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

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.
(© The Author(s) 2024. Published by Oxford University Press on behalf of Sleep Research Society.)