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

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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 ±–1.0 (SD) yrs; BMI 47.8 ±–.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––.015) and had a higher BMI (P––.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––.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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Abbreviations

BMI:

Body Mass Index

OSA:

Obstructive Sleep Apnea

NASH:

Non-Alcoholic SteatoHepatitis

AHI:

Apnea–Hypopnea Index

WHR:

Waist-to-Hip Ratio

ALT:

alanine aminotransferase activity

AST:

aspartate aminotransferase activity

GGT:

gamma glutamyltransferase

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Authors and Affiliations

  1. Service d’Hépato-Gastroentérologie, Assistance Publique - Hôpitaux de Paris (APHP) Hôpital Louis Mourier, 178, rue des Renouillers, 92701, Colombes Cedex, France

    Pauline Jouët, Jean-Marc Sabaté, Florence Harnois & Benoit Coffin

  2. Service des Explorations Fonctionnelles, AP-HP Hôpital Louis Mourier, Colombes, France

    Dominique Maillard & Séverine Ledoux

  3. Service de Chirurgie viscérale, AP-HP Hôpital Louis Mourier, Colombes, France

    Simon Msika

  4. Service d’Anatomo-Pathologie, AP-HP Hôpital Louis Mourier, Colombes, France

    Charlotte Mechler

Authors
  1. Pauline Jouët
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  2. Jean-Marc Sabaté
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  3. Dominique Maillard
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  4. Simon Msika
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  5. Charlotte Mechler
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  6. Séverine Ledoux
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  7. Florence Harnois
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  8. Benoit Coffin
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Corresponding author

Correspondence to Benoit Coffin.

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Jouët, P., Sabaté, JM., Maillard, D. et al. Relationship between Obstructive Sleep Apnea and Liver Abnormalities in Morbidly Obese Patients: A Prospective Study. OBES SURG 17, 478–485 (2007). https://doi.org/10.1007/s11695-007-9085-3

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  • DOI: https://doi.org/10.1007/s11695-007-9085-3

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