Association between self-reported sleep apnea and biomarkers of liver injury: Evidence from National Health and Nutrition Examination Survey

• Published in: Medicine (Baltimore) 2024-09, Vol.103 (36), p.e39393
• Main Authors: Jiang, Yi-Bin, Huang, Zhi-Wei, Lin, Xue-Jun, Luo, Jia-Min, Chen, Li-Da
• Format: Article
• Language: English
• Subjects: Adult; Alanine Transaminase - blood; Biomarkers - blood; Cross-Sectional Studies; Female; Humans; Liver - injuries; Liver Function Tests - methods; Male; Middle Aged; Nutrition Surveys; Self Report; Sleep Apnea Syndromes - blood; Sleep Apnea Syndromes - epidemiology; Sleep Apnea, Obstructive - blood; Sleep Apnea, Obstructive - complications; Sleep Apnea, Obstructive - epidemiology; United States - epidemiology
• ISSN: 0025-7974; 1536-5964; 1536-5964
• DOI: 10.1097/MD.0000000000039393

The community population based studies on the relationship between obstructive sleep apnea and liver injury are limited. The study aimed to clarify the association between sleep apnea (SA) and liver injury by using the data in The National Health and Nutrition Examination Survey. SA was assessed by the sleep questionnaire and liver injury was evaluated by liver function test, hepatic steatosis index, and fibrosis-4. Weighted multivariable linear regression was performed to examine the association between SA and liver injury. Subgroup analyses and sensitivity analysis were also conducted. A total of 19,362 eligible participants were included in the study. After adjusting for confounders, the presence of SA was significantly associated with increased levels of lnALT, lnAST/alanine aminotransferase, lnGGT, and lnHSI (all P values  .05). There is a dose-response relationship between the severity of SA and increased levels of lnALT, lnGGT, and decreased levels of lnAST/alanine aminotransferase (test for trend, all P values