In the first study to examine liver injury in patients with OSA, researchers led by Lawrence Serfaty, M.D. at the Hepatology Department at Saint-Antoine Hospital in Paris, France tested liver function in patients being evaluated for OSA in order to determine if sleep apnea by itself was a risk factor for liver disease and if so, the mechanism involved.
The results of the study appear in the June 2005 issue of Hepatology, the official journal of the American Association for the Study of Liver Diseases (AASLD), published by John Wiley & Sons, Inc. Hepatology is available online via Wiley InterScience at http://www.interscience.wiley.com/journal/hepatology.
The study included 163 patients who were referred to the Sleep Unit of Saint-Antoine Hospital between September 2000 and May 2001 to undergo evaluation for OSA. Blood levels of liver enzymes were measured in the morning after sleeping at the clinic, and patients with elevated levels underwent liver biopsies, also in the morning. Patients were categorized into groups according to the level of severity of OSA: severe (44 patients), moderate (84 patients), or non-existent (35 patients). This last group, who did not have OSA, was used as the control group. Elevated liver enzymes were found in 32 patients, 29 of whom were in the severe or moderate group. Liver biopsies were performed in 18 of these patients: 9 with severe OSA, 6 with moderate OSA and 3 with no OSA. Patients with severe OSA had a significantly higher percentage of steatosis (fatty liver disease), lobular necrosis and fibrosis (two signs of liver damage) than patients in the other two groups, regardless of body mass index
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