Elevated levels of neopterin in sleep-disordered breathing

Naresh M. Punjabi, Brock A. Beamer, Alka Jain, Monique E. Spencer, Neal Fedarko

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


Background: Sleep-disordered breathing (SDB) is increasingly being recognized as an independent risk factor for hypertension and cardiovascular disease. Recent evidence suggests that the maladaptive physiologic response to SDB, particularly cardiovascular effects, may result in part from systemic inflammation. Although abnormal cytokine levels have been documented in SDB, data on whether SDB is associated with cellular activation are limited. Thus, this investigation sought to determine whether neopterin, a marker released by activated macrophages, is increased in SDB. Methods and results: Fifty-five men, free of medical comorbidity, undergoing polysomnography had fasting serum tested for neopterin levels. Multivariable regression methods were used to quantify the association between neopterin and quartiles of the apnea hypopnea index (AHI) while accounting for body mass index, waist circumference, and percentage of body fat. Quartiles of AHI (I: < 3.83 events per hour; II: 3.83 to 11.98 events per hour; III: 11.99 to 36.82 events per hour; IV > 36.82 events per hour) indicated a range from no SDB through severe SDB. Compared to the subjects in the first AHI quartile, serum neopterin levels were higher by 3.0%, 10.9%, and 26.5% in the second, third, and fourth AHI quartiles, respectively (p < 0.001 for linear trend). Neopterin levels also were higher in those with greater degree of sleep-related hypoxemia, more stage 1 sleep, and less stage 2 sleep. Conclusion: The results of this study indicate that severity of SDB independently associates with serum levels of neopterin, a marker for macrophage activation that may play an important role in the pathogenesis of SDB-related cardiovascular disease.

Original languageEnglish (US)
Pages (from-to)1124-1130
Number of pages7
Issue number4
StatePublished - Oct 2007


  • Neopterin
  • Obstructive sleep apnea
  • Sleep-disordered breathing

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine


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