Nature and Science of Sleep (Feb 2023)

Association Between Metabolic-Associated Fatty Liver Disease and Obstructive Sleep Apnea: A Cross-Sectional Study

  • Huang J,
  • Chen L,
  • Li X,
  • Chen M,
  • Lin T,
  • Chen G

Journal volume & issue
Vol. Volume 15
pp. 49 – 57

Abstract

Read online

Jiefeng Huang,1– 3,* Lida Chen,4,* Xiuling Li,1– 3,* Menglan Chen,1– 3 Ting Lin,1– 3 Gongping Chen1– 3 1Department of Respiratory and Critical Care Medicine, the First Affiliated Hospital of Fujian Medical University, Fujian Medical University, Fuzhou, People’s Republic of China; 2Institute of Respiratory Disease, Fujian Medical University, Fujian Medical University, Fuzhou, People’s Republic of China; 3Department of Respiratory and Critical Care Medicine, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou, People’s Republic of China; 4Department of Respiratory and Critical Care Medicine, Zhangzhou Affiliated Hospital of Fujian Medical University, Xiangcheng, Zhangzhou, People’s Republic of China*These authors contributed equally to this workCorrespondence: Gongping Chen, Tel/Fax +86591-87981697, Email [email protected]: Emerging evidence has revealed that obstructive sleep apnea (OSA) is an independent risk factor for the development of a variety of adverse metabolic disease states. In this study, we evaluated the association between OSA severity and metabolic dysfunction-associated fatty liver disease (MAFLD) among Asian populations.Materials and Methods: This was a cross-sectional, single-center study. The study cohort consisted of patients undergoing polysomnography and abdominal ultrasonography. Logistic regression analysis was used to evaluate the independent risk factors of MAFLD in patients with OSA.Results: A total of 1065 patients (277 non-MAFLD and 788 MAFLD) were included in the study. The prevalence of MAFLD in non-OSA, mild-moderate OSA, and severe OSA patients was 58.16%, 72.41%, and 78.0%, respectively (p < 0.001). We identified significant differences in body mass index (BMI), apnea-hypopnea index (AHI), oxygen desaturation index (ODI), and lowest O2 saturation (LaSO2) between non-MAFLD and MAFLD patients (all p < 0.001). After adjusting for confounding variables, we used multivariate regression analysis to show that BMI, ODI, and triglyceride (TG) levels independently predicted the occurrence of MAFLD (odds ratio [OR] = 1.234, p < 0.001; OR = 1.022, p = 0.013; OR = 1.384, p = 0.001, respectively). Moreover, stratified analysis according to BMI indicated that TG levels were the predominant risk factor for MAFLD in a group of patients with a BMI < 23 kg/m2, while BMI, ODI, TG levels, and total cholesterol (TC) were the major risk factors for MAFLD in a group of patients with a BMI ≥ 23 kg/m2 (all p < 0.05).Conclusion: OSA-associated chronic intermittent hypoxia was independently associated with the risk of MAFLD, especially in OSA patients with a BMI ≥ 23 kg/m2, suggesting that oxidative stress might play an important role in the pathogenesis of MAFLD in patients with OSA.Keywords: obstructive sleep apnea, chronic intermittent hypoxia, metabolic dysfunction-associated fatty liver disease, obesity

Keywords