Association between serum neopterin, obesity and daytime sleepiness in patients with obstructive sleep apnea.
OBJECTIVE
Obesity and obstructive sleep apnea (OSA) and systemic inflammation may interact through biochemical pathways. Neopterin (NP) is a monocyte/macrophage activation marker produced by macrophages in response to interferon-gamma secreted by activated T-lymphocytes. This study examines the association between NP, obesity and OSA.


METHODS
The study included 22 newly diagnosed OSA (+) patients and 18 OSA (-) patients. Subjects with history of coronary artery disease, transplant patients, history of alcohol and drug abuse, history of HIV and any other significant medical illnesses such as active infections, autoimmune disease, malignancy, liver disease, pulmonary disease (COPD, asthma,...), neuromuscular disease, patients on immunomodulating therapy or HMG-CoA reductase inhibitors were excluded.


RESULTS
There were no significant differences in age, body mass index (BMI), and smoking habits of the OSA (+) patients and OSA (-) patients. Serum NP levels did not show any significant difference between the OSA (+) patients and OSA (-) patients, however, NP levels were positively correlated with BMI (r=0.320, p=0.044). There was no significant correlation between NP and any of the polysomnographic parameters. The result of stepwise regression analyses (r(2)=0.320, p<0.001) showed that high serum NP levels (p=0.004) and apnea-hypopnea index (AHI) were a risk factor for elevated Epworth sleepiness score, independent of BMI.


CONCLUSIONS
We suggest that serum NP levels correlate with BMI. There was a significant relationship between serum NP levels and excessive daytime sleepiness in OSA patients.
Ursavaş
Ahmet
A
Pulmonary Medicine Department, School of Medicine, University of Uludag, Bursa, Turkey. ahmetursavas@gmail.com
Karadag
Mehmet
M
Oral
Arzu Yilmaztepe
AY
Demirdogen
Ezgi
E
Oral
Haluk Barbaros
HB
Ege
Ercüment
E
D000328:Adult; D015415:Biomarkers / Q000097:blood; D015992:Body Mass Index; D003430:Cross-Sectional Studies; D006970:Disorders of Excessive Somnolence / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D009765:Obesity / Q000097:blood* / Q000150:complications; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications
D015415:Biomarkers; D019798:Neopterin