Background Nonalcoholic fatty liver disease (NAFLD) is a disorder that is associated with the metabolic syndrome and typically presents with elevated serum transaminase levels, fatty infiltration, inflammation, and/or fibrosis of the liver. Recent studies have shown that an association exists between NAFLD and obstructive sleep apnea (OSA) and hypothesized that oxidative stress from repetitive nocturnal desaturation in OSA may contribute to NAFLD development.
Methods We analyzed laboratory and polysomnographic data from 59 patients with OSA to evaluate how factors associated with the metabolic syndrome (age, body mass index [BMI], lipid profile, blood pressure, fasting glucose) and factors associated with OSA severity (apnea-hypopnea index [AHI], lowest oxygen saturation, oxygen desaturation index, percent of time below 90% saturation) correlate with serum transaminase levels.
Results Markers of OSA severity (specifically lowest oxygen saturation level and percentage of night spent below 90% saturation) correlated significantly with SGOT and SGPT, whereas AHI, BMI, blood pressure, fasting glucose, triglyceride, and total cholesterol levels did not. Linear regression analysis with forced entry of metabolic syndrome-associated variables (age, BMI, lipid panel, and glucose levels) as one block and markers of OSA severity (AHI, percentage of night spent with saturation < 90%) as another block demonstrated that only total cholesterol level and percentage of night spent with saturation < 90% were predictive of transaminase levels, with percentage of night spent with saturation < 90% playing the larger role.
Conclusion In patients with known obstructive sleep apnea, markers of oxygen desaturation correlate significantly and play more of a role in predicting serum transaminase levels than do factors traditionally associated with the metabolic syndrome.
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