Zhong Yue, Wang Biying, Huang Jiefeng, Nian Meixin, Zhao Jianming, Chen Gongping
Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350005, People's Republic of China.
Institute of Respiratory Disease, Fujian Medical University, Fuzhou, 350005, People's Republic of China.
Nat Sci Sleep. 2024 Dec 20;16:2143-2150. doi: 10.2147/NSS.S480186. eCollection 2024.
Obstructive sleep apnea (OSA) is a contributing factor to nonalcoholic fatty liver disease (NAFLD). This study aimed to investigate the clinical and polysomnographic characteristics of OSA patients with and without NAFLD, focusing on the relationships between sleep fragmentation, arousal and NAFLD.
We consecutively enrolled patients who underwent polysomnography, anthropometry, blood sampling, and abdominal ultrasonography. Patients were categorized into NAFLD and non-NAFLD groups. A comparative analysis of clinical and polysomnographic profiles was conducted, followed by multivariate binary logistic regression to explore the relationship between sleep disturbance indices and NAFLD.
A total of 403 subjects were included, including 92 patients with NAFLD and 311 with non-NAFLD. NAFLD patients exhibited a greater apnea-hypopnea index (AHI) (51.19/h vs 33.60/h, p = 0.002) and oxygen desaturation index (ODI) (37.90/h vs 21.40/h, p=0.034) compared to non-NAFLD patients. Specifically, NAFLD patients had a higher rapid eye movement (REM)-AHI (53.70/h vs 43.60/h, p=0.001) and greater arousal index (AI) (32 vs 25, p = 0.009). Additionally, sleep latency (SL) was significantly lower in the NAFLD group (p < 0.05). Multivariate logistic regression analysis confirmed that REM-AHI (OR=1.023, p = 0.024), AI (OR=1.140, p = 0.01), and SL (OR=0.956, p = 0.035) were significantly associated with NAFLD in OSA patients.
This study revealed that sleep disturbance indices, especially AI, REM-AHI and SL, were closely related to NAFLD. When evaluating whether OSA patients are complicated with NAFLD, more attention should be given to sleep fragmentation and arousal.
阻塞性睡眠呼吸暂停（OSA）是非酒精性脂肪性肝病（NAFLD）的一个促成因素。本研究旨在调查合并和未合并NAFLD的OSA患者的临床和多导睡眠图特征，重点关注睡眠片段化、觉醒与NAFLD之间的关系。
我们连续纳入了接受多导睡眠图检查、人体测量、血液采样和腹部超声检查的患者。患者被分为NAFLD组和非NAFLD组。对临床和多导睡眠图特征进行了比较分析，随后进行多变量二元逻辑回归以探讨睡眠障碍指标与NAFLD之间的关系。
共纳入403名受试者，其中92例为NAFLD患者，311例为非NAFLD患者。与非NAFLD患者相比，NAFLD患者表现出更高的呼吸暂停低通气指数（AHI）（51.19次/小时 vs 33.60次/小时，p = 0.002）和氧饱和度下降指数（ODI）（37.90次/小时 vs 21.40次/小时，p = 0.034）。具体而言，NAFLD患者的快速眼动（REM）-AHI更高（53.70次/小时 vs 43.60次/小时，p = 0.001），觉醒指数（AI）更高（32 vs 25，p = 0.009）。此外，NAFLD组的睡眠潜伏期（SL）显著更低（p < 0.05）。多变量逻辑回归分析证实，REM-AHI（OR = 1.023，p = 0.024）、AI（OR = 1.140，p = 0.01）和SL（OR = 0.956，p = 0.035）与OSA患者的NAFLD显著相关。
本研究表明，睡眠障碍指标，尤其是AI、REM-AHI和SL，与NAFLD密切相关。在评估OSA患者是否合并NAFLD时，应更多关注睡眠片段化和觉醒。
