Association between nocturnal hypoxia and liver injury in the setting of nonalcoholic fatty liver disease

Abstract

PurposeObstructive sleep apnea (OSA) is suggested as a potential risk factor of nonalcoholic fatty liver disease (NAFLD). However, the underlying mechanism is still far from clear. The aim of this observational study was to investigate the influence of OSA-related hypoxia on severity of liver injury in patients with NAFLD.MethodsConsecutive patients with ultrasound-diagnosed NAFLD who underwent standard polysomnography were enrolled. Fasting blood samples were obtained from all patients for biological profile measurements, and demographic data were collected. Subjects were divided into control, moderate, and severe groups.ResultsA total of 85 subjects with 73 males and 12 females were included (mean age, 44.67 ± 1.28 years; mean body mass index, 27.28 ± 0.33 kg/m2). Alanine aminotransferase (ALT), aspartate aminotransferase (AST), ALT/AST, gamma glutamyltransferase, total cholesterol, low density lipoprotein-cholesterol, fasting glucose, and high-sensitivity C-reactive protein significantly increased with the aggravation of OSA. In multivariate analysis, oxygen desaturation index was the major contributing factor for elevated ALT (β = 0.435, p = 0.000), average O2 saturation was the major independent predictor of elevated AST (β = −0.269, p = 0.020).ConclusionsOSA-related hypoxia was independently associated with the biochemical evidence of liver injury in the presence of NAFLD.

Sodium pentobarbital dosages for exsanguination affect biochemical, molecular and histological measurements in rats

“…During pathogenesis of liver injury, the determination of enzyme levels such as serum aminotransferases, www.nature.com/scientificreports www.nature.com/scientificreports/ AST and ALT is usually used for accurate diagnosis. The present investigation confirmed the explanation of Johnson et al, Norman et al and Lin et al [35][36][37] who reported that, the elevation in the serum enzymes AST and ALT in response to the induction of Hif1a mRNA expression in the liver organ following sodium pentobarbital overdoses (100 and 150 mg/kg) may be subsequent to hypoxia. These findings are further confirmed by the histological results; the high dose of sodium pentobarbital (150 mg/kg) could induce considerable hepatocellular and renal injury in both male and female rats more than that induced by 100 mg/kg as compared to the lower dose (50 mg/kg).…”

Nighttime sleep duration and risk of nonalcoholic fatty liver disease: the Dongfeng-Tongji prospective study

“…Of which, sleep apnea, which is a common sleep disorder among the elderly,(43) is a key potential confounding factor. It has been reported that sleep apnea can lead to oxidative stress, systemic inflammation and endothelial dysfunction (44,45) and has also been suggested to be associated with both long sleep duration and liver injury (46)(47)(48). Despite the confounding postulation, long sleep duration has also been found to be associated with insulin resistance and secretion in individuals without diabetes in the recent PPP-Botnia study (49).…”

Multiscale Entropy Analysis of Heart Rate Variability for Assessing the Severity of Sleep Disordered Breathing

“…Sleep efficiency is defined as the number of minutes of sleep divided by the number of minutes in bed. Moreover, to compare the severity of OSA among different groups, the parameter of lowest arterial oxygen saturation (LSaO2), which objectively reflects the severity of OSA [15], was adopted in the current study to abolish the potential individual differences in the level of physiological tolerance and adaptation to the degree of hypoxia before arousal that may contribute to sleep fragmentation. Besides, the percentage of sleep that each subject spent at each stage was recorded and compared.…”