Association between obstructive sleep apnea and non-alcoholic fatty liver disease in pediatric patients: a meta-analysis
Association between obstructive sleep apnea and non-alcoholic fatty liver disease in pediatric patients: a meta-analysis
复制标题
儿科患者阻塞性睡眠呼吸暂停与非酒精性脂肪肝之间的关联：荟萃分析
DOI：
10.1111/ijpo.12718
复制
发表时间：
2020-09-02
影响因子：
3.8
通讯作者：
Lin, Qi-Chang
中科院分区：
文献类型：
--
作者：
Chen, Li-Da;Chen, Meng-Xue;Lin, Qi-Chang
背景一些研究报道了儿童阻塞性睡眠呼吸暂停（OSA）与非酒精性脂肪性肝病（NAFLD）之间的关系。然而，这一问题仍然存在争议。目的探讨儿童阻塞性睡眠呼吸暂停（OSA）与非酒精性脂肪肝（NAFLD）的关系。方法系统检索PubMed、Web of Science、Embase等文献。提取OSA组和对照组的NAFLD标志物丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、肝脏炎症、肝纤维化的相关数据。通过固定或随机效应模型适当计算合并标准化平均差异（SMD）和加权平均差异（WMD）。结果共纳入9个横断面研究，1133名儿童和青少年。OSA与ALT、AST和NAFLD纤维化分期显著相关，但与NAFLD炎症分级无关。亚组分析表明，轻度和重度OSA均与ALT和AST升高显著相关。此外，在所有主要混杂因素（年龄、性别和BMI）匹配的研究中，OSA组的ALT和AST水平高于对照组。结论在儿童人群中，OSA与NAFLD相关，表现为肝酶升高和进行性肝纤维化。在患有肥胖相关OSA的儿童患者中筛查和监测NAFLD是必要的。
Background Some studies have reported a relationship between obstructive sleep apnea (OSA) and non-alcoholic fatty liver disease (NAFLD) in pediatric population. However, this issue remains controversial. Objectives The purpose of the present study was to investigate the association between OSA and NAFLD in pediatric population. Methods We systematically searched PubMed, Web of Science, Embase for eligible studies. The data involving markers of NAFLD including alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatic inflammation, hepatic fibrosis of both OSA group and control group were extracted. Pooled standardised mean difference (SMD) and weighted mean difference (WMD) were appropriately calculated through a fixed or random-effect model. Results Nine cross-sectional studies with 1133 children and adolescents were included. OSA was significantly associated with ALT, AST, and NAFLD fibrosis stage, but not NAFLD inflammation grade. Subgroup analysis indicated that both mild OSA and severe OSA were significantly associated with elevated ALT and AST. Furthermore, in the studies with all main confounding factors (age, gender, and BMI) matched, OSA group had higher ALT and AST levels than control group. Conclusions This meta-analysis suggested that OSA was associated with NAFLD evidenced by elevated liver enzymes and progressive hepatic fibrosis in pediatric population. Screening and monitoring of NAFLD in pediatric patients with obesity-related OSA are necessary.