Hepatic dysfunction in patients with obstructive sleep apnea; prevalence and how to assess

Abstract

<b>Background:</b> obstructive sleep apnea (OSA) has an overall prevalence of 2-4 %. Non-alcoholic fatty liver disease is associated with OSA, which leads to increased morbidity and mortality. <b>Objective:</b> The aim of this study was to assess the prevalence of hepatic dysfunction in patients with OSA and best way for its detection. <b>Subjects and Methods:</b> Seventy subjects are included in the current study. Forty five patients have OSA and 25 healthy subjects, that match the patients in age and body mass index, are used as a control group. Measurement of serum level of liver enzymes was done for all the subjects participating in the study. Also, measurement of liver stiffness (LS) was done using shear wave elastography (SWE). <b>Results:</b> Serum level of liver enzymes was not significantly different between patients and healthy control subjects. Furthermore, no significant differences exist between patients with varying degree of severity of OSA. LSM showed a statistically significant increase among patients with OSA,&nbsp;(p &lt;0.001).&nbsp;A positive correlation between LSM and apnea/hypopnea index was detected in the studied OSA patients. According to LSM, 28 patients (62.2 %) had mild – moderate fibrosis, 14 (31%) patients had normal – mild fibrosis, and 3 patients (6.7%) had a normal liver. In the control group, we found that 1 subject (4%) had mild – moderate liver fibrosis, 8 subjects(32%) had normal – mild liver fibrosis, and 16 (64%) had a normal liver. <b>Conclusion:</b> Liver affection is a common finding in patients with OSA; however, Liver function tests are not reliable to detect hepatic dysfunction in such patients. Assessment of LS can be used to detect hepatic dysfunction in patient with OSA.