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. 2024 Jul 18;5(1):zpae048.
doi: 10.1093/sleepadvances/zpae048. eCollection 2024.

Ferritin is a potential marker of cardiometabolic risk in adolescents and young adults with sleep-disordered breathing

Esther T W Cheng  1 , Chun T Au  1   2 , Raymond N C Chan  1 , Joey W Y Chan  3   4 , Ngan Y Chan  3   4 , Yun K Wing  3   4 , Albert M Li  1   5   6 , Ethan Lam  1 , Kate C Chan  1   5   6
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Ferritin is a potential marker of cardiometabolic risk in adolescents and young adults with sleep-disordered breathing

Esther T W Cheng et al. Sleep Adv. .

Abstract

Objective: To explore markers that reflect sleep-disordered breathing (SDB) severity and investigate their associations with cardiometabolic risk factors in adolescents and young adults.

Methods: Participants were recruited from our SDB epidemiological cohort. They underwent overnight polysomnography and ambulatory blood pressure (BP) monitoring. Complete blood count, ferritin, high-sensitivity C-reactive protein (hs-CRP), fasting blood glucose, and lipid profile were measured. Multiple linear regression was used to examine the association between red cell indices (RCIs), ferritin, and obstructive apnea-hypopnea index (OAHI). Subgroup analyses on participants with SDB were performed for the association of RCIs and ferritin with lipid profile, hs-CRP, and BP.

Results: There were 88 participants with SDB and 155 healthy controls aged 16-25 years. Hemoglobin (Hb; p < .001), hematocrit (HCT; p < .001), and ferritin (p < .001) were elevated with increasing SDB severity and were independently associated with OAHI (β=1.06, p < .001; β=40.2, p < .001; β=4.89 × 10-3, p = .024, respectively). In participants with SDB, after adjusting for age, sex, and BMI, significant associations were found between ferritin with low-density lipoprotein (LDL; β=0.936 × 10-3, p = .008) and triglyceride (TG; β =1.08 × 10-3, p < .001), as well as between Hb (β=1.40, p = .007), HCT (β=51.5, p = .010) and mean arterial pressure (MAP). Ferritin (β=0.091, p = .002), Hb (β=0.975, p = .005), and HCT (β=38.8, p = .004) were associated with hs-CRP independent of age, sex, BMI, plasma LDL, and MAP. OAHI was not associated with LDL and TG in the multivariable models.

Conclusions: Serum ferritin, but not OAHI, was associated with LDL and TG in participants with SDB, suggesting it is a potential marker of cardiometabolic risk in patients with SDB.

Keywords: cardiometabolic risk; low-density lipoprotein; obstructive sleep apnea; serum ferritin; sleep-disordered breathing; triglyceride.

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