Obstructive sleep apnea linked to liver fibrosis regardless of obesity

Recent research has found that moderate to severe obstructive sleep apnea (OSA) is associated with Fatty liver disease fibrosis. The study was published in the journal, "European Journal of Gastroenterology & Hepatology" 2020.

Obstructive sleep apnea is one of the established factors for the pathogenesis and exacerbation of non-alcoholic fatty liver disease (NAFLD). Insulin resistance and dyslipidemia are involved in non-alcoholic fatty liver disease. Obstructive sleep apnea may also disrupt the gut liver axis, increasing intestinal permeability and with a possible role of gut microbiota in the pathogenesis of the non-alcoholic fatty liver disease. But the association between obstructive sleep apnea and the severity of the non-alcoholic fatty liver disease is not established.

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Researchers from Brazil conducted a prospective study to examine the association between obstructive sleep apnea and the severity of the non-alcoholic fatty liver disease. They included patients with at least one of metabolic syndrome (MS) criteria by assessing the NAFLD fibrosis score initially. Based on the outcome if it is an intermediate or high risk of advanced fibrosis, patients underwent liver biopsy. Patients with clinical, ultrasound or endoscopic diagnosis of cirrhosis did not undergo liver biopsy. Polysomnography was done for all the patients. Patients were divided into two groups for statistical analysis. They were patients without apnea or mild apnea and patients with moderate or severe apnea. For correlating OSA with the severity of NAFLD various risk factors like the degree of steatosis, presence, and severity of non-alcoholic steatohepatitis (NASH), and fibrosis were assessed.