美国超重/肥胖人群血清铁蛋白水平与阻塞性睡眠呼吸暂停的关联：一项基于美国国家健康与营养检查调查（NHANES）的人群研究

Association of Serum Ferritin Levels With Obstructive Sleep Apnea in Overweight/Obese US Populations: A Population-Based Study From the NHANES.

作者信息

Zhang Yang, Zhou Pinglang, Xu Chuan, Su Hua, Li Rendong, Sun Longhua, Yang Yihan

机构信息

Jiangxi Provincial Key Laboratory of Respiratory Diseases, Jiangxi Institute of Respiratory Diseases, The Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, People's Republic of China.

The Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital, Jiangxi Medical College, Nanchang University, Nanchang, 330006, People's Republic of China.

出版信息

Nat Sci Sleep. 2025 Feb 5;17:223-238. doi: 10.2147/NSS.S499446. eCollection 2025.

DOI:10.2147/NSS.S499446

PMID:39931349

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11807773/

Abstract

OBJECTIVE

To investigate the relationship between serum ferritin levels and OSA in overweight/obese individuals and assess the association between ferritin levels and all-cause mortality in overweight/obese female OSA patients.

METHODS

Cross-sectional (n = 4,809) and prospective (n = 832) data from overweight/obese adults from the 2005-2008, and 2015-March 2020 NHANES cycles were analyzed. Participants were categorized into quartiles (Q1-Q4) based on their ln-transformed serum ferritin levels. Multivariable logistic regression and restricted cubic spline regression (RCS) investigate associations. Kaplan-Meier survival analyses and Cox proportional hazards regression examined the relationship between ferritin levels and all-cause mortality in OSA patients.

RESULTS

After adjusting for potential confounding factors, we found that ln-transformed ferritin levels were associated with an increased risk of OSA (Q4 vs Q2: OR = 1.07, 95% CI: 1.01-1.13, P = 0.020, P for trend = 0.010). A non-linear U-shaped association was observed between ferritin levels and OSA risk (P-non-linear = 0.029), with an inflection point at ln-transformed ferritin of 4.58 (corresponding to a serum ferritin concentration of 97.51 ng/mL). In female OSA patients, elevated ferritin levels were associated with increased all-cause mortality risk (Q4 vs Q2: HR: 5.46, 95% CI: 1.18-25.16, P = 0.029, P for trend = 0.032).

CONCLUSION

Ferritin levels in overweight/obese individuals show a U-shaped relationship with OSA risk, and elevated levels correlate with increased all-cause mortality in female overweight/obese OSA patients. In the future, further research is needed to explore the potential associations between ferritin, inflammation, obesity, and OSA.

摘要

目的

研究超重/肥胖个体血清铁蛋白水平与阻塞性睡眠呼吸暂停（OSA）之间的关系，并评估超重/肥胖女性OSA患者铁蛋白水平与全因死亡率之间的关联。

方法

分析了2005 - 2008年以及2015年至2020年3月美国国家健康与营养检查调查（NHANES）周期中超重/肥胖成年人的横断面数据（n = 4809）和前瞻性数据（n = 832）。参与者根据其对数转换后的血清铁蛋白水平分为四分位数（Q1 - Q4）。采用多变量逻辑回归和受限立方样条回归（RCS）研究关联。采用Kaplan - Meier生存分析和Cox比例风险回归检验铁蛋白水平与OSA患者全因死亡率之间的关系。

结果

在调整潜在混杂因素后，我们发现对数转换后的铁蛋白水平与OSA风险增加相关（Q4与Q2相比：比值比（OR）= 1.07，95%置信区间（CI）：1.01 - 1.13，P = 0.020，趋势P值 = 0.010）。铁蛋白水平与OSA风险之间观察到非线性U型关联（非线性P值 = 0.029），对数转换后的铁蛋白拐点为4.58（对应血清铁蛋白浓度为97.51 ng/mL）。在女性OSA患者中，铁蛋白水平升高与全因死亡风险增加相关（Q4与Q2相比：风险比（HR）：5.46，95% CI：1.18 - 25.16，P = 0.029，趋势P值 = 0.032）。