Bahr Katharina, Simon Perikles, Leggewie Barbara, Gouveris Haralampos, Schattenberg Jörn
Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany.
Department of Sports Medicine, Johannes-Gutenberg-University, 55122 Mainz, Germany.
Biology (Basel). 2021 Dec 22;11(1):10. doi: 10.3390/biology11010010.
The aim of this observational cohort study was to explore the severity of liver disease in patients with suspected obstructive sleep apnea in Germany.
Patients undergoing polysomnography or home sleep apnea testing (HSAT) as an evaluation for the presence of OSA were screened using vibration-controlled transient elastography (VCTE) and continuous attenuation parameter (CAP) with a Fibroscan ® Mini 430. Clinical and laboratory data were collected following the overnight exam.
In total, 78 patients (28 female (35.9%), mean age 54.2 years) with OSA defined by an apnea-hypopnea-index >5 events/hour were included between OCT 2020 and APR 2021. Patients exhibited a high metabolic risk profile with 17% known diabetes mellitus type 2 (T2D), 62% arterial hypertension, 14% hyperlipidemia and 36% BMI > 30 kg/m. The prevalence of steatosis defined by a CAP > 280 dB/m was 54%. The prevalence of at least significant fibrosis was 16% (E > 9.0 kPa). Interestingly, patients with a snoring index above the median of 278/h showed significantly higher CAP-values ( = 0.0002). In addition, the proportion of oxygen saturations below 90% (t90) correlated with CAP-values ( = 0.02), as well as metabolic risk factors including increased waist circumference ( = 0.005) and body mass index (BMI) ( = 0.035). On the other hand, the apnea-hypopnea-index (AHI) as a marker of OSA severity did not correlate with VCTE, CAP or laboratory parameters.
Patients with moderate to severe OSA have a high prevalence of hepatic steatosis. The snoring index is an easy-to-use clinical tool to identify patients at risk for relevant liver disease within the larger group of patients with OSA.
这项观察性队列研究的目的是探讨德国疑似阻塞性睡眠呼吸暂停患者的肝病严重程度。
对接受多导睡眠图或家庭睡眠呼吸暂停检测（HSAT）以评估是否存在阻塞性睡眠呼吸暂停（OSA）的患者，使用Fibroscan® Mini 430通过振动控制瞬时弹性成像（VCTE）和连续衰减参数（CAP）进行筛查。在夜间检查后收集临床和实验室数据。
在2020年10月至2021年4月期间，共纳入78例阻塞性睡眠呼吸暂停患者（28例女性（35.9%），平均年龄54.2岁），其呼吸暂停低通气指数>5次/小时。患者表现出较高的代谢风险特征，其中17%患有2型糖尿病（T2D），62%患有动脉高血压，14%患有高脂血症，36%的体重指数（BMI）>30 kg/m²。CAP>280 dB/m定义的脂肪变性患病率为54%。至少显著纤维化的患病率为16%（E>9.0 kPa）。有趣的是，打鼾指数高于中位数278次/小时的患者显示出显著更高的CAP值（P = 0.0002）。此外，低于90%的氧饱和度（t90）比例与CAP值相关（P = 0.02），以及与代谢风险因素相关，包括腰围增加（P = 0.005）和体重指数（BMI）（P = 0.035）。另一方面，作为阻塞性睡眠呼吸暂停严重程度标志物的呼吸暂停低通气指数（AHI）与VCTE、CAP或实验室参数无关。
中重度阻塞性睡眠呼吸暂停患者的肝脂肪变性患病率较高。打鼾指数是一种易于使用的临床工具，可在较大的阻塞性睡眠呼吸暂停患者群体中识别有相关肝病风险的患者。
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