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Sleep and Breathing

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01-05-2016 | Original Article

Relationship between obstructive sleep apnea and nonalcoholic fatty liver disease in nonobese adults

Authors: Jia-Chao Qi, Jian-Chai Huang, Qi-Chang Lin, Jian-Ming Zhao, Xin Lin, Li-Da Chen, Jie-Feng Huang, Xiao Chen

Published in: Sleep and Breathing | Issue 2/2016

Abstract

Purpose

Obstructive sleep apnea (OSA) is closely related to nonalcoholic fatty liver disease (NAFLD), though the mechanism is not conclusive as obesity is a confounder. The objective of this observational study was to investigate the correlation between these disorders in nonobese subjects.

Methods

We consecutively enrolled nonobese individuals undergoing polysomnography and abdominal ultrasonography and analyzed differences in NAFLD patients grouped by the apnea–hypopnea index (AHI) and in OSA patients according to the presence or absence of NAFLD. Multivariate regression analysis was used to evaluate the independent risks of NAFLD in OSA patients.

Results

A total of 175 participants were included. The 106 ultrasound-diagnosed NAFLD patients were classified into four groups by AHI. There were no significant differences in triglycerides (TG), serum aminotransferase levels of alanine aminotransferase and aspartate aminotransferase, high-sensitivity C-reactive protein, and homeostasis model assessment of insulin resistance (HOMA-IR) with worsening OSA. In both OSA patients with NAFLD and those without NAFLD, body mass index (BMI), the lowest oxygen saturation (LaSO₂), HOMA-IR, and TG were significantly associated. Additionally, BMI, LaSO₂, and TG independently predicted the development of NAFLD after adjustments (odds ratio [OR] = 1.562, p = 0.003; OR = 0.960, p = 0.03; OR = 3.410, p < 0.001, respectively).

Conclusions

In nonobese subjects, OSA itself does not appear to induce significant changes in liver enzymes. With reference to lipid metabolism, weight control and OSA-related hypoxemia are key factors in reducing the risk of NAFLD in OSA patients. Additional large-scale, prospective studies are warranted to investigate the impact of OSA on liver injury in nonobese adults.

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Title: Relationship between obstructive sleep apnea and nonalcoholic fatty liver disease in nonobese adults
Authors: Jia-Chao Qi
Jian-Chai Huang
Qi-Chang Lin
Jian-Ming Zhao
Xin Lin
Li-Da Chen
Jie-Feng Huang
Xiao Chen
Publication date: 01-05-2016
Publisher: Springer Berlin Heidelberg
Published in: Sleep and Breathing / Issue 2/2016
Print ISSN: 1520-9512
Electronic ISSN: 1522-1709
DOI: https://doi.org/10.1007/s11325-015-1232-9

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Abstract

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