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Review
. 2019 May;23(2):363-382.
doi: 10.1016/j.cld.2019.01.001.

Obstructive Sleep Apnea and the Liver

Malav P Parikh  1 , Niyati M Gupta  1 , Arthur J McCullough  2
Affiliations
Review

Obstructive Sleep Apnea and the Liver

Malav P Parikh et al. Clin Liver Dis. 2019 May.

Abstract

Nonalcoholic fatty liver disease (NAFLD), a disorder of altered metabolic pathways, is increasing worldwide. Recent studies established obstructive sleep apnea (OSA) and chronic intermittent hypoxia (CIH) as NAFLD risk factors. Studies have ascertained that CIH is independently related to NAFLD. Continuous positive airway pressure (CPAP) shows inconsistent results regarding its efficacy in improving NAFLD. Observational, longer duration CPAP therapy studies have shown positive outcomes, whereas shorter duration, randomized controlled trials have shown no benefit. A multifaceted approach to NAFLD management with sufficiently longer duration of CPAP therapy may be beneficial in patients with moderate to severe OSA.

Keywords: Chronic intermittent hypoxia and insulin resistance; Hepatic steatosis; Nonalcoholic fatty liver disease; Obstructive sleep apnea.

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Figures

Fig. 1.
Fig. 1.
Two-hit hypothesis. CYP2E1, cytochrome P450 2E1; NF-κB, in nuclear factor-κβ.
Fig. 2.
Fig. 2.
Increased de novo lipogenesis. SREBP, sterol receptor element-binding protein.
Fig. 3.
Fig. 3.
OSA and insulin resistance.
Fig. 4.
Fig. 4.
OSA and liver fibrosis.
See this image and copyright information in PMC

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