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Obes Facts. 2012;5(4):587-96. doi: 10.1159/000342677. Epub 2012 Sep 5.

Nonalcoholic steatohepatitis in bariatric patients with a diagnosis of obstructive sleep apnea.

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1
Department of Anesthesiology, College of Medicine, Mayo Clinic, Rochester, MN 55905, USA.

Abstract

OBJECTIVE:

To study a possible association between obstructive sleep apnea (OSA) severity, managed with noninvasive ventilation, and nonalcoholic steatohepatitis (NASH) in bariatric surgical patients.

METHODS:

Medical records of 218 bariatric surgical patients who underwent liver biopsy were reviewed. OSA severity was determined from preoperative polysomnography (apnea-hypopnea index (AHI) ≤ 15 no/mild OSA vs. AHI ≥ 16 moderate/severe OSA). Patients diagnosed with OSA were prescribed noninvasive ventilation. Patients were categorized according to liver histopathology into 3 groups: (i) no liver disease or simple steatosis, (ii) mild NASH (steatosis with necroinflammation and mild fibrosis (stage 0-1)), and iii) advanced NASH (steatosis with necroinflammation and more advanced fibrosis (stage ≥ 2)).

RESULTS:

125 patients (57%) had no/mild OSA, and 93 (43%) had moderate/severe OSA. There was no difference in serum aminotransferases between patients by OSA severity classification. There was a high prevalence of hepatic histopathological abnormalities: 84% patients had steatosis, 57% had necroinflammation, 34% had fibrotic changes, and 14% had advanced NASH. There was no association between severity of NASH and severity of OSA.

CONCLUSIONS:

There is no association between stage of steatohepatitis and OSA severity among morbidly obese patients managed with noninvasive ventilation.

PMID:
22986647
DOI:
10.1159/000342677
[Indexed for MEDLINE]
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