TY - JOUR T1 - In sleep apnea patients nonalcoholic fatty liver disease (NAFLD) is associated with the severity of intermittent hypoxia and more severe endothelial dysfunction JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P1882 AU - Caroline Minville AU - Marie-Noëlle Hilleret AU - Renaud Tamisier AU - Patrick Levy AU - Jean-Pierre Zarski AU - Jean-Louis Pepin Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P1882.abstract N2 - Introduction: Nonalcoholic fatty liver disease (NAFLD) begins with the accumulation of triglycerides in the liver and elicits an inflammatory response that can progress to cardiovascular complications, cirrhosis and liver cancer. Intermittent hypoxia is a potential contributing factor but NAFLD has not been investigated in an unselected obstructive sleep apnea (OSA) population. Beyond liver biopsy, there are non invasive validated tools allowing a screening of NAFLD in large populations.Aims: (i) To use non-invasive blood tests (Steatotest®, NASHtest® and Fibrotest®) to evaluate steatosis, Nonalcoholic Steato hepatitis (NASH) and fibrosis in a large cohort of OSA (II) To assess endothelial function by peripheral arterial tone (PAT).Patients: 226 subjects referred for suspicion of OSA were included (men: 55%, median age: 56 years, mean BMI: 34 kg/m2).Results: 61.5% of OSA patients exhibited advanced steatosis. By multivariate analysis, triglycerides (p<0.0001), insulin resistance (p=0.0004) and nocturnal cumulative time spent <90% of SaO2 (CT90) (p=0.01) were independent factors for liver steatosis. 38% of OSA displayed NASH (N1 or N2 with NASHtest®). CT90 was significantly associated with NASH (p=0.035) but this became non significant in multivariate analysis. Endothelial function was more impaired in OSA patients with advanced steatosis (p=0.04) and NASH (p=0.013).Discussion/Conclusion: In a large unselected population of OSA, the severity of intermittent hypoxia was independently associated with steatosis. Endothelial dysfunction was more severely impaired in OSA patients demonstrating NAFLD. ER -