title: Liver Steatosis and Fibrosis in OSA patients After Long-term CPAP Treatment: A Preliminary Ultrasound Study.
abstract: In cases of morbid obesity, obstructive sleep apnea (OSA) was associated with biopsy-proven liver damage. The role of non-invasive techniques to monitor liver changes during OSA treatment with continuous positive airway pressure (CPAP) is unknown. We used non-invasive ultrasound techniques to assess liver steatosis and fibrosis in severe OSA patients at diagnosis and during long-term CPAP treatment. Fifteen consecutive patients with severe OSA (apnea hypopnea index 52.5 ± 19.1/h) were studied by liver ultrasound and elastography (Fibroscan) at 6-mo (n = 3) or 1-y (n = 12) follow-up. Mean age was 49.3 ± 11.9 y, body mass index (BMI) was 35.4 ± 6.4 kg/m(2). Adherence to CPAP was ≥5 h/night. At baseline, most patients had severe liver steatosis independent of BMI; at follow-up, liver steatosis was not statistically different, but a relationship between severity of steatosis and BMI became apparent (Spearman's rho: 0.53, p = 0.03). Significant fibrosis as assessed by Fibroscan was absent at diagnosis or follow-up (failure or unreliable measurements in four markedly obese patients). Therefore, ultrasound liver assessment is feasible in most OSA patients, and CPAP treatment may positively affect liver steatosis.
authors.affiliation: Biomedical Department Internal and Specialistic Medicine (DiBiMIS), University of Palermo, Palermo, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Buttacavoli
authors.affiliation: Biomedical Department Internal and Specialistic Medicine (DiBiMIS), University of Palermo, Palermo, Italy.
authors.forename: Claudia I
authors.initials: CI
authors.lastname: Gruttad'Auria
authors.affiliation: Division of Internal Medicine, Villa Sofia-Cervello Hospital, Palermo, Italy.
authors.forename: Mirko
authors.initials: M
authors.lastname: Olivo
authors.affiliation: Division of Internal Medicine, Villa Sofia-Cervello Hospital, Palermo, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Virdone
authors.affiliation: Biomedical Department Internal and Specialistic Medicine (DiBiMIS), University of Palermo, Palermo, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Castrogiovanni
authors.affiliation: Biomedical Department Internal and Specialistic Medicine (DiBiMIS), University of Palermo, Palermo, Italy.
authors.forename: Emilia
authors.initials: E
authors.lastname: Mazzuca
authors.affiliation: Biomedical Department Internal and Specialistic Medicine (DiBiMIS), University of Palermo, Palermo, Italy.
authors.forename: Anna Maria
authors.initials: AM
authors.lastname: Marotta
authors.affiliation: Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy.
authors.forename: Oreste
authors.initials: O
authors.lastname: Marrone
authors.affiliation: Division of Internal Medicine, Villa Sofia-Cervello Hospital, Palermo, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Madonia
authors.affiliation: Biomedical Department Internal and Specialistic Medicine (DiBiMIS), University of Palermo, Palermo, Italy; Institute of Biomedicine and Molecular Immunology (IBIM), National Research Council (CNR), Palermo, Italy. Electronic address: marisa@ibim.cnr.it.
authors.forename: Maria R
authors.initials: MR
authors.lastname: Bonsignore
mesh_terms: D015992:Body Mass Index; D045422:Continuous Positive Airway Pressure; D005234:Fatty Liver / Q000150:complications* / Q000000981:diagnostic imaging*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging; D008103:Liver Cirrhosis / Q000150:complications* / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000000981:diagnostic imaging; D013995:Time; D014463:Ultrasonography
keywords: Liver fibrosis; Liver steatosis; Longitudinal study; Non-invasive assessment; Obesity; Obstructive sleep apnea