Elif TORUN PARMAKSIZ, Sevda ŞENER ÇÖMERT, Seda Beyhan SAĞMEN, Banu SALEPÇİ, Ali FİDAN

Liver functions in patients with obstructive sleep apnea syndrome

Objectives: Objective. Previous studies showed that obstructive sleep apnea syndrome (OSAS) was associatedwith liver diseases such as elevated liver enzyme levels and hepatic steatosis. The aim of this study was toassess the relationship between serum aspartate aminotransferase (AST) and alanine aminotransferase (ALT)levels and OSAS and its severity.Methods: A total of 617 patients who underwent PSG (polysomnography) between January 2016 and May2017 were evaluated in this study. AST, ALT, total cholesterol, triglyceride levels and body mass index wereanalyzed. The data were analyzed using the Student's t-test, ANOVA, Chi-square test, and Pearson's correlationcoefficient.Results: Five hundreds and thirty patients with OSAS and 60 healthy controls were included in the study. Ofthe patients in the OSAS group, 17.7% had an elevated ALT level and 7.9% had an elevated AST level. Therewas a statistically significant difference in ALT and AST levels between the OSAS and control groups (p

PDF

___

Lindberg E, Gislason T. Epidemiology of sleep-related obstructive breathing. Sleep Med Rev 2000;4:411-33.
Punjabi NM. The epidemiology of adult obstructive sleep apnea. Proc Am Thorac Soc 2008;5:136-43.
Lam JC, Lam B, Lam CL, Fong D, Wang JK, Tse HF, et al. Obstructive sleep apnea and the metabolic syndrome in communitybased Chinese adults in Hong Kong. Respir Med 2006;100:980-7.
Somers VK, Dyken ME, Clary MP, Abbod FM Symphathetic neural mechanisms in obstructive sleep apnea. J Clin Invest 1995;96:1897-904.
Oh SY, Cho YK, Kang MS, Yoo TW, Park JH, Kim HJ, et al. The association between increased alanine aminotransferase activity and metabolic factors in nonalcoholic fatty liver disease. Metab Clin Exp 2006;55:1604-9.
Tanne, F, Gagnadoux, F, Chazouilleres O, Fleury B, Wendum D, Lasnier E, et al. Chronic liver injury during obstructive sleep apnea. Hepatology 2005;41:1290-6.
Savransky V, Bevans S, Nanayakkara A, Li J, Smith PL, Torbenson MS, et al. Chronic intermittent hypoxia causes hepatitis in a mouse model of diet-induced fatty liver. Am J Physiol Gastrointest Liver Physiol 2007;293:G871-7.
Byrne TJ, Parish JM, Somers V, Aqel BA, Rakela J. Evidence for liver injury in the setting of obstructive sleep apnea. Ann Hepatol 2012;11:228-31.
Jouët P, Sabaté JM, Maillard D, Msika S, Mechler C, Ledoux S, et al. Relationship between obstructive sleep apnea and liver abnormalities in morbidly obese patients: A prospective study. Obes Surg 2007;17:478- 85.
Sookoian S, Pirola CJ. Obstructive sleep apnea is associated with fatty liver and abnormal liver enzymes: A meta-analysis. Obes Surg 2013;23:1815-25.
Li J, Zhang YL, Chen R, Wang Y, Xiong KP, Huang JY, et al. Elevated serum liver enzymes in patients with obstructive sleep apneahypopnea syndrome. Chin Med J (Engl) 2015;128: 2983-7.
Chin K, Nakamura T, Takahashi K, Sumi K, Ogawa Y, Masuzaki H, et al. Effects of obstructive sleep apnea syndrome on serum aminotransferase levels in obese patients. Am J Med 2003;114:370-6.
Norman N, Bardwell WA, Arosemena F, Nelesen R, Mills PJ, Loredo JS, et al. Serum aminotransferase levels are associated with markers of hypoxia in patients with obstructive sleep apnea. Sleep 2008;31:121-6.
Daltro C, Cotrim HP, Alves E, de Freitas LA, Araújo L, Boente L, et al. Nonalcoholic fatty liver disease associated with obstructive sleep apnea: Just a coincidence? Obes Surg 2010;20:1536-43.
Mishra P, Nugent C, Afendy A, Bai C, Bhatia P, Afendy M, et al. Apnoeic-hypopnoeic episodes during obstructive sleep apnoea are associated with histological nonalcoholic steatohepatitis. Liver Int 2008;28:1080-6.
Sadasivam K, Patial K, Ravi K, Aiyyavo S. Liver enzymes in obstructive sleep apnoea syndrome. Natl J of Physiol, Pharm Pharmacol 2017;7:865-9.
Sookoian S, Rosselli MS, Gemma C, Burgueño AL, Fernández Gianotti T, Castaño GO, et al. Epigenetic regulation of insulin resistance in nonalcoholic fatty liver disease: impact of liver methylation of the peroxisome proliferator-activated receptor γ coactivator 1α promoter. Hepatology 2010;52:1992-2000.
Rosmorduc O, Housset C. Hypoxia: a link between fibrogenesis, angiogenesis, and carcinogenesis in liver disease. Semin Liver Dis 2010;30:258-70.