Abstract
ObjectivesObstructive sleep apnea (OSA) and nonalcoholic fatty liver disease (NAFLD) are prevalent and commonly associated conditions. We aimed to estimate the prevalence of NAFLD and identify liver fibrosis risk using noninvasive scoring methods in a cohort of patients with OSA.MethodologyIn this retrospective study of patients with confirmed OSA, patients who underwent abdominal ultrasonography were recruited. The primary outcome was the prevalence of suspected NAFLD (steatosis on ultrasound and/or elevated alanine transaminase [ALT]). The secondary outcomes included the prevalence and predictors of liver fibrosis risk as assessed by the NAFLD fibrosis score (NFS) and fibrosis-4 (FIB-4) score.ResultsA total of 133 patients fulfilled the study inclusion criteria. The average age was 49.8±15.1 years, and 57.1% were females. The average BMI was 37.3±14.5. According to the apnea-hypopnea index (AHI) scores, 37.9%, 29.6%, and 32.6% of participants had mild (5-14), moderate (15-29), and severe (>=30) OSA, respectively. Radiologically defined NAFLD was detected in 44.4% of the participants, and elevated liver enzymes were detected in 63.9% of the patients. High NFS and FIB-4 scores were recorded in 9% and 3.8% of the patients, respectively. According to logistic regression analysis, age and BMI significantly predicted high NFS scores.ConclusionNAFLD appears to be common among OSA patients. Age and obesity, but not OSA severity, predicted high liver fibrosis risk as assessed by noninvasive scoring systems.
Highlights
Defined nonalcoholic fatty liver disease (NAFLD) was detected in 44.4% of the participants, and elevated liver enzymes were detected in 63.9% of the patients
Obstructive sleep apnea (OSA) and nonalcoholic fatty liver disease (NAFLD) are highly prevalent medical conditions, and both are commonly associated with obesity and metabolic syndrome
High NAFLD fibrosis score (NFS) and FIB-4 scores were recorded in 9% and 3.8% of all OSA patients, respectively
Summary
Obstructive sleep apnea (OSA) and nonalcoholic fatty liver disease (NAFLD) are highly prevalent medical conditions, and both are commonly associated with obesity and metabolic syndrome. Over the past few years, accumulating evidence has shown OSA to be independently related to the development and progression of NAFLD [4,5,6,7] The mechanisms behind this association are not well identified, but chronic intermittent hypoxia (CIH), as quantified by oxygen saturation, has been shown to be an important trigger [8]. Histopathological examination of a liver biopsy is considered the gold standard for staging liver fibrosis [12] It is invasive in nature and carries a small yet potentially serious risk of complications and should be performed only when the expected benefits outweigh the risks, especially in the context of a highly prevalent condition such as NAFLD. These scores are calculated using readily available patient demographic data and biochemical tests and
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
