Sleep apnea hypopnea syndrome and liver injury.
OBJECTIVE
A general review was made of studies involving: (1) the relationship between sleep apnea hypopnea syndrome/sleep apnea style intermittent hypoxia and liver injury and (2) the mechanism that causes the liver injury.


METHODS
The data used in this review were mainly from Medline and PubMed published in English from 1993 to February 2009. The search term was "sleep apnea hypopnea syndrome".


METHODS
(1) Clinical and laboratory evidence that sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia leads to liver injury; (2) the mechanism that causes the liver injury.


RESULTS
The effect of sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia on the liver function is characterized by serum aminotransferase elevation. The liver histological injury includes hepatic steatosis, hepatocyte ballooning, lobular inflammation, lobular necrosis, and liver fibrosis. Sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia can cause insulin resistance and oxidative stress.


CONCLUSIONS
Sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia can lead to chronic liver injury, which, in most cases, is shown as nonalcoholic fatty liver disease. Insulin resistance and oxidative stress caused by sleep apnea hypopnea syndrome and sleep apnea style intermittent hypoxia play an important role in the mechanism of chronic liver disease development.
Department of Gerontology, Tianjin Medical University General Hospital, Tianjin 300052, China. tjltianjianli@hotmail.com
Jian-li
JL
Tian
Yun
Y
Zhang
Bao-yuan
BY
Chen
D000818:Animals; D005234:Fatty Liver / Q000378:metabolism / Q000473:pathology; D006801:Humans; D000860:Hypoxia / Q000209:etiology / Q000503:physiopathology; D007333:Insulin Resistance / Q000502:physiology; D008107:Liver Diseases / Q000209:etiology*; D018384:Oxidative Stress / Q000502:physiology; D012891:Sleep Apnea Syndromes / Q000378:metabolism / Q000503:physiopathology*