title: Association Between Severity of Obstructive Sleep Apnea and Blood Markers of Liver Injury.
abstract: Obstructive sleep apnea (OSA) may contribute to the development of nonalcoholic fatty liver disease. We performed a multisite cross-sectional study to evaluate the association between the severity of OSA and blood markers of liver steatosis (using the hepatic steatosis index), cytolysis (based on alanine aminotransferase activity), and significant liver fibrosis (based on the FibroMeter [Echosens] nonalcoholic fatty liver disease score) in 1285 patients with suspected OSA in France. After adjusting for confounders including central obesity, the risk of liver steatosis increased with the severity of OSA (P for trend < .0001) and sleep-related hypoxemia (P for trend < .0003 for mean oxygen saturation). Decreasing mean oxygen saturation during sleep also was associated independently with a higher risk of liver cytolysis (P for trend < .0048). Severe OSA conferred an approximate 2.5-fold increase in risk for significant liver fibrosis compared with patients without OSA, but the association between OSA severity and liver fibrosis was not maintained after adjusting for confounders.
authors.affiliation: Département de Pneumologie, Centre Hospitalier Universitaire, Université Bretagne Loire, Angers, France; INSERM U1063, Université Bretagne Loire, Angers, France. Electronic address: wotrzepizur@chu-angers.fr.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Trzepizur
authors.affiliation: Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Université Bretagne Loire, Angers, France; Laboratoire Hémodynamique, Interaction Fibrose, et Invasivité Tumorale Hépatique, Unité Propre de Recherche de l'Enseignement Supérieur 3859, Structure Fédérative de Recherche 4208, Université Bretagne Loire, Angers, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Boursier
authors.affiliation: Département de Pneumologie, Centre Hospitalier Universitaire, Université Bretagne Loire, Angers, France; Service de Pneumologie, Centre Hospitalier, Le Mans, France.
authors.forename: Yasmina
authors.initials: Y
authors.lastname: Mansour
authors.affiliation: Centre de Recherche Médecine, Sciences, Santé, Santé mentale, Société, Centre National de la Recherche Scientifique Unité Mixte de Recherche 8211, INSERM U988, École Des Hautes Etudes en Sciences Sociales, Villejuif, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Le Vaillant
authors.affiliation: Institut du Thorax, Pneumologie, Hôpital Laennec, Nantes, France.
authors.forename: Sylvaine
authors.initials: S
authors.lastname: Chollet
authors.affiliation: Unité de Pneumologie, Pôle Santé des Olonnes, Olonne sur Mer, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Pigeanne
authors.affiliation: Service de Pneumologie, Centre Hospitalier, La Roche sur Yon, France.
authors.forename: Acya
authors.initials: A
authors.lastname: Bizieux-Thaminy
authors.affiliation: Pneumologie, Nouvelles Cliniques Nantaises, Nantes, France.
authors.forename: Marie-Pierre
authors.initials: MP
authors.lastname: Humeau
authors.affiliation: Service de Pneumologie, Centre Hospitalier, Cholet, France.
authors.forename: Claire
authors.initials: C
authors.lastname: Alizon
authors.affiliation: Service de Pneumologie, Centre Hospitalier, Le Mans, France.
authors.forename: François
authors.initials: F
authors.lastname: Goupil
authors.affiliation: Département de Pneumologie, Centre Hospitalier Universitaire, Université Bretagne Loire, Angers, France; INSERM U1063, Université Bretagne Loire, Angers, France.
authors.forename: Nicole
authors.initials: N
authors.lastname: Meslier
authors.affiliation: Département de Pneumologie, Centre Hospitalier Universitaire, Université Bretagne Loire, Angers, France; INSERM U1063, Université Bretagne Loire, Angers, France.
authors.forename: Pascaline
authors.initials: P
authors.lastname: Priou
authors.affiliation: Service d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Université Bretagne Loire, Angers, France; Laboratoire Hémodynamique, Interaction Fibrose, et Invasivité Tumorale Hépatique, Unité Propre de Recherche de l'Enseignement Supérieur 3859, Structure Fédérative de Recherche 4208, Université Bretagne Loire, Angers, France.
authors.forename: Paul
authors.initials: P
authors.lastname: Calès
authors.affiliation: Département de Pneumologie, Centre Hospitalier Universitaire, Université Bretagne Loire, Angers, France; INSERM U1063, Université Bretagne Loire, Angers, France.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Gagnadoux
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D015415:Biomarkers / Q000097:blood*; D003430:Cross-Sectional Studies; D005234:Fatty Liver / Q000209:etiology* / Q000473:pathology*; D005260:Female; D005602:France; D006801:Humans; D008103:Liver Cirrhosis / Q000209:etiology / Q000473:pathology; D008297:Male; D008875:Middle Aged; D018570:Risk Assessment; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000473:pathology*
chemical_list: D015415:Biomarkers; D000410:Alanine Transaminase
keywords: Clinic-Based Study; Sleep-Disordered Breathing; Sleep-Related Hypoxia