The Korean journal of internal medicine

The Korean Association of Internal Medicine (대한내과학회)
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Obstructive sleep apnea with excessive daytime sleepiness is associated with non-alcoholic fatty liver disease regardless of visceral fat

  • Yu, Ji Hee (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Ahn, Jae Hee (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Yoo, Hye Jin (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital) ;
  • Seo, Ji A (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Kim, Sin Gon (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital) ;
  • Choi, Kyung Mook (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital) ;
  • Baik, Sei Hyun (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital) ;
  • Choi, Dong Seop (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Anam Hospital) ;
  • Shin, Chol (Division of Respiratory and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital) ;
  • Kim, Nan Hee (Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Ansan Hospital)
  • Received : 2014.10.16
  • Accepted : 2015.01.30
  • Published : 2015.11.01
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Abstract

Background/Aims: Obstructive sleep apnea (OSA) is associated with an increased risk of obesity and non-alcoholic fatty liver disease (NAFLD), but it remains unclear whether the risk of NAFLD is independently related to OSA regardless of visceral obesity. Thus, the aim of the present study was to examine whether OSA alone or in combination with excessive daytime sleepiness (EDS) or short sleep duration was associated with NAFLD independent of visceral fat in Korean adults. Methods: A total of 621 participants were selected from the Korean Genome and Epidemiology Study (KoGES). The abdominal visceral fat area (VFA) and hepatic fat components of the participants were assessed using computed tomography scans and they were then categorized into four groups depending on the presence of OSA and EDS. Results: The proportions of NAFLD were 21.1%, 18.5%, 32.4%, and 46.7% in participants without OSA/EDS, with only EDS, with only OSA, and with both OSA and EDS, respectively. A combination of OSA and EDS increased the odds ratio (OR) for developing NAFLD (OR, 2.75; 95% confidence interval [CI], 1.21 to 6.28) compared to those without OSA/EDS, and this association remained significant (OR, 2.38; 95% CI, 1.01 to 5.59) even after adjusting for VFA. In short sleepers (< 5 hours) with OSA, the adjusted OR for NAFLD was 2.50 (95% CI, 1.08 to 5.75) compared to those sleeping longer than 5 hours without OSA. Conclusions: In the present study, OSA was closely associated with NAFLD in Korean adults. This association was particularly strong in those with EDS or short sleep duration regardless of VFA.

Keywords

Acknowledgement

Supported by : Korea Centers for Disease Control and Prevention

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