Obstructive Sleep Apnea and the Liver

Clin Liver Dis. 2019 May;23(2):363-382. doi: 10.1016/j.cld.2019.01.001.

Abstract

Nonalcoholic fatty liver disease (NAFLD), a disorder of altered metabolic pathways, is increasing worldwide. Recent studies established obstructive sleep apnea (OSA) and chronic intermittent hypoxia (CIH) as NAFLD risk factors. Studies have ascertained that CIH is independently related to NAFLD. Continuous positive airway pressure (CPAP) shows inconsistent results regarding its efficacy in improving NAFLD. Observational, longer duration CPAP therapy studies have shown positive outcomes, whereas shorter duration, randomized controlled trials have shown no benefit. A multifaceted approach to NAFLD management with sufficiently longer duration of CPAP therapy may be beneficial in patients with moderate to severe OSA.

Keywords: Chronic intermittent hypoxia and insulin resistance; Hepatic steatosis; Nonalcoholic fatty liver disease; Obstructive sleep apnea.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Adipose Tissue / physiopathology
  • Animals
  • Continuous Positive Airway Pressure
  • Dyslipidemias / physiopathology
  • Humans
  • Hypoxia / complications
  • Hypoxia / etiology*
  • Hypoxia / physiopathology*
  • Insulin Resistance
  • Lipogenesis
  • Lipolysis
  • Non-alcoholic Fatty Liver Disease / etiology*
  • Sleep Apnea, Obstructive / complications*
  • Sleep Apnea, Obstructive / physiopathology*
  • Sleep Apnea, Obstructive / therapy