Serum Neopterin as a Novel Marker for Carotid Artery Stenosis in Community Subjects

Background: Carotid Artery Stenosis (CAS) is one of the major high-risk mechanisms of stroke. Neopterin, an immune modulator secreted by macrophages, have been reported to be elevated in patients with cerebrovascular disease. However, an association between serum neopterin level and CAS has not been firmly established. Objective: To investigate the cross-sectional relationship between serum neopterin levels and CAS assessed by ultrasound. Methods: The study participants were volunteers in a community-based cohort aiming to prevent stroke in Guangzhou. Bilateral carotid artery ultrasonography was performed to assess the carotid atherosclerosis. After participant criterion screening and random sampling, finally 140 subjects were studied in our present study. Enzyme-linked immunosorbent assay was performed to measured serum neopterin concentrations. Results: Neopterin level in the CAS and control group was 5.4 (3.3-7.3) nmol/L and 4.6 (3.6-5.4) nmol/L respectively, with a significant difference (P<0.05). After multivariate adjusted, neopterin levels remained an independent factor. With per 1.0 nmol/L (approximately 1 IQR) increased, the OR value was 1.84 (95% CI: 1.25-2.71, P<0.05). ROC curve of serum neopterin concentrations for the prediction of CAS revealed that the area under curve was 0.665 (P<0.01). The cut-off value of 5.1 nmol/L had a sensitivity of 68.6% and specificity of 61.5% in detecting CAS. Conclusion: These findings demonstrate that circulating neopterin level is increased in subclinical carotid atherosclerosis population with CAS and reinforce the key roles of inflammatory response in the pathogenesis.