Apnoeic–hypopnoeic episodes during obstructive sleep apnoea are associated with histological nonalcoholic steatohepatitis

Mishra, Poonam; Nugent, Clare; Afendy, Arian; Bai, Chunhong; Bhatia, P.; Afendy, Mariam; Fang, Yun; Elariny, Hazem; Goodman, Zachary; Younossi, Zobair M.

doi:10.1111/j.1478-3231.2008.01822.x

Cited by 108 publications

(94 citation statements)

References 32 publications

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“…In subjects with OSA and elevated liver enzymes in the absence of any known liver disease, an AHI .50 was associated with more severe hepatic steatosis, necrosis and fibrosis compared to patients with an AHI f50, despite similar degree of obesity [239]. Other studies reported an association of intermittent hypoxia during sleep with NASH and liver fibrosis [233,235,240] or high serum aminotransferase levels [241]. Severity of nocturnal hypoxaemia also correlated with markers of liver dysfunction in non-obese OSA patients [240].…”

Section: Obstructive Sleep Apnoeamentioning

confidence: 93%

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Adipose tissue in obesity and obstructive sleep apnoea

Bonsignore¹,

McNicholas²,

Montserrat³

et al. 2011

Eur Respir J

116

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A European Respiratory Society research seminar on ''Metabolic alterations in obstructive sleep apnoea (OSA)'' was jointly organised in October 2009 together with two EU COST actions (Cardiovascular risk in the obstructive sleep apnoea syndrome, action B26, and Adipose tissue and the metabolic syndrome, action BM0602) in order to discuss the interactions between obesity and OSA.Such interactions can be particularly significant in the pathogenesis of metabolic abnormalities and in increased cardiovascular risk in OSA patients. However, studying the respective role of OSA and obesity is difficult in patients, making it necessary to refer to animal models or in vitro systems. Since most OSA patients are obese, their management requires a multidisciplinary approach.This review summarises some aspects of the pathophysiology and treatment of obesity, and the possible effects of sleep loss on metabolism. OSA-associated metabolic dysfunction (insulin resistance, liver dysfunction and atherogenic dyslipidaemia) is discussed from the perspective of both obesity and OSA in adults and children.Finally, the effects of treatment for obesity or OSA, or both, on cardio-metabolic variables are summarised. Further interdisciplinary research is needed in order to develop new comprehensive treatment approaches aimed at reducing sleep disordered breathing, obesity and cardiovascular risk.

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Section: Obstructive Sleep Apnoeamentioning

confidence: 93%

“…In morbidly obese subjects, the degree of pathological liver abnormalities and/or enzymes increased with OSA severity in some [233][234][235][236] but not all studies [237,238]. Table 1 summarises the main studies on liver function in OSA patients.…”

Section: Obstructive Sleep Apnoeamentioning

confidence: 99%

Adipose tissue in obesity and obstructive sleep apnoea

Bonsignore¹,

McNicholas²,

Montserrat³

et al. 2011

Eur Respir J

116

View full text Add to dashboard Cite

show abstract

“…60 In a study of 101 patients undergoing bariatric surgery with extensive clinical and histologic data for whom polysomnography data were available, subjects with histologic NASH were found to have significantly lower lowest desaturation, lower mean nocturnal oxygen saturation, higher respiratory disturbance index, and higher ALT/aspartate aminotransferase ratio compared with non-NASH controls. 61 Further studies are needed in this area to better understand but it appears that OSA most likely aggravates the development of NAFLD to NASH in obese individuals.…”

Section: Obstructive Sleep Apneamentioning

confidence: 99%

Epidemiology and Natural History of Non-alcoholic Fatty Liver Disease

Mishra¹,

Younossi²

2012

Journal of Clinical and Experimental Hepatology

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Non-alcoholic fatty liver disease (NAFLD) is an important cause of liver disease burden across the world. By definition, although the histopathologic features of NAFLD are identical to that of alcoholic liver disease, its diagnosis requires absence of significant alcohol use and absence of other causes of chronic liver disease. We now know that NAFLD is not simply a disease of the Western world. It is manifested across the world, in varying rates, across gender, across varying ethnicities, and in its association with other host factors. In this review article, the definition of NAFLD, its spectrum, ranging from mild steatosis to hepatocellular injury and inflammation defined as non-alcoholic steatohepatitis (NASH) is discussed. Mild steatosis is generally a stable disease whereas NASH can be progressive. Based on current published literature, current incidence and prevalence of NAFLD and NASH are discussed. It is also accepted that these processes will continue to increase in prevalence with the rise of obesity, type II diabetes, and associated metabolic syndrome. Some of the risk factors have been well-established and are discussed. In addition, this review also presents emerging associations with other risk factors for NAFLD. Natural history of NAFLD is variable depending upon the histologic subtypes and other underlying comorbidities and is discussed in this review as well. (J CLIN EXP HEPATOL 2012;2:135-144)

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“…40 In addition, OSA is associated with non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH). 27,41 OSA predicts the development of incident T2D independently of age, obesity or other confounders, 39,42-46 and 8 hours/night of CPAP improved post-load glycaemia (oral glucose tolerance test) insulin sensitivity, 24-hour BP and norepinephrine levels in a randomised placebo-controlled trial. 47 However, this study was conducted in the laboratory environment to ensure the high compliance with CPAP, and the effects of CPAP on the incidence of T2D in uncontrolled settings remains to be determined.…”

Section: Osa Is a Risk Factor For T2dmentioning

confidence: 96%

Obstructive sleep apnoea: a diabetologist’s perspective

Tahrani

2016

Br J Diabetes

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Obstructive sleep apnoea (OSA) is very common in patients with type 2 diabetes (T2D), which is unsurprising given that obesity is a major risk factor for both conditions. OSA has been associated with impaired quality of life, many cardiovascular disease (CVD) risk factors and cardiovascular disease in general. Continuous positive airway pressure treatment has beneficial impacts on CVD risk factors and CVD. However, the true impact of OSA in patients with T2D remains unclear. The International Diabetes Federation recommended routine screening for OSA in patients with T2D, but two-thirds of diabetes healthcare professionals were unaware of these recommendations. The aim of this review is to attempt to answer the following questions. Is OSA diagnosis and treatment important in patients with T2D and why? What is the relevance of OSA to the practising diabetologist? Br J Diabetes 2016;16:107-113

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Apnoeic–hypopnoeic episodes during obstructive sleep apnoea are associated with histological nonalcoholic steatohepatitis

Abstract: Our results suggest that the frequent nocturnal hypoxic episodes in NAFLD patients may be a risk factor for developing NASH. Additional studies are needed to study the effect of optimizing sleep apnoea management on the outcomes of patients with NAFLD.

Cited by 108 publications

References 32 publications

Adipose tissue in obesity and obstructive sleep apnoea

Adipose tissue in obesity and obstructive sleep apnoea

Epidemiology and Natural History of Non-alcoholic Fatty Liver Disease

Obstructive sleep apnoea: a diabetologist’s perspective

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