Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity

Background: Owing to the increasing rate of pediatric obesity, its complications such as non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) have become prevalent already in childhood. We aimed to assess the relationship between these two diseases in a cohort of children with...

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Autores principales:	Marco Carotenuto, Anna Di Sessa, Maria Esposito, Anna Grandone, Pierluigi Marzuillo, Ilaria Bitetti, Giuseppina Rosaria Umano, Francesco Precenzano, Emanuele Miraglia del Giudice, Nicola Santoro
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	obstructive sleep apnea fatty liver apnea hypopnea index (AHI) oxygen desaturation index (ODI) insulin resistance (IR) children Pediatrics RJ1-570
Acceso en línea:	https://doaj.org/article/db442c1aa7324b26a33f665a31c1a6de
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spelling	oai:doaj.org-article:db442c1aa7324b26a33f665a31c1a6de2021-11-25T17:14:12ZAssociation between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity10.3390/children81109842227-9067https://doaj.org/article/db442c1aa7324b26a33f665a31c1a6de2021-11-01T00:00:00Zhttps://www.mdpi.com/2227-9067/8/11/984https://doaj.org/toc/2227-9067Background: Owing to the increasing rate of pediatric obesity, its complications such as non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) have become prevalent already in childhood. We aimed to assess the relationship between these two diseases in a cohort of children with obesity. Methods: We enrolled 153 children with obesity (mean age 10.5 ± 2.66, mean BMI 30.9 ± 5.1) showing OSA. Subjects underwent a laboratory evaluation, a cardio-respiratory polysomnography (PSG), and a liver ultrasound. Results: All subjects had a clinical diagnosis of OSA based on the AHI > 1/h (mean AHI 8.0 ± 5.9; range 2.21–19.0). Of these, 69 showed hepatic steatosis (62.3% as mild, 20.3% as moderate, and 17.4% as severe degree). A strong association between ALT and apnea/hypopnea index (AHI) was observed (<i>p</i> = 0.0003). This association was not confirmed after adjusting for hepatic steatosis (<i>p</i> = 0.53). By subdividing our population according to the presence/absence of steatosis, this association was found only in the steatosis group (<i>p</i> = 0.009). As the severity of steatosis increased, the significance of its association with AHI compared to the absence of steatosis became progressively stronger (all <i>p</i> < 0.0001). Conclusions: Hepatic steatosis seems to drive the association between OSA and ALT levels, suggesting a potential pathogenic role of OSA in NAFLD.Marco CarotenutoAnna Di SessaMaria EspositoAnna GrandonePierluigi MarzuilloIlaria BitettiGiuseppina Rosaria UmanoFrancesco PrecenzanoEmanuele Miraglia del GiudiceNicola SantoroMDPI AGarticleobstructive sleep apneafatty liverapnea hypopnea index (AHI)oxygen desaturation index (ODI)insulin resistance (IR)childrenPediatricsRJ1-570ENChildren, Vol 8, Iss 984, p 984 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	obstructive sleep apnea fatty liver apnea hypopnea index (AHI) oxygen desaturation index (ODI) insulin resistance (IR) children Pediatrics RJ1-570
spellingShingle	obstructive sleep apnea fatty liver apnea hypopnea index (AHI) oxygen desaturation index (ODI) insulin resistance (IR) children Pediatrics RJ1-570 Marco Carotenuto Anna Di Sessa Maria Esposito Anna Grandone Pierluigi Marzuillo Ilaria Bitetti Giuseppina Rosaria Umano Francesco Precenzano Emanuele Miraglia del Giudice Nicola Santoro Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity
description	Background: Owing to the increasing rate of pediatric obesity, its complications such as non-alcoholic fatty liver disease (NAFLD) and obstructive sleep apnea (OSA) have become prevalent already in childhood. We aimed to assess the relationship between these two diseases in a cohort of children with obesity. Methods: We enrolled 153 children with obesity (mean age 10.5 ± 2.66, mean BMI 30.9 ± 5.1) showing OSA. Subjects underwent a laboratory evaluation, a cardio-respiratory polysomnography (PSG), and a liver ultrasound. Results: All subjects had a clinical diagnosis of OSA based on the AHI > 1/h (mean AHI 8.0 ± 5.9; range 2.21–19.0). Of these, 69 showed hepatic steatosis (62.3% as mild, 20.3% as moderate, and 17.4% as severe degree). A strong association between ALT and apnea/hypopnea index (AHI) was observed (<i>p</i> = 0.0003). This association was not confirmed after adjusting for hepatic steatosis (<i>p</i> = 0.53). By subdividing our population according to the presence/absence of steatosis, this association was found only in the steatosis group (<i>p</i> = 0.009). As the severity of steatosis increased, the significance of its association with AHI compared to the absence of steatosis became progressively stronger (all <i>p</i> < 0.0001). Conclusions: Hepatic steatosis seems to drive the association between OSA and ALT levels, suggesting a potential pathogenic role of OSA in NAFLD.
format	article
author	Marco Carotenuto Anna Di Sessa Maria Esposito Anna Grandone Pierluigi Marzuillo Ilaria Bitetti Giuseppina Rosaria Umano Francesco Precenzano Emanuele Miraglia del Giudice Nicola Santoro
author_facet	Marco Carotenuto Anna Di Sessa Maria Esposito Anna Grandone Pierluigi Marzuillo Ilaria Bitetti Giuseppina Rosaria Umano Francesco Precenzano Emanuele Miraglia del Giudice Nicola Santoro
author_sort	Marco Carotenuto
title	Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity
title_short	Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity
title_full	Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity
title_fullStr	Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity
title_full_unstemmed	Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity
title_sort	association between hepatic steatosis and obstructive sleep apnea in children and adolescents with obesity
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/db442c1aa7324b26a33f665a31c1a6de
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Association between Hepatic Steatosis and Obstructive Sleep Apnea in Children and Adolescents with Obesity

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