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09.12.2017 | Sleep Breathing Physiology and Disorders • Original Article | Ausgabe 3/2018

Sleep and Breathing 3/2018

Serum ferritin and obstructive sleep apnea—epidemiological study

Sleep and Breathing > Ausgabe 3/2018
Elin H. Thorarinsdottir, Erna S. Arnardottir, Bryndis Benediktsdottir, Christer Janson, Isleifur Olafsson, Allan I. Pack, Thorarinn Gislason, Brendan T. Keenan
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s11325-017-1598-y) contains supplementary material, which is available to authorized users.

Statement of significance

There is a need to better understand the characteristics of systemic inflammation in the pathophysiology of OSA so that we can better assess and treat OSA patients and comorbid conditions. S-Ferritin, a marker of systemic inflammation, is a commonly measured biomarker in clinical practice. Previous studies have shown that subjects with OSA have higher levels of circulating pro-inflammatory cytokines, especially in severely obese patients but little is known about the association between S-Ferritin and OSA.



Ferritin is an intracellular iron storage protein and a marker of inflammation. Studies have shown that subjects with obstructive sleep apnea (OSA) have higher levels of circulating pro-inflammatory cytokines, but little is known about the association between ferritin and OSA. The aims of the study were to evaluate serum ferritin (S-Ferritin) levels in OSA patients compared to levels in the general population and also examine the effect of obesity level and treatment with positive airway pressure (PAP) on S-Ferritin levels.


The OSA subjects (n = 796) were part of the Icelandic Sleep Apnea Cohort. The control subjects (n = 637) were randomly chosen Icelanders who participated in an epidemiological study. Propensity score (PS) methodologies were employed to minimize selection bias and strengthen causal inferences when comparing non-randomized groups. S-Ferritin levels were measured and all participants answered the same detailed questionnaire about sleep and health. Only OSA patients underwent a sleep study and were re-invited for a 2-year follow-up.


S-Ferritin levels were significantly higher in OSA males than controls (213.3 vs. 197.3 μg/L, p = 0.007). However, after adjusting for confounders and using our PS methodology, no significant difference was found. S-Ferritin levels were not correlated with severity of OSA, obesity level, or clinical symptoms. Also, no significant change in S-Ferritin levels was found with 2 years of PAP treatment.


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

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