Obstructive Sleep Apnoea: Another Burden on Cirrhotic Liver
Science Journal of Public Health
Volume 4, Issue 2-1, April 2016, Pages: 1-5
Received: Jul. 4, 2015; Accepted: Jul. 6, 2015; Published: Sep. 8, 2015
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Authors
Aliae AR Mohamed-Hussein, Chest Department, Assiut University Hospitals, Assiut, Egypt
Mohamed-Eltaher AA Ibrahim, Gastroenterology and Hepatology Department, Assiut University Hospitals, Assiut, Egypt
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Abstract
Obstructive sleep apnea syndrome (OSAS) may cause aggressive deterioration in the course of liver cirrhosis and may have an impact on the development of hepatic cell failure in patients with concomitant diseases. Patients and Methods: 34 patients with OSAS and compensated cirrhosis as well as 30 compensated cirrhotic patients were followed for 1 year to demonstrate the effect of hypoxia and body mass index (BMI) on their prognosis. Polysomnography, abdominal sonography, liver function tests and portal venous pressure were assessed on inclusion. Parameters of hepatic de-compensation (HD) as ascites, hepatic encephalopathy and bleeding esophageal varices (variceal hemorrhage) were recorded. Results: BMI was significantly higher in patients with concomitant OSAS and cirrhosis (p<0.01), and manifestations of hepatic de-compensation occurred in 32.3% of those cases compared to 10% in patients with cirrhosis alone (p<0.01) in one year. Positive correlations were recorded between BMI, desaturation index, sleep duration SpO2<90% and predictors of HD. Multivariate analysis showed that BMI, AHI, sleep duration SpO2< 90%, desaturation index were independent predictors of de-compensation, together with high portal venous pressure and lower serum albumin. Conclusion: Obesity and intermittent hypoxemia in OSAS may have deleterious effect on the natural history of compensated cirrhosis independent of portal venous pressure and liver function. Treatment of OSAS and weight reduction may decrease considerable burden on cirrhosis.
Keywords
OSAS, Liver Cirrhosis, Ascites, Hepatic Encephalopathy, Variceal Hemorrhage, Obesity.
To cite this article
Aliae AR Mohamed-Hussein, Mohamed-Eltaher AA Ibrahim, Obstructive Sleep Apnoea: Another Burden on Cirrhotic Liver, Science Journal of Public Health. Special Issue: Obstructive Sleep Apnea: A Systemic Disease. Vol. 4, No. 2-1, 2016, pp. 1-5. doi: 10.11648/j.sjph.s.2016040201.11
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