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Original Articles
- Association Between Serum Trace Elements and Obstructive Sleep Apnea in Iranian Adults: Multiple-exposure Models
- Habibolah Khazaie, Samaneh Nakhaee, Zohreh Manoochehri, Omran Davarinejad, Ayoob Rezaei, Borhan Mansouri, Adele Elahi, Saba Kakaei
- J Prev Med Public Health. 2026;59(5):498-508. Published online August 8, 2026
- DOI: https://doi.org/10.3961/jpmph.25.904
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- 51 Download
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Abstract
Summary
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Supplementary Material - Objectives
The association between trace elements and obstructive sleep apnea (OSA) remains an active area of research, and further studies are needed to clarify these relationships. This study examined correlations between serum essential trace element concentrations and polysomnography-confirmed OSA.
Methods
This cross-sectional study included patients recruited from the Sleep Disorders Center of Farabi Hospital in western Iran. Participants were classified as patients with OSA (n=54) or controls without OSA (n=45).
Results
Iron (Fe) levels were significantly higher in participants with OSA than in controls (p=0.04). Higher Fe levels were associated with greater odds of OSA (p for trend=0.02). Participants in the fourth Fe quartile had higher odds of OSA than those in the lowest quartile, although this association was of borderline statistical significance (odds ratio [OR], 3.00; 95% confidence interval [CI], 0.96 to 10.00; p=0.06). In contrast, participants in the second and third magnesium (Mg) quartiles had lower odds of OSA than those in the first quartile (Q2: OR, 0.31; 95% CI, 0.09 to 0.96; Q3: OR, 0.26; 95% CI, 0.07 to 0.82). In the generalized weighted quantile sum regression model, the association between the metal mixture and OSA was not statistically significant (β=–0.22, p=0.59).
Conclusions
Serum concentrations of selected micronutrients may be associated with OSA. The findings suggested a positive association between higher Fe concentrations and OSA, whereas intermediate Mg concentrations were associated with lower odds of OSA. -
SummaryKey Message
This cross-sectional study of 99 Iranian adults found that higher serum iron (Fe) concentrations were associated with increased odds of obstructive sleep apnea (OSA), while intermediate magnesium (Mg) levels showed an inverse association. In adjusted multiple-exposure models, manganese (Mn) was also associated with OSA. These preliminary findings suggest that serum trace element levels, particularly Fe and Mg, may be linked to OSA, though longitudinal studies are needed to confirm causality.- Effects of Comorbid Sleep Disorders on Cardiovascular Complications of Hypertension Among Patients With Newly-diagnosed Hypertension: An Analysis of the Korean National Health Insurance Service-National Sample Cohort
- Jeongmook Kang, Yoon-Hyung Park, Kwang Ik Yang, Jose Rene Bagani Cruz, Young Hwangbo
- J Prev Med Public Health. 2020;53(1):37-44. Published online November 6, 2019
- DOI: https://doi.org/10.3961/jpmph.19.248
- 14,070 View
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- 2 Crossref
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Abstract
Summary
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- Objectives
This study investigated the effects of comorbid sleep disorders (SD) on the incidence of cardiovascular complications among newly-diagnosed hypertension (HTN) patients.
Methods
As study population, 124 057 newly-diagnosed essential HTN patients aged 30 or older, without cardiovascular complications at diagnosis with HTN, were selected from the National Health Insurance Service-National Sample Cohort. The incidence of cardiovascular complications was calculated, Cox proportional-hazards regression model was used to analyze the risk of complications, and the population attributable fraction (PAF) for cardiovascular complications of having comorbid SD at HTN diagnosis was calculated.
Results
Over 10 years, 32 275 patients (26.0%) developed cardiovascular complications. In HTN patients with comorbid SD at diagnosis of HTN, the incidence of cardiovascular complications (78.3/1000 person-years; 95% confidence interval [CI], 75.8 to 80.9) was higher than in those without comorbid SD (58.6/1000 person-years; 95% CI, 57.9 to 59.3) and the risk of cardiovascular complications was 1.21 times higher (95% CI, 1.17 to 1.25), adjusting for age, gender, income, area of residence, and comorbid diabetes mellitus. The PAF of having comorbid SD at diagnosis of HTN for the incidence of cardiovascular complications was 2.07% (95% CI, 1.69 to 2.44).
Conclusions
Newly-diagnosed essential HTN patients aged 30 or older who had comorbid SD at the time of their HTN diagnosis had a higher incidence of cardiovascular complications than those without comorbid SD. Age, gender, income, area of residence, and comorbid diabetes mellitus had a significant effect on the incidence of cardiovascular complications. Approximately 2% of cardiovascular complications were found to occur due to the presence of SD. -
SummaryKorean summary
본 연구 결과 심뇌혈관 합병증이 없었던 30세 이상 신규 일차성 고혈압 환자에서 고혈압 진단시 수면장애을 동반한 경우 심뇌혈관합병증 발생율은 78.3/1000인년(95% CI 75.8-80.9)으로 나타났으며, 수면장애을 동반하지 않은 경우 심뇌혈관합병증 발생율은 58.6/1000인년(95%CI 57.9-59.3)인 것으로 관찰되었다. 고혈압 진단시의 연령, 성별, 수입, 거주지역, 동반된 당뇨병력을 보정한 다중회귀분석에서 수면장애병력이 있는 고혈압 환자군의 심뇌혈관합병증 발생 위험도는 수면장애병력이 없는 환자에 비하여 1.21배(95% CI 1.17-1.25) 높은 것으로 나타났으며, 연구대상자에게 발생한 심뇌혈관합병증의 약 2%는 고혈압 진단시 동반된 수면장애가 기여한 것으로 분석되었다. -
Citations
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- The effect of chronotype on social functioning in schizophrenic patients: examining the chain-mediating role of sleep quality and anxiety
Zheng Luo, Jing Zhang, Maoting Guo, Dongmei Wu
Frontiers in Psychiatry.2025;[Epub] CrossRef - Association Between Sleep Quality and Anxiety in Korean Adolescents
Hyunkyu Kim, Seung Hoon Kim, Sung-In Jang, Eun-Cheol Park
Journal of Preventive Medicine and Public Health.2022; 55(2): 173. CrossRef
- The effect of chronotype on social functioning in schizophrenic patients: examining the chain-mediating role of sleep quality and anxiety
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