Risk Factors of Nonalcoholic Fatty Liver Disease and Liver Fibrosis in Non-Obese Patients with Obstructive Sleep Apnea

Ningfang Lian; Jiawei Wu; Biying Wang; Su Lin; Jiefeng Huang; Jia Chen; Qichang Lin

doi:10.2147/NSS.S388203

Risk Factors of Nonalcoholic Fatty Liver Disease and Liver Fibrosis in Non-Obese Patients with Obstructive Sleep Apnea

Nat Sci Sleep. 2022 Dec 5:14:2143-2149. doi: 10.2147/NSS.S388203. eCollection 2022.

Authors

Ningfang Lian^#¹, Jiawei Wu^#¹, Biying Wang¹, Su Lin², Jiefeng Huang¹, Jia Chen¹, Qichang Lin¹

Affiliations

¹ Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University; Fujian Provincial Sleep-Disordered Breathing Clinic Center; National Regional Medical Center, Binhai Campus of The First Affiliated Hospital, Fujian Medical University; Institute of Respiratory Disease, Fujian Medical University, Fuzhou, People's Republic of China.
² Liver Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, People's Republic of China.

^# Contributed equally.

Abstract

Purpose: Liver injury in non-obese obstructive sleep apnea (OSA) patients has received much attention in recent years. This study aimed to investigate risk factors of nonalcoholic fatty liver disease (NAFLD) and liver fibrosis in non-obese patients with OSA.

Methods: A retrospective study was conducted in the Sleep Center of the First Affiliated Hospital of Fujian Medical University. All consecutive non-obese patients with suspected sleep apnea admitted to the center were enrolled. The clinical characteristics of patients with simple snoring and with different severity OSA were compared. Multivariate logistic regression models were used to analyze the risk factors of NAFLD and liver fibrosis.

Results: A total of 410 patients were enrolled. The levels of triglyceride, alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased with the aggravation of OSA (All p<0.05). Among non-obese patients with OSA, 17 (5%) were diagnosed with liver fibrosis and 228 (65%) with NAFLD; Apnea‑hyponea index (AHI) was an independent predictor for NAFLD and liver fibrosis [OR (95% CI): 1.02 (1.00-1.03), 1.04 (1.00-1.07), both p<0.05]; hypertriglyceridemia was an independent predictor for NAFLD [OR (95% CI): 1.13 (1.12-1.99), p<0.05].

Conclusion: NAFLD and liver fibrosis were common in non-obese OSA patients and the severity of OSA was an independent risk factor for them.

Keywords: liver fibrosis; non-alcoholic fatty liver disease; obstructive sleep apnea.

Grants and funding

This work was supported by the Natural Science Foundation of China; under Grant number 82170101; The Medical Elite Cultivation Program of Fujian in China, under Grant number 2020GGA044.