Treating Obstructive Sleep Apnea and Chronic Intermittent Hypoxia Improves the Severity of Nonalcoholic Fatty Liver Disease in Children - 22/06/18
, Ann C. Halbower, MD 2, Jelena Klawitter, PhD 3, Zhaoxing Pan, PhD 4, Kristen Robbins, BS 1, Kelley E. Capocelli, MD 5, Ronald J. Sokol, MD 1Abstract |
Objective |
To determine the effects of treating obstructive sleep apnea/nocturnal hypoxia on pediatric nonalcoholic fatty liver disease (NAFLD) severity and oxidative stress.
Study design |
Biopsy proven participants (n = 9) with NAFLD and obstructive sleep apnea/hypoxia were studied before and after treatment with continuous positive airway pressure (CPAP) for sleep disordered breathing, including laboratory testing and markers of oxidative stress, urine F(2)-isoprostanes.
Results |
Adolescents (age 11.5 ± 1.2 years; body mass index, 29.5 ± 3.8 kg/m2) with significant NAFLD (mean histologic necroinflammation grade, 2.3 ± 0.9; fibrosis stage, 1.4 ± 1.3; NAFLD Activity Score summary, 4.8 ± 1.6) had obstructive sleep apnea/hypoxia by polysomnography. At baseline, they had severe obstructive sleep apnea/hypoxia, elevated aminotransferases, the metabolic syndrome, and significant oxidative stress (high F(2)-isoprostanes). Obstructive sleep apnea/hypoxia was treated with home CPAP for a mean 89 ± 62 days. Although body mass index increased, obstructive sleep apnea/hypoxia severity improved on CPAP and was accompanied by reduced alanine aminotransferase, metabolic syndrome markers, and F(2)-isoprostanes.
Conclusions |
This study provides strong evidence that treatment of obstructive sleep apnea/nocturnal hypoxia with CPAP in children with NAFLD may reverse parameters of liver injury and reduce oxidative stress. These data also suggest CPAP as a new therapy to prevent progression of NAFLD in those children with obesity found to have obstructive sleep apnea/nocturnal hypoxia.
Le texte complet de cet article est disponible en PDF.Keywords : hypoxia, NASH, sleep apnea, CPAP, reactive oxygen species, F(2)-isoprostanes
Abbreviations : AHI, ALT, AST, BMI, CPAP, CRP, ΔAHI, HDL, NAFLD, NAS, NASH, PDSS, SaO2
Plan
| Supported by the National Institutes of Health (NIH, K23 DK085150) and NIH/NCATS Colorado CTSA (UL1TR001082). Its contents are the authors' sole responsibility and do not necessarily represent official NIH views. The authors declare no conflicts of interest. |
Vol 198
P. 67 - juillet 2018 Retour au numéro
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