Serum ferritin and obstructive sleep apnea—epidemiological study

Thorarinsdottir, Elin H; Arnardóttir, Erna Sif; Benediktsdóttir, Bryndís; Janson, Christer; Ólafsson, Ísleifur; Gíslason, Þórarinn; Keenan, Brendan T.

doi:10.1007/s11325-017-1598-y

Cited by 5 publications

(4 citation statements)

References 40 publications

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“…Our results are contradictory to what was described by Thorarinsdottir et al among 796 subjects with OSA that were part of the Icelandic Sleep Apnea Cohort [ 26 ]. In their study, OSA patients were compared to 637 randomly chosen Icelanders who participated in an epidemiological study.…”

Section: Discussioncontrasting

confidence: 99%

“…In addition, the authors found no significant associations between serum ferritin levels and OSA severity, both unadjusted and after adjusting for relevant confounders. Of note, Thorarinsdottir et al found that serum ferritin levels were significantly higher in OSA males than OSA females [ 26 ], an observation that is also true for our cohort. Another study by Abakay et al compared 44 patients with OSA to 46 controls and found no significant correlation between serum ferritin levels and OSA [ 27 ].…”

Section: Discussionsupporting

confidence: 86%

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Serum Ferritin Levels in Severe Obstructive Sleep Apnea

et al. 2023

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Obstructive sleep apnea (OSA) has been associated with various acute and chronic inflammatory diseases, as has serum ferritin, an intracellular iron storage protein. Little is known about the relationship between severity of OSA and serum ferritin levels in otherwise healthy subjects. In this study, all polysomnographic recordings, serum levels of ferritin, C-reactive protein (CRP), and hemoglobin, as well as patient files from 90 consecutive, otherwise healthy individuals with suspected OSA who presented to a tertiary sleep medical center were retrospectively analyzed. For comparison, three groups were formed based on apnea–hypopnea index (AHI; none or mild OSA: <15/h vs. moderate OSA: 15–30/h vs. severe OSA: >30/h). Serum ferritin levels were significantly positively correlated with AHI (r = 0.3240, p = 0.0020). A clear trend of higher serum ferritin levels was found when patients with severe OSA were compared to those without or with mild OSA. Serum CRP and serum hemoglobin levels did not differ significantly among OSA severity groups. Age and body–mass index (BMI) tended to be higher with increasing OSA severity. The BMI was significant higher in patients with severe OSA compared to those without or with mild (p < 0.001). Therefore, serum ferritin levels may provide a biochemical surrogate marker for OSA severity.

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Section: Discussioncontrasting

confidence: 99%

Section: Discussionsupporting

confidence: 86%

Serum Ferritin Levels in Severe Obstructive Sleep Apnea

et al. 2023

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“…After adjustment on potential confounding factors, we found no difference in serum ferritin concentrations according to the severity of OSAS or hypoxia. This is consistent with previous studies (38). Despite the statistically significant relationship between transferrin saturation level and severity of OSAS, serum transferrin saturation remained within the normal values.…”

Section: Accepted Manuscriptsupporting

confidence: 93%

Transferrin saturation is independently associated with the severity of obstructive sleep apnea syndrome and hypoxia among obese subjects

et al. 2021

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Introduction and aims: Obstructive sleep apnea syndrome (OSAS) is a frequent complication of obesity. Intermittent chronic hypoxia which frequently results from OSAS could modulate the systemic control of iron metabolism and alter serum iron parameters, especially among obese patients. Aims: to evaluate whether serum parameters of iron bioavailability and storage (primary), as well as age, waist circumference, arterial hypertension and tobacco use (secondary) are associated with OSAS severity and/or hypoxia. Methods: design: a singlecenter retrospective study with prospective data collection; inclusion criteria: consecutive patients referred for initial assessment for obesity underwent nocturnal respiratory polygraphy and iron status serum assessment within a 3-month period. The adjusted analyzes were performed using ANOVA and reported as adjusted means and 95% confidence interval (95% CI). Results: 13 men and 56 women were included. OSAS prevalence : 72% (n=50). Ferritin (mean±SD, 260±276 vs. 111±89 μg/l, p=0.01) and transferrin saturation (31±10 vs. 24±9%, p=0.002) were significantly higher in case of moderate/severe OSAS than in absent/mild OSAS, independently from gender and tobacco use. Serum iron (19.4 μg/l [CI95%, vs. 16.2 μg/l ([14.1-18.2], p=0.056) and transferrin saturation (31.5 % [26.3-36.7]) vs. 25.3%[21.6-29.1], p=0.043) were higher when time under oxygen saturation <90% was >15%. Age (mean±SD, 51±11 vs. 41±12 yr, p=0.001), waist circumference (136±18 vs. 123±12 cm, p=0.003), arterial hypertension (59% (n=13/22) vs. 23% (n=11/47), p=0.004) and tobacco use (64% (n= 14/22) vs. 32% (n= 15/47), p=0.01) were significantly greater in moderate/severe OSAS than in absent/mild OSAS. Conclusions. Transferrin saturation was associated with OSAS severity and time under hypoxia. This suggests a relationship between OSAS-induced hypoxia and iron metabolism among obese patients.

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“…Similar to obesity, the important perturbations of iron metabolism may be linked to the progression of OSA. There are many studies on iron metabolism and OSA [ 12 , 13 , 14 , 15 ], but only limited studies focus on body iron transport as reflected by serum TF levels and the results are controversial. Baik et al [ 16 ] indicated that OSA cases showed lower serum TF saturation levels than those without OSA no matter with male-pattern baldness or not.…”

Section: Introductionmentioning

confidence: 99%

Serum Transferrin Level Is Associated with the Severity of Obstructive Sleep Apnea Independently of Obesity: A Propensity Score-Match Observational Study

Ming

Yang

et al. 2022

Obes Facts

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Introduction: Dysregulation of iron metabolism is closely associated with the development of obesity and obstructive sleep apnea (OSA), but little is known about the relationship between serum transferrin (TF) level and OSA severity. We aimed to verify this relationship and fit into account for obesity related confounders among bariatric candidates. Methods: We compared data retrospectively collected in 270 bariatric candidates. A propensity score-matched (PSM) analysis was used to determine the impact of iron metabolism on OSA severity independently of obesity. Univariate analysis was used to evaluate the relationship between serum TF level and the severity of OSA reflected by hypoxia and night awakenings parameters. Serum TF level to predict the severity of OSA was assessed by using univariate and multiple logistic regression model. Results: The preliminary analysis showed that serum ferritin (SF) [113 ng/ml (50-203) vs 79 ng/ml (40-130), p=0.009] and TF [2.72 g/L (2.46-3.09) vs 2.65 g/L (2.34-2.93), p=0.039] level was significantly higher in moderate/severe OSA group than no/mild OSA group. After PSM, there were 75 patients in each group and only serum TF level remained significant difference (p=0.014). The proportion of patients with combined T2D and hyperlipidemia also remained higher in moderate/severe OSA groups. Univariate analysis showed that the group with higher degree of hypoxia had higher serum TF levels [2.55 g/L (2.22-2.84) vs 2.79 g/L (2.56-3.06), p＜0.001]. Univariate and multiple logistic regression analysis showed that serum TF level emerged as a significant and independent factor associated with OSA severity especially grouped by oxygen desaturation index (ODI) (odds ratio: 2.91, 95% CI: 1.36-6.23, p = 0.006). Discussion/Conclusions: The existence of obstructive sleep apnea exacerbates obesity comorbidities, particularly type 2 diabetes and hyperlipidemia. Serum transferrin level is associated with the severity of OSA independently of obesity and might be a potential identification and therapeutic targets.

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Serum ferritin and obstructive sleep apnea—epidemiological study

Abstract: S-Ferritin levels are comparable in OSA patients and controls and do not change consistently with obesity level or PAP treatment in our sample.

Cited by 5 publications

References 40 publications

Serum Ferritin Levels in Severe Obstructive Sleep Apnea

Serum Ferritin Levels in Severe Obstructive Sleep Apnea

Transferrin saturation is independently associated with the severity of obstructive sleep apnea syndrome and hypoxia among obese subjects

Serum Transferrin Level Is Associated with the Severity of Obstructive Sleep Apnea Independently of Obesity: A Propensity Score-Match Observational Study

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