Ingrid Jullian-Desayes1,2, Renaud Tamisier1,2, Jean-Pierre Zarski3, Judith Aron-Wisnewsky4,5, Sandrine H Launois-Rollinat1,2, Candice Trocme6, Patrick Levy1,2, Marie Joyeux-Faure1,2, Jean-Louis Pepin1,2. 1. HP2; INSERM, U1042, University Grenoble Alpes, Grenoble, France. 2. Laboratoire EFCR, Grenoble, France. 3. Hepato-Gastro-Enterology Department, CHU Grenoble, Grenoble, France. 4. Endocrinology and Nutrition Department, AP-HP, La Pitié-Salpétrière, Hospital, Paris, France. 5. Nutriomic Department, INSERM, UMRS 872, University Pierre and Marie Curie-Paris 6, Paris, France. 6. Biochemistry, Toxicology and Pharmacology Department, CHU Grenoble, Grenoble, France.
Abstract
BACKGROUND AND OBJECTIVE: Obstructive sleep apnoea (OSA) could be an independent risk factor for non-alcoholic fatty liver disease (NAFLD) occurrence and progression. The impact of continuous positive airway pressure (CPAP) treatment on non-invasive markers of NAFLD has not been studied. The aim of this study was to evaluate the effect of 6-12 weeks of effective CPAP on the FibroMax test (comprising components including the SteatoTest, NashTest and FibroTest) through three randomized sham controlled studies. METHODS: The FibroMax test was performed in 103 obstructive sleep apnoea patients (apnoea + hypopnoea index > 15/h) enrolled in a randomized study comparing sham versus effective CPAP. RESULTS: At baseline, 40.4% of patients in the sham CPAP group and 45.5% in the CPAP group exhibited liver steatosis. Furthermore, 39.6% of patients in the sham CPAP group and 58.4% in the CPAP group displayed borderline or possible non-alcoholic steatohepatitis (NASH). Six to twelve weeks of effective CPAP did not demonstrate any impact on reducing steatosis, NASH or liver fibrosis even after adjustment for gender, BMI, baseline apnoea + hypopnoea index and severity of liver injury. CONCLUSION: A number of non-invasive markers of liver damage are increased in untreated obstructive sleep apnoea patients, potentially contributing to cardiometabolic risk, but they do not improve after 6-12 weeks of effective CPAP treatment. CLINICAL TRIAL REGISTRATION: NCT01196845 (ADISAS), NCT00464659 (MneSAS) and NCT00669695 (StatinflaSAS) at ClinicalTrials.gov.
RCT Entities:
BACKGROUND AND OBJECTIVE:Obstructive sleep apnoea (OSA) could be an independent risk factor for non-alcoholic fatty liver disease (NAFLD) occurrence and progression. The impact of continuous positive airway pressure (CPAP) treatment on non-invasive markers of NAFLD has not been studied. The aim of this study was to evaluate the effect of 6-12 weeks of effective CPAP on the FibroMax test (comprising components including the SteatoTest, NashTest and FibroTest) through three randomized sham controlled studies. METHODS: The FibroMax test was performed in 103 obstructive sleep apnoeapatients (apnoea + hypopnoea index > 15/h) enrolled in a randomized study comparing sham versus effective CPAP. RESULTS: At baseline, 40.4% of patients in the sham CPAP group and 45.5% in the CPAP group exhibited liver steatosis. Furthermore, 39.6% of patients in the sham CPAP group and 58.4% in the CPAP group displayed borderline or possible non-alcoholic steatohepatitis (NASH). Six to twelve weeks of effective CPAP did not demonstrate any impact on reducing steatosis, NASH or liver fibrosis even after adjustment for gender, BMI, baseline apnoea + hypopnoea index and severity of liver injury. CONCLUSION: A number of non-invasive markers of liver damage are increased in untreated obstructive sleep apnoeapatients, potentially contributing to cardiometabolic risk, but they do not improve after 6-12 weeks of effective CPAP treatment. CLINICAL TRIAL REGISTRATION: NCT01196845 (ADISAS), NCT00464659 (MneSAS) and NCT00669695 (StatinflaSAS) at ClinicalTrials.gov.
Authors: Sushmita Pamidi; Susan Redline; David Rapoport; Indu Ayappa; Luciana Palombini; Ramon Farre; Jason Kirkness; Jean-Louis Pépin; Olli Polo; Andrew Wellman; R John Kimoff Journal: Ann Am Thorac Soc Date: 2017-07