Relationship between Obstructive Sleep Apnea and Liver Abnormalities in Morbidly Obese Patients: A Prospective Study |
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Authors: | Pauline Jouët Jean-Marc Sabaté Dominique Maillard Simon Msika Charlotte Mechler Séverine Ledoux Florence Harnois Benoit Coffin |
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Institution: | 1. Service d’Hépato-Gastroentérologie, Assistance Publique - H?pitaux de Paris (APHP) H?pital Louis Mourier, 178, rue des Renouillers, 92701, Colombes Cedex, France 2. Service des Explorations Fonctionnelles, AP-HP H?pital Louis Mourier, Colombes, France 3. Service de Chirurgie viscérale, AP-HP H?pital Louis Mourier, Colombes, France 4. Service d’Anatomo-Pathologie, AP-HP H?pital Louis Mourier, Colombes, France
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Abstract: | Background Morbid obesity is a risk factor of nonalcoholic steatohepatitis (NASH). Obstructive sleep apnea (OSA) could also be an independent
risk factor for elevated liver enzymes and NASH. The relationships between liver injuries and OSA in morbidly obese patients
requiring bariatric surgery were studied prospectively.
Methods Every consecutive morbidly obese patient (BMI ≥40 kg/m2 or ≥35 kg/m2 with severe comorbidities) requiring bariatric surgery was included between January 2003 and October 2004. Polygraphic recording,
serum aminotransferases (ALT, AST), γ-glutamyltransferase (GGT) and liver biopsy were systematically performed. OSA was present
when the apnea–hypopnea index (AHI) was >10/h.
Results 62 patients (54 F; age 38.5 ± 11.0 (SD) yrs; BMI 47.8 ± 8.4 kg/m2) were included. Liver enzymes (AST, ALT or GGT) were increased in 46.6%. NASH was present in 34.4% and OSA in 84.7%. Patients
with OSA were significantly older (P = 0.015) and had a higher BMI (P = 0.003). In multivariate analysis, risk factors for elevated liver enzymes were the presence of OSA and male sex.The presence
of NASH was similar in patients with or without OSA (32.7% vs 44.4% of patients, P = 0.76).
Conclusion In this cohort of morbidly obese patients requiring bariatric surgery, one-third of patients had NASH, a prevalence similar
to previous studies. OSA was found to be a risk factor for elevated liver enzymes but not for NASH. |
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Keywords: | Non-alcoholic steatohepatitis steatosis morbid obesity surgery |
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