INVESTIGADORES
PIROLA Carlos Jose
artículos
Título:
Obstructive Sleep Apnea Is Associated with Fatty Liver and Abnormal Liver Enzymes: a Meta-analysis.
Autor/es:
SILVIA C. SOOKOIAN; CARLOS JOSE PIROLA
Revista:
OBESITY SURGERY : THE OFFICIAL JOURNAL OF THE AMERICAN SOCIETY FOR BARIATRIC SURGERY AND OF THE OBESITY SURGERY SOCIETY OF AUSTRALIA AND NEW ZEALAND.
Editorial:
SPRINGER
Referencias:
Lugar: Berlin; Año: 2013 vol. 23 p. 1815 - 1825
ISSN:
0960-8923
Resumen:
Abstract
Background Obstructive sleep apnea (OSA) is associated
with the cluster of clinical conditions that comprise the
metabolic syndrome, including nonalcoholic fatty liver disease
(NAFLD). Our primary purpose was to estimate the
effect of OSA on serum alanine aminotransferase (ALT) and
aspartate aminotransferase (AST). Our secondary purpose
was to investigate the potential influence of OSA on histological
severity of NAFLD to explore whether chronic intermittent
hypoxia is associated with inflammation and fibrosis.
Methods Our literature search identified 11 studies, from
which we extracted information about numbers of control
subjects and OSA patients, and ALT, AST, and NAFLD.
Results From a total of 668 OSA patients and 404 controls, we
found that the standardized difference in mean values of ALT
and AST levels in patients with OSA was significantly different
from that in the controls. Meta-regression showed that the
association was independent of body mass index and type 2
diabetes. Fatty liver was associated with OSA in five studies
with 400 subjects. OSAwas significantly associated with liver
fibrosis in 208 subjects, but not with lobular inflammation.
Conclusions Routine assessment of liver enzymes and liver
damage should be implemented in OSA patients because they
have an increase of 13.3 % of ALT and 4.4 % of AST levels,
and a 2.6-fold higher risk of liver fibrosis when they have
NAFLD, which is 2.6 times more frequent in OSA patients.