Association of obstructive sleep apnoea with the presence and severity of non‐alcoholic fatty liver disease. A systematic review and meta‐analysis

  title={Association of obstructive sleep apnoea with the presence and severity of non‐alcoholic fatty liver disease. A systematic review and meta‐analysis},
  author={Giovanni Musso and Maurizio Cassader and C. Olivetti and Floriano Rosina and Gabriele Carbone and R Gambino},
  journal={Obesity Reviews},
Obstructive sleep apnoea syndrome (OSAS) and non‐alcoholic fatty liver disease (NAFLD) are common in clinical practice. NAFLD encompasses simple steatosis and non‐alcoholic steatohepatitis (NASH): both confer an increased risk of cardiovascular disease and diabetes; NASH increases also liver‐related risk. Growing experimental evidence connects chronic intermittent hypoxia of OSAS to NAFLD. We reviewed English and non‐English articles and international meeting abstracts through December 2012… 

Association between obstructive sleep apnea and non-alcoholic fatty liver disease: a systematic review and meta-analysis

It was demonstrated that OSA was related to ALT levels, but no significant correlation was found with AST levels, and future studies should investigate the possible relevant mechanisms to prevent the progression of disease.


A high prevalence of risk for OSAS was observed in the studied group, with a higher risk being independently associated with BMI and presence of steatohepatitis, suggesting that it is a factor associated with the severity of the disease.

Obstructive sleep apnea with excessive daytime sleepiness is associated with non-alcoholic fatty liver disease regardless of visceral fat

In the present study, OSA was closely associated with NAFLD in Korean adults, particularly strong in those with EDS or short sleep duration regardless of VFA.

Association of obstructive sleep apnea with non-alcoholic fatty liver disease in patients with obesity: an observational study

Investigation of the relationship between the severity of OSA and NAFLD and a polysomnographic parameter correlated with progression of fibrosis found meanSpO2% represented an independent determinant for the worsening of FIB-4 in patients with severe obesity and OSA could hypothesize a clinical role of meanSaO2%, to undergo further investigation.

Non-alcoholic fatty liver disease is an independent risk factor for inflammation in obstructive sleep apnea syndrome in obese Asian Indians

NAFLD is an additional risk factor in OSA subject which contributes to systemic inflammation in Asian Indians and is positively associated with the NAFLD.

Significantly higher atherosclerosis risks in patients with obstructive sleep apnea and non-alcoholic fatty liver disease

The degree of steatosis in patients with NAFLD was significantly correlated with severity of OSA, CIMT measurements, ICAM-1 and Lp(a) and the findings underscore screening forNAFLD in patientswith OSA to ensure prompt risk stratification and management.

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

A proportion of NAFLD patients without severe obesity is at risk for OSAS with daytime sleepiness, which is associated with the severity of liver damage independently of body mass and other cofactors.

RE: Association of obstructive sleep apnea with non-alcoholic fatty liver disease in patients with obesity—an observational study

  • T. Kawada
  • Medicine
    Eating and Weight Disorders - Studies on Anorexia, Bulimia and Obesity
  • 2021
There is a need of verifying the relationship with special reference to the interrelationship among FIB-4, meanSaO2% and other significant independent variables among several indicators of OSA, and a meta-analysis on the association between OSA and NAFLD is conducted.

Correlation between Obstructive Sleep Apnea and Non-Alcoholic Fatty Liver Disease before and after Metabolic Bariatric Surgery

MBS plays a pivotal role in the control of medical conditions in obese patients with OSA and NAFLD, and in the case of both the severity at baseline as well as the improvement after surgery, OSA may pose an impact on the prognosis ofNAFLD in bariatric patients.



Nonalcoholic Fatty Liver Disease Associated with Obstructive Sleep Apnea: Just a Coincidence?

Obese patients had elevated OSA and NAFLD frequencies and OSA was associated with insulin resistance but not with the severity of NASH, but no association was found between AHI and NASH.

Evidence for liver injury in the setting of obstructive sleep apnea.

Obstructive sleep apnea-hypopnea syndrome and nonalcoholic fatty liver disease: emerging evidence and mechanisms.

Critical review of experimental and human evidence connecting OSAS to NAFLD pathogenesis is critically reviewed, trying to dissect the effect of intermittent hypoxia from that of obesity and associated comorbidities, and molecular mechanisms connectingOSAS to liver and metabolic disease inNAFLD are examined.

Meta-analysis: Natural history of non-alcoholic fatty liver disease (NAFLD) and diagnostic accuracy of non-invasive tests for liver disease severity

NAFLD warrants screening for cardio-metabolic risk and for progressive liver disease and the combination of three noninvasive tests with LB may optimally individuate patients with NASH, with or without advanced fibrosis.

Influence of Obstructive Sleep Apnea on Fatty Liver Disease: Role of Chronic Intermittent Hypoxia

The prevalence of NAFLD was higher in patients with severe OSA, suggesting a role for nocturnal hypoxemia in the pathogenesis of fatty liver disease.

Liver Enzymes and Histology in Obese Patients With Obstructive Sleep Apnea

In obese patients with NAFLD, OSA was associated with elevated alanine aminotransferase levels and a trend toward histologic evidence of progressive liver disease, as indicated by inflammation plus fibrosis, compared with those with inflammation alone.

Relationship between Obstructive Sleep Apnea and Liver Abnormalities in Morbidly Obese Patients: A Prospective Study

One-third of patients requiring bariatric surgery had NASH, a prevalence similar to previous studies, and OSA was found to be a risk factor for elevated liver enzymes but not for NASH.

Effects of obstructive sleep apnea syndrome on hepatic steatosis and nonalcoholic steatohepatitis.

  • K. TatsumiT. Saibara
  • Medicine
    Hepatology research : the official journal of the Japan Society of Hepatology
  • 2005

Sleep-disordered breathing: a new risk factor of suspected fatty liver disease in overweight children and adolescents?

The respiratory disturbance index, percentage of total sleep time with SO2 < 90%, and SaO2nadir were associated with higher alanine amino-transferases (ALT) independent of abdominal obesity, and this study supports the association between the severity of SDB and suspected fatty liver disease in a clinical sample of overweight children and adolescents.

Obstructive Sleep Apnoea, Glucose Tolerance and Liver Steatosis in Obese Women

OSA is an independent predictor of IGT which, in turn, is associated with severe liver steatosis in an obesity unit-based sample of women, and IGT was the only predictor of grade III Steatosis.