Association between continuous positive airway pressure and serum aminotransferases in patients with obstructive sleep apnea
Association between continuous positive airway pressure and serum aminotransferases in patients with obstructive sleep apnea
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DOI：
10.1007/s00405-017-4840-0
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发表时间：
2018-02-01
影响因子：
2.6
通讯作者：
Lin, Li
中科院分区：
文献类型：
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作者：
Chen, Li-Da;Zhang, Liang-Ji;Lin, Li
阻塞性睡眠呼吸暂停（OSA）已被认为是非酒精性脂肪肝（NAFLD）的潜在促成因素。针对持续气道正压通气（CPAP）治疗OSA患者与NAFLD的相关性研究较少且存在争议，本研究旨在探讨OSA与NAFLD的关系以及CPAP治疗对OSA患者血清转氨酶水平的影响。在睡眠后的早晨获得血液样品用于生物特征测量。非侵入性超声技术用于评估肝脏脂肪变性和纤维化。在OSA组中，在CPAP治疗前后检测血清转氨酶，丙氨酸氨基转移酶（ALT）、天冬氨酸氨基转移酶（AST）、γ-谷氨酰转移酶和肝脏脂肪变性评分随着OSA严重程度的增加而显著增加。以肝脏脂肪变性评分、ALT、AST分别作为因变量的逐步多元回归，呼吸暂停低通气指数（β = 0.447，p = 0.020; β = 0.266，p = 0.001; β = 0.351，p = 0.020）在调整混杂因素后显着预测肝脏脂肪变性评分、ALT、AST。CPAP治疗3个月后，ALT和ALT均显著下降，（54.20 +/- 24.34 vs. 46.52 +/- 24.95，p = 0.000）和AST（31.82 +/- 8.91对29.00 +/- 8.34，p = 0.039）dOSA严重程度与肝脂肪变性和血清转氨酶升高独立相关。3个月的CPAP治疗与OSA患者肝损伤的统计学显著改善相关。
Obstructive sleep apnea (OSA) has been suggested to be a potential contributing factor for nonalcoholic fatty liver disease (NAFLD). Studies on the association between continuous positive airway pressure (CPAP) and NAFLD in OSA patients are limited and controversial.The aim of this study was to assess the relationship between OSA and NAFLD and the effect of CPAP therapy on serum aminotransferase levels in OSA patients.A total of 160 consecutive patients who underwent standard polysomnography were enrolled. Blood samples were obtained in the morning after sleep for biological profile measurements. Non-invasive ultrasound techniques were used to assess liver steatosis and fibrosis. Within the OSA group, serum aminotransferases were detected before and after CPAP treatment.Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyltransferase, and liver steatosis score increased significantly with an increase in OSA severity. Stepwise multiple regression with liver steatosis score, ALT, AST as dependent variable, respectively, apnea-hypopnea index (beta = 0.447, p = 0.020; beta = 0.266, p = 0.001; beta = 0.351, p = 0.020, respectively) significantly predicted the liver steatosis score, ALT, AST after adjustment for confounders. After 3 months of CPAP treatment, there was a significant decrease in both ALT (54.20 +/- 24.34 vs. 46.52 +/- 24.95, p = 0.000) and AST (31.82 +/- 8.91 vs. 29.00 +/- 8.34, p = 0.039).OSA severity was independently associated with liver steatosis and elevation of serum aminotransferases. 3 months of CPAP therapy were associated with a statistically significant improvement on liver injury in OSA patients.