassar W.; Yehia F.G.; Elawady M.M.I.; Mayah F.I.I.; Shaheen M.A.E.; Zaghloul B.A.M.; Ahmed F.A.M.; Metwally A.S.A.A.; Alnabawy S.M.; Said S.R.A.; Fayad N.I.; El-Mahalawy M.H.; Elgazzar Y.A.; Hegazy M.M.; Abdel-Halim M.M.; Elnaghy W.S.; Omair H.

Journal: Journal of Medicinal and Pharmaceutical Chemistry Research

Publisher: Sami Publishing Company

Publication Date: 2026

Volume / Issue: Volume 8 / Issue 4

Pages: 779–795

ISSN: 29810221

DOI: 10.48309/jmpcr.2026.531400.1755

Scopus: View on Scopus

Document Type: Article

Authors and Affiliations

Abdelkhalek Z.S., Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo University Children’s Hospital, Monira, Cairo, 11628, Egypt; Omar A., Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Alwaseef M.A., Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Abdelbaset N.E.S., Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University Cairo, Egypt; Morsy M.M., Department of Plastic &Reconstructive surgery, King Abdullah medical City, Makkah, Saudi Arabia; Mekheimar M.A.M., Internal Medicine Department, Faculty of Medicine for Boys, Al-Azhar University, New Damietta, Egypt; Ahmed H.A., Department of Radiodiagnosis and Intervention, Faculty of medicine for girls, Al Azhar University, Cairo, Egypt; Alsayyad M.M.A.A., Internal Medicine Department, Faculty of Medicine for Boys, Al-Azhar University, New Damietta, Egypt; Bahgat O.A., Department of Radiodiagnosis and Intervention, Faculty of medicine for girls, Al Azhar University, Cairo, Egypt; Kotb F.M., Department of Internal Medicine, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt; Abdelmageed N.A., Department of Hepatology, gastroenterology and Infectious Diseases, Faculty of Medicine for Girls, Al-Azhar University, Cairo, Egypt; Metwally R.A., Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Mahrose H.K.A., Clinical Chemistry Department, Theodor Bilharz Research Institute, Giza, Egypt; Mosa M.F.I., Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Mohamed E.E., Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University Cairo, Egypt; Nassar W., Department of Internal Medicine and Nephrology, Suez Canal University hospital, Egypt; Yehia F.G., Department of Clinical Pathology, Faculty of Medicine for Girls, Al-Azhar University Cairo, Egypt; Elawady M.M.I., Department of Hepatogastroenterology and Infectious Diseases, Faculty of Medicine Al-Azhar University, Cairo, Egypt; Mayah F.I.I., Department of Internal Medicine, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt; Shaheen M.A.E., Department of Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Zaghloul B.A.M., Department of Radiodiagnosis and Intervention, Faculty of medicine for girls, Al Azhar University, Cairo, Egypt; Ahmed F.A.M., Department of Radiodiagnosis and Intervention, Faculty of medicine for girls, Al Azhar University, Cairo, Egypt; Metwally A.S.A.A., Department of Radiodiagnosis and Intervention, Faculty of medicine for girls, Al Azhar University, Cairo, Egypt; Alnabawy S.M., Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta, Egypt; Said S.R.A., Department of Internal Medicine, Faculty of Medicine for Girls, Al Azhar University, Cairo, Egypt; Fayad N.I., Department of Diagnostic Radiology, Faculty of Medicine, Al-Azhar, University, Cairo, Egypt; El-Mahalawy M.H., Department of Internal Medicine, Faculty of Medicine, Al-Azhar University, Cairo, Egypt; Elgazzar Y.A., Department of Geriatric Medicine, Faculty of Medicine, Helwan University, Cairo, Egypt; Hegazy M.M., Department of Hepatogastroenterology and Infectious Diseases, Faculty of Medicine Al-Azhar University, Cairo, Egypt; Abdel-Halim M.M., Department of Internal Medicine and Nephrology, Suez Canal University hospital, Egypt; Elnaghy W.S., Department of Medical Microbiology & Immunology, Faculty OF Medicine, Tanta University, Egypt; Omair H., Clinical and Chemical Pathology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

Abstract

Background and Objective: Traditional prognostic scores for cirrhosis incompletely capture real-time circulatory stress, prompting interest in copeptin, the stable C-terminal fragment of pre-vasopressin. The objective of this study is to explore the relationship between serum copeptin levels and other laboratory and radiological investigations in assessing the severity of liver cirrhosis and its complications. Materials and Methods: In this January-May 2025 cross-sectional study at Al-Azhar University Hospitals, 120 cirrhotic adults (40 each with CLD, DLD, or HE by clinical criteria) and 40 age/sex-matched controls underwent fasting blood analysis (liver biochemistry, coagulation, creatinine, sodium, and ammonia) and copeptin measurement (Brand ELISA). Ultrasound-graded ascites were assessed by blinded radiologists. Pearson/Spearman correlations and paired t-tests with Welch's correction analyzed stage-specific biomarker relationships. Results: Copeptin increased progressively from CLD (5.2±1.8 ng/mL) to DLD (18.6±4.3 ng/mL, p<0.001) but plateaued in HE (19.1±5.1 ng/mL, p=0.91 vs DLD). Albumin correlated positively in CLD (r=0.46) but inversely in DLD (r=-0.45, both p<0.05). Ammonia showed the strongest HE relationship (r=0.53, p=0.017). Ascites severity progressed with clinical stage (moderate/marked: 50% DLD, 85% HE). Conclusion: Copeptin's non-linear trajectory and dissociation from routine markers suggest potential utility for identifying de-compensation risk, though HE plateauing warrants further study. Prospective validation against mortality/TIPS outcomes is needed. © 2026 by SPC (Sami Publishing Company).

Keywords

ascites; biomarker; cirrhosis; Copeptin; neuro-hormonal activation

Citation Information

Scopus Citations: 0

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