Association Between Nocturnal Hypoxia And Liver Injury In The Setting Of Nonalcoholic Fatty Liver Disease

Purpose: Obstructive sleep apnea hypopnea syndrome(OSAHS) is suggested as apotential risk factor of nonalcoholic fatty liver disease (NAFLD). However, theunderlying mechanism is still far from clear. The aim of this observational study wasto investigate the influence of OSAHS-related hypoxia on severity of liver injury inpatients with NAFLD.Methods: Consecutive patients with ultrasound-diagnosed NAFLD who underwentstandard polysomnography between December2012to October2013were enrolled.Fasting blood samples were obtained from all patients for biological profilemeasurements and demographic data were collected. Subjects were divided intocontrol, moderate and severe groups.Results: A total of85subjects with73males and12females were included (mean age44.67±1.28years, mean body mass index27.28±0.33kg/m2). Alanine aminotransferase(ALT), aspartate aminotransferase (AST), ALT/AST, gamma glutamyltransferase,total cholesterol, low density lipoprotein-cholesterol, fasting glucose andhigh-sensitivity C-reactive protein significantly increased with the aggravation ofOSA. In multivariate analysis, oxygen desaturation index was the major contributingfactor for elevated ALT (β=0.435, p=0.000), average O2saturation was themajor independent predictor of elevated AST (β=0.269, p=0.020).Conclusions: OSAHS-related hypoxia was independently associated with the biochemical evidence of liver injury in the presence of NAFLD.