BACKGROUND: Fatty liver disease (FLD) is a highly prevalent condition in obese (Ob) children, who are at increased risk for obstructive sleep apnea (OSA). However, the contribution of OSA to FLD remains unknown. DESIGN: Prospective study. SETTING: Polysomnographic evaluation and assessment of plasma levels of insulin, glucose, and lipids, and liver function tests. PARTICIPANTS: A total of 518 consecutive snoring children 4 to 17 years of age who were being evaluated for habitual snoring and suspected OSA. RESULTS: A total of 376 children had body mass index z score of < 1.20 (non-Ob children), 3 children (<1%) had elevated serum aminotransferase (LFT) levels, and 248 had OSA (65.9%). Among the 142 overweight/Ob children, 46 had elevated LFT levels (32.4%); of these children, 42 had OSA (91.3%). In contrast, OSA was present in only 71.8% of Ob children without elevated LFT level (p < 0.01). Insulin resistance and hyperlipidemia were more likely to occur in children with FLD. Furthermore, FLD was improved after treatment of OSA in 32 of 42 Ob children (p < 0.0001). CONCLUSION: Increased liver enzyme levels are frequently found in Ob snoring children, particularly among those with OSA and/or metabolic dysfunction. Effective treatment of OSA results in improved liver function test results in the vast majority of these patients.
BACKGROUND:Fatty liver disease (FLD) is a highly prevalent condition in obese (Ob) children, who are at increased risk for obstructive sleep apnea (OSA). However, the contribution of OSA to FLD remains unknown. DESIGN: Prospective study. SETTING: Polysomnographic evaluation and assessment of plasma levels of insulin, glucose, and lipids, and liver function tests. PARTICIPANTS: A total of 518 consecutive snoring children 4 to 17 years of age who were being evaluated for habitual snoring and suspected OSA. RESULTS: A total of 376 children had body mass index z score of < 1.20 (non-Ob children), 3 children (<1%) had elevated serum aminotransferase (LFT) levels, and 248 had OSA (65.9%). Among the 142 overweight/Ob children, 46 had elevated LFT levels (32.4%); of these children, 42 had OSA (91.3%). In contrast, OSA was present in only 71.8% of Ob children without elevated LFT level (p < 0.01). Insulin resistance and hyperlipidemia were more likely to occur in children with FLD. Furthermore, FLD was improved after treatment of OSA in 32 of 42 Ob children (p < 0.0001). CONCLUSION: Increased liver enzyme levels are frequently found in Ob snoring children, particularly among those with OSA and/or metabolic dysfunction. Effective treatment of OSA results in improved liver function test results in the vast majority of these patients.
Authors: Mirja Quante; Rui Wang; Jia Weng; Carol L Rosen; Raouf Amin; Susan L Garetz; Eliot Katz; Shalini Paruthi; Raanan Arens; Hiren Muzumdar; Carole L Marcus; Susan Ellenberg; Susan Redline Journal: Sleep Date: 2015-09-01 Impact factor: 5.849
Authors: Shikha S Sundaram; Ronald J Sokol; Kelley E Capocelli; Zhaoxing Pan; Jillian S Sullivan; Kristen Robbins; Ann C Halbower Journal: J Pediatr Date: 2013-12-07 Impact factor: 4.406
Authors: Vsevolod Y Polotsky; Susheel P Patil; Vladimir Savransky; Alison Laffan; Shannon Fonti; Leigh A Frame; Kimberly E Steele; Michael A Schweizter; Jeanne M Clark; Michael S Torbenson; Alan R Schwartz Journal: Am J Respir Crit Care Med Date: 2008-10-31 Impact factor: 21.405
Authors: Jonathan Jun; Vladimir Savransky; Ashika Nanayakkara; Shannon Bevans; Jianguo Li; Philip L Smith; Vsevolod Y Polotsky Journal: Am J Physiol Regul Integr Comp Physiol Date: 2008-08-13 Impact factor: 3.619