Effects of obstructive sleep apnea syndrome on serum aminotransferase levels in obese patients.
OBJECTIVE
Obesity has been associated with obstructive sleep apnea and hepatic steatosis. We investigated the effects of obstructive sleep apnea and treatment with nasal continuous positive airway pressure (CPAP) on serum aminotransferase levels in obese patients.


METHODS
We studied 40 obese men with obstructive sleep apnea syndrome. None had hepatitis B antigen or C antibody, autoimmune disease, or an excessive intake of alcohol. Serum levels of aspartate aminotransferase, alanine aminotransferase, triglyceride, glucose, insulin, and leptin were determined in the afternoon and in the morning immediately after sleep, before and after nasal CPAP treatment.


RESULTS
Aminotransferase levels were abnormal in 35% (n = 14) of patients. Before treatment, mean (+/- SD) aspartate aminotransferase levels were higher in the morning than in the previous afternoon (presleep, 34 +/- 20 IU/L; postsleep, 39 +/- 28 IU/L; P = 0.006). The overnight mean increases in aminotransferase levels were less marked after the first night of nasal CPAP treatment (aspartate aminotransferase: from 6 +/- 11 IU/L to 2 +/- 6 IU/L, P = 0.0003; alanine aminotransferase: from 5 +/- 9 IU/L to 2 +/- 6 IU/L, P = 0.006). Leptin levels (n = 23) decreased significantly after treatment (P = 0.0002), whereas insulin resistance (calculated by the homeostasis model assessment method) and triglyceride levels were unchanged. Improvements in aspartate and alanine aminotransferase levels were maintained after 1 and 6 months of nasal CPAP treatment.


CONCLUSIONS
Nasal CPAP therapy may have beneficial effects on serum aminotransferase abnormalities in obese patients who have obstructive sleep apnea.
Chin
Kazuo
K
Department of Physical Therapeutics, Kyoto University Hospital, Kyoto, Japan. chink@kuhp.kyoto-u.ac.jp
Nakamura
Takaya
T
Takahashi
Kenichi
K
Sumi
Kensuke
K
Ogawa
Yoshihiro
Y
Masuzaki
Hiroaki
H
Muro
Shigeo
S
Hattori
Noboru
N
Matsumoto
Hisako
H
Niimi
Akio
A
Chiba
Tsutomu
T
Nakao
Kazuwa
K
Mishima
Michiaki
M
Ohi
Motoharu
M
Nakamura
Takashi
T
D000410:Alanine Transaminase / Q000097:blood*; D001219:Aspartate Aminotransferases / Q000097:blood*; D005234:Fatty Liver / Q000209:etiology; D005260:Female; D006801:Humans; D007328:Insulin / Q000097:blood; D020738:Leptin / Q000097:blood; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000150:complications* / Q000201:enzymology*; D011175:Positive-Pressure Respiration; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000628:therapy; D013997:Time Factors; D014280:Triglycerides / Q000097:blood
D007328:Insulin; D020738:Leptin; D014280:Triglycerides; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase