Correlation between Obstructive Sleep Apnea and Non-Alcoholic Fatty Liver Disease before and after Metabolic Bariatric S
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ORIGINAL CONTRIBUTIONS
Correlation between Obstructive Sleep Apnea and Non-Alcoholic Fatty Liver Disease before and after Metabolic Bariatric Surgery Y. X. Zhang 1 & L. Yang 2 & C. C. Yang 1 & W. Y. Wang 1 & J. H. Shen 1 & M. L. Shi 1 & Y. Yu 1 & Q. C. Dai 1 & Y. Gu 1 & J. J. Yang 1 & W. W. Yu 3 & K. Yao 3 & M. Hu 1 & J. Ni 1 & J. L. Sun 1 & L. Zhang 1 & H. X. Sun 3 & X. F. Lu 3 & B. Wang 1
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Background Emerging evidence has revealed that obstructive sleep apnea (OSA) is associated with non-alcoholic fatty liver disease (NAFLD). However, the impact of OSA on NAFLD among obese patients undergoing metabolic and bariatric surgery (MBS), especially during follow-up period, remains unclear. Objective To analyze the correlation based on preoperative characteristics and postoperative conditions among bariatric patients with comorbid OSA and NAFLD. Methods: Clinical data of patients who underwent MBS in our institution between January 2016 and June 2019 were reviewed retrospectively. Correlation analysis and linear regressions were used to identify how OSA links with NAFLD before and after treatment of MBS. Results Of 308 patients, 181 were diagnosed with OSA and enrolled in the present study, and 127 completed follow-up visits at 6 months. The proportion of NAFLD in the mild-moderate OSA and severe OSA groups was 75.0% and 96.0%, respectively. MBS was effective at improving sleep apnea and nocturnal hypoxia, as well as liver steatosis and fibrosis (P < 0.05). And we also found that there were significant correlations not only between OSA- and NAFLD-related characteristics at baseline but also between their improvements after surgery, eventually leading to similar prognosis of NAFLD for both groups (P < 0.05), no matter what presurgical differences existed. In addition, the results of the univariate and multivariate linear regression analyses supported preoperative liver/spleen Hounsfield units ratio (LSR) by computerized tomography (CT) as an independent predictor of the effect of MBS on liver steatosis. Conclusion In conclusion, MBS plays a pivotal role in the control of medical conditions in obese patients with OSA and NAFLD. Given the correlation between OSA and NAFLD in the present study, in the case of both the severity at baseline as well as the improvement after surgery, OSA may pose an impact on the prognosis of NAFLD in bariatric patients. Keywords Obstructive sleep apnea . Non-alcoholic fatty liver disease . Obesity . Metabolic and bariatric surgery . Correlation analysis
Introduction Zhang YX and Yang L contributed equally to this work. Zhang YX is the first author of this article, and Yang L is the co-first author of this article. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11695-020-04696-w) contains supplementary material, which is available to authorized users. * X. F. Lu [email protected] * B. Wang [email protected] Extended author information available on the last page of the ar
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