Association of obstructive sleep apnea syndrome with the signs of non-alcoholic fatty liver disease and calculated glomerular filtration rate in metabolic syndrome

Abstract

Aim: to assess a relationship between obstructive sleep apnea syndrome (OSAS) and the signs of non-alcoholic fatty liver disease (NAFLD) in patients with metabolic syndrome (MS). Material and methods. Serum total cholesterol, triglycerides, high-density lipoprotein cholesterol concentrations, fasting blood glucose, ASAT, ALAT, γ-glutamyl transpeptidase (γ-GT), alkaline phosphatase (AP), total bilirubin, uricemia, and creatininemia were determined in 32 patients (mean age 47.6±9.7 years) with MS. The authors also measured fasting blood insulin levels with the further calculation of the homeostatic model assessment (HOMA) index, as well as plasma C-peptide concentration. Abdominal ultrasound study and OSAS diagnosis by the routine scheme were made in all the patients. Results. OSAS was associated with the significant increase in the body mass index (40.5±9.4 and 31.9±4.6 kg/m2; p = 0.001), waist circumference (130.0±22.5 and 107.5±11.0 cm; p = 0.001), and C-peptide levels (1611.0±614.0 pmol/l; p = 0.019), and the serum activities of γ-GT (117.0±57.0 and 42.0±14.0 IU/ml; p = 0.05) and AP (80.0±53.0 and 74.0±48.0 UI/ml; p = 0.05). The patients with OSAS had also a significantly lower glomerular filtration rate (GFR) estimated using the modification of diet in renal disease (MDRD) formula (66.0±19.0 and 82.0±21.0 ml/min/1.73 m2; p < 0.05). Conclusion. The presence of OSAS in patients with MS is associated with the increase in laboratory signs of NAFLD and the decrease in the GFR calculated by the MDRD formula.

Keywords

• non-alcoholic fatty liver disease
• obstructive sleep apnea syndrome
• metabolic syndrome
• glomerular filtration rate