Risk of Obstructive Sleep Apnea with Daytime Sleepiness Is Associated with Liver Damage in Non-Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease

Pulixi, E.A.; Tobaldini, Eleonora; Battezzati, Pier Maria; Dingianna, Paola; Borroni, V.; Fracanzani, Anna Ludovica; Maggioni, Marco; Pelusi, Serena; Bulgheroni, Mara; Zuin, Massimo; Fargion, Silvia; Montano, Nicola; Valenti, Luca

doi:10.1371/journal.pone.0096349

Cited by 32 publications

(25 citation statements)

References 38 publications

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“…Uncontrolled treatment studies of adults and children with OSAS receiving CPAP treatment and tonsillectomy have shown a decrease in liver enzymes [66] . In addition a proportion of NAFLD patients without severe obesity are at risk for OSAS and this is associated with the severity of the liver damage independently of BMI and other co-factors [67] .…”

Section: Apnea Syndromementioning

confidence: 99%

Non-alcoholic fatty liver disease - the heart of the matter

Azzam

Malnick

2015

WJH

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Non-alcoholic fatty liver disease (NAFLD) is one of the most common forms of chronic liver disease in the Western world. There is a close association with the metabolic syndrome and NAFLD is considered to be the hepatic manifestation of the metabolic syndrome. The components of the metabolic syndrome include hypertension, obesity and insulin resistance which are well established cardiovascular risk factors. The mortality rate of NAFLD patients from myocardial infarction is higher than that in the general United States population and there is also an increased risk of nonfatal cardiovascular events. This article reviews the cardiovascular complications associated with NAFLD. In order to provide comprehensive care of NAFLD patients, physicians need to be aware of, and search for, the cardiac morbidity associated with NAFLD. Core tip: Non-alcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome. Due to the overlapping cardiovascular risk factors in the metabolic syndrome, there are cardiovascular consequences linked to the presence of NAFLD in a patient. We review these complications and also a less well appreciated complication of diastolic dysfunction that is intimately associated with NAFLD. Physicians looking after NAFLD patients need to be aware of these complications and actively search for and treat them.Azzam H, Malnick S. Non-alcoholic fatty liver disease -the heart of the matter. World J Hepatol 2015; 7(10):

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Section: Apnea Syndromementioning

confidence: 99%

Non-alcoholic fatty liver disease - the heart of the matter

Azzam

Malnick

2015

WJH

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“…The pathomechanisms are manifold, including lipotoxicity, oxidative stress, chronic inflammation and hypercoagulability [13,14]. Additional aspects contributing to the complexity in the management of NAFLD/NASH include sleep apnea [15,16], potentially contributing to NASH progression due to hypoxia [17,18], and the increased risk for colonic neoplasia [19]. …”

Section: Introductionmentioning

confidence: 99%

Challenges and Management of Liver Cirrhosis: Practical Issues in the Therapy of Patients with Cirrhosis due to NAFLD and NASH

Traussnigg

Kienbacher

Halilbasic

et al. 2015

Dig Dis

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Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of the metabolic syndrome and comprises a liver disease spectrum ranging from steatosis to nonalcoholic steatohepatitis (NASH) with risk of progression to liver cirrhosis and hepatocellular carcinoma (HCC). Associated metabolic conditions and comorbidities such as obesity, diabetes and cardiovascular diseases are common and require concerted management. Adiponutrin (PNPLA3) variants may help to identify NAFLD patients at higher risk for liver disease progression towards advanced fibrosis and HCC. The therapeutic options in NAFLD/NASH include lifestyle modification, pharmacological treatment, bariatric surgery for patients with morbid obesity and treatment of complications of liver cirrhosis and HCC, including liver transplantation. Insulin sensitizers and antioxidative treatment strategies with vitamin E are among the best-established pharmacological approaches, but both drugs have long-term safety issues and there is limited evidence in cirrhotic patients. Treatment of concomitant/underlying metabolic conditions with statins or metformin may also have beneficial effects on portal hypertension, complications of liver cirrhosis and HCC prevention. The bile acid receptor FXR may be a promising novel therapeutic target for the treatment of NAFLD/NASH, fibrosis and portal hypertension, but the prognostic implications of associated changes in low- and high-density lipoprotein cholesterol require further studies. Morbidly obese NASH patients can benefit from bariatric surgery which may reduce liver fibrosis but carries a risk of decompensation in patients with advanced liver cirrhosis. When carefully selected, patients with NASH cirrhosis undergoing liver transplantation have a good outcome. This review summarizes recent progress in the management of patients with liver cirrhosis due to NASH.

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“…Segundo estudos que utilizaram a PSG para o diagnóstico da SAOS, estimase 1,2-26% da população adulta seja afetada, sendo duas a três vezes mais prevalentes em homens do que em mulheres (BIXLER et al, 2001;IP et al, 2001;GOTTLIEB, 2002;STRADLING;DAVIES, 2004;UDWADIA et al, 2004;KIM et al, 2004;LEE et al, 2008). Ao se adotar somente sintomas, avaliação clínica e questionários para o diagnóstico de SAOS estima-se uma prevalência de 12% até mais dos 90%, com prevalências maiores para a população asiática (CHUNG et al, 2007;AMRA et al, 2013;KUMAR et al, 2013, KANG et al, 2014PULIXI et al, 2014 , 2002;GIBSON, 2005;SCHUARTZ et al, 2008;HERNÁNDEZ et al, 2009) 1996(NETZER et al, 1999. Trata-se de um método simples e validado na língua portuguesa para diagnosticar alto risco de SAOS (VAZ et al, 2011).…”

Section: Epidemiologiaunclassified

“…Furuta et al (2010) (DALTRO et al, 2007;LEONG et al, 2013;LOPES NETO et al, 2013). No entanto, outros estudos identificaram estimativas menores de 12,43% até 68% (NETZER et al, 1969;SHARMA et al, 2006;CHUNG et al, 2007;VAZ et al, 2011;AMRA et al, 2013;PULIXI et al, 2014;KANG et al, 2014), que poderia explicar-se pelo tipo de população estudada.…”

Section: Condições Periodontaisunclassified

“…A hipertensão arterial é considerada um dos modelos preditores mais exatos em indivíduos com SAOS (VAZ et al, 2011), Assim neste estudo se identificou 60,19% de indivíduos com hipertensão arterial, dados que se assemelham a outros estudos (CHUNG et al, 2007;VAZ et al, 2011;AMRA et al, 2013;PULIXI et al, 2014) Outros dos parâmetros que ajudam o diagnóstico objetivo de SAOS, é a presença de sintomatologia auto referida pelos indivíduos. Assim, neste estudo de acordo a história clínica dos indivíduos envolvidos, reportaram-se como sintomáticos 46,27% deles, mostrando uma relação significativa entre a SAOS auto relatada e o risco de SAOS.…”

Section: Condições Periodontaisunclassified

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Avaliação da doença periodontal e do risco de síndrome de apneia obstrutiva do sono, em pacientes obesos de grau III

Rojas¹

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Risk of Obstructive Sleep Apnea with Daytime Sleepiness Is Associated with Liver Damage in Non-Morbidly Obese Patients with Nonalcoholic Fatty Liver Disease

Cited by 32 publications

References 38 publications

Non-alcoholic fatty liver disease - the heart of the matter

Non-alcoholic fatty liver disease - the heart of the matter

Challenges and Management of Liver Cirrhosis: Practical Issues in the Therapy of Patients with Cirrhosis due to NAFLD and NASH

Avaliação da doença periodontal e do risco de síndrome de apneia obstrutiva do sono, em pacientes obesos de grau III

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