title: Impact of effective versus sham continuous positive airway pressure on liver injury in obstructive sleep apnoea: Data from randomized trials.
abstract: OBJECTIVE
  Obstructive sleep apnoea (OSA) could be an independent risk factor for non-alcoholic fatty liver disease (NAFLD) occurrence and progression. The impact of continuous positive airway pressure (CPAP) treatment on non-invasive markers of NAFLD has not been studied. The aim of this study was to evaluate the effect of 6-12 weeks of effective CPAP on the FibroMax test (comprising components including the SteatoTest, NashTest and FibroTest) through three randomized sham controlled studies.
  
  
  METHODS
  The FibroMax test was performed in 103 obstructive sleep apnoea patients (apnoea + hypopnoea index > 15/h) enrolled in a randomized study comparing sham versus effective CPAP.
  
  
  RESULTS
  At baseline, 40.4% of patients in the sham CPAP group and 45.5% in the CPAP group exhibited liver steatosis. Furthermore, 39.6% of patients in the sham CPAP group and 58.4% in the CPAP group displayed borderline or possible non-alcoholic steatohepatitis (NASH). Six to twelve weeks of effective CPAP did not demonstrate any impact on reducing steatosis, NASH or liver fibrosis even after adjustment for gender, BMI, baseline apnoea + hypopnoea index and severity of liver injury.
  
  
  CONCLUSIONS
  A number of non-invasive markers of liver damage are increased in untreated obstructive sleep apnoea patients, potentially contributing to cardiometabolic risk, but they do not improve after 6-12 weeks of effective CPAP treatment.
  
  
  BACKGROUND
  NCT01196845 (ADISAS), NCT00464659 (MneSAS) and NCT00669695 (StatinflaSAS) at ClinicalTrials.gov.
authors.affiliation: HP2; INSERM, U1042, University Grenoble Alpes, Grenoble, France.|Laboratoire EFCR, Grenoble, France.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Jullian-Desayes
authors.affiliation: HP2; INSERM, U1042, University Grenoble Alpes, Grenoble, France.|Laboratoire EFCR, Grenoble, France.
authors.forename: Renaud
authors.initials: R
authors.lastname: Tamisier
authors.affiliation: Hepato-Gastro-Enterology Department, CHU Grenoble, Grenoble, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Zarski
authors.affiliation: Endocrinology and Nutrition Department, AP-HP, La Pitié-Salpétrière, Hospital, Paris, France.|Nutriomic Department, INSERM, UMRS 872, University Pierre and Marie Curie-Paris 6, Paris, France.
authors.forename: Judith
authors.initials: J
authors.lastname: Aron-Wisnewsky
authors.affiliation: HP2; INSERM, U1042, University Grenoble Alpes, Grenoble, France.|Laboratoire EFCR, Grenoble, France.
authors.forename: Sandrine H
authors.initials: SH
authors.lastname: Launois-Rollinat
authors.affiliation: Biochemistry, Toxicology and Pharmacology Department, CHU Grenoble, Grenoble, France.
authors.forename: Candice
authors.initials: C
authors.lastname: Trocme
authors.affiliation: HP2; INSERM, U1042, University Grenoble Alpes, Grenoble, France.|Laboratoire EFCR, Grenoble, France.
authors.forename: Patrick
authors.initials: P
authors.lastname: Levy
authors.affiliation: HP2; INSERM, U1042, University Grenoble Alpes, Grenoble, France.|Laboratoire EFCR, Grenoble, France.
authors.forename: Marie
authors.initials: M
authors.lastname: Joyeux-Faure
authors.affiliation: HP2; INSERM, U1042, University Grenoble Alpes, Grenoble, France.|Laboratoire EFCR, Grenoble, France.
authors.forename: Jean-Louis
authors.initials: JL
authors.lastname: Pepin
mesh_terms: D015415:Biomarkers / Q000097:blood; D045422:Continuous Positive Airway Pressure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D065626:Non-alcoholic Fatty Liver Disease / Q000097:blood* / Q000209:etiology; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000097:blood* / Q000150:complications / Q000628:therapy*; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers
keywords: comorbidities; continuous positive airway pressure treatment; intermittent hypoxia; liver disease; obstructive sleep apnoea