Increased liver stiffness in patients with severe sleep apnoea and metabolic comorbidities
- Wojciech Trzepizur1,2,
- Jérôme Boursier3,4,
- Marc Le Vaillant5,
- Pierre-Henri Ducluzeau6,
- Séverine Dubois7,2,
- Samir Henni8,9,
- Pierre Abraham8,9,
- Christophe Aubé10,4,
- Paul Calès3,4 and
- Frédéric Gagnadoux1,2
- on the behalf of the METABOL group
- 1Département de Pneumologie, Centre Hospitalier Universitaire, Angers, France
- 2INSERM UMR 1063, Université d'Angers, France
- 3Département d'Hépato-Gastroentérologie, Centre Hospitalier Universitaire, Angers, France
- 4HIFIH, EA3859, Université d'Angers, Angers, France
- 5Institut de Recherche en Santé Respiratoire des Pays de la Loire, Beaucouzé, France
- 6Unité d'Endocrinologie-Diabétologie-Nutrition, Pole de Médecine, Centre Hospitalier Universitaire, Tours, France
- 7Département d'Endocrinologie, Diabétologie et Nutrition, Centre Hospitalier Universitaire, Angers, France
- 8Département de Médecine du Sport et Explorations Fonctionnelles Vasculaires, Centre Hospitalier Universitaire, Angers, France
- 9Institut MITOVASC, UMR CNRS 6015, INSERM 1083, Université d'Angers, Angers, France
- 10Département de Radiologie, Centre Hospitalier Universitaire, Angers, France
- Wojciech Trzepizur, Département de Pneumologie, CHU, 4 rue Larrey, 49100, Angers, France. E-mail: wotrzepizur{at}chu-angers.fr
Abstract
The goal of this study was to assess the relationship between the severity of obstructive sleep apnoea (OSA) and liver stiffness measurement (LSM), one of the most accurate non-invasive screening tools for liver fibrosis in nonalcoholic fatty liver disease.
The study included 147 patients with at least one criterion for the metabolic syndrome (MS), assessed by polysomnography for suspected OSA. LSM was performed using FibroScan. Significant liver disease and advanced liver fibrosis were defined as LSM≥7.3 kiloPascal (kPa) and LSM≥9.6 kPa, respectively.
Twenty-three patients were excluded because of unreliable LSM. Among 124 patients, 34 (27.4%) had mild OSA, 38 (30.6%) had moderate OSA and 52 (42.0%) had severe OSA. LSM values were between 7.3 and <9.6 kPa in 18 (14.5%) patients and ≥9.6 kPa in 15 (12.1%) patients. A dose-response relationship was observed between OSA severity and LSM values (p=0.004). After adjustment for age, gender, MS and insulin resistance, severe OSA was associated with an increased risk of LSM≥7.3 kPa (odds ratios [95% confidence interval]): 7.17 [2.51–20.50]) and LSM≥9.6 kPa (4.73 [1.25–17.88]).
In patients with metabolic comorbidities, severe OSA is independently associated with increased liver stiffness, which may predispose to a higher risk of significant liver disease and poorer prognosis.
Abstract
In patients with metabolic comorbidities, severe OSA is independently linked with an increased risk of liver disease as assessed by liver stiffness measurement
Footnotes
This manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.
Conflict of interest: Dr. Trzepizur has nothing to disclose.
Conflict of interest: Dr. Boursier reports personal fees from Echosens, a company that has a license for FibroMeter from Angers University, during the conduct of the study.
Conflict of interest: Dr. Le Vaillant has nothing to disclose.
Conflict of interest: Dr. Ducluzeau has nothing to disclose.
Conflict of interest: Dr. Dubois has nothing to disclose.
Conflict of interest: Dr. Henni has nothing to disclose.
Conflict of interest: Dr. Abraham has nothing to disclose.
Conflict of interest: Dr. Aubé has nothing to disclose.
Conflict of interest: Dr. Calès reports personal fees from Echosens, a company that has a license for FibroMeter from Angers University, during the conduct of the study.
Conflict of interest: Dr. Gagnadoux has nothing to disclose.
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- Copyright ©ERS 2018