Clinical studyEffects of obstructive sleep apnea syndrome on serum aminotransferase levels in obese patients☆
Section snippets
Subjects
We studied 44 consecutive patients (41 men, 3 women; mean [± SD] age, 47 ± 12 years) with obstructive sleep apnea syndrome who were determined by polysomnography and clinical symptoms to be candidates for nasal CPAP treatment (2). Polysomnography was performed in the hospital before CPAP treatment and on the first night of CPAP therapy 1 week later. All patients were obese by Japanese criteria (body mass index >25 kg/m2). We could not obtain blood from 2 patients, and samples from 2 other
Results
Patients were middle-aged men with minimal use of alcohol (Table 1). All but 1 patient ingested less than 30 g/d of alcohol; that patient ingested 50 g/d. There was no past history of alcohol ingestion greater than 30 g/d. The ratio of the levels of alanine to aspartate aminotransferase was >1 in 35 (88%) of the 40 patients, whereas the ratio of visceral to subcutaneous was >0.4 (the criterion for visceral obesity) in 37 (97%) of the 38 patients in whom it was measured. Eleven patients had
Discussion
We found that about one third of obese patients with moderate or severe obstructive sleep apnea had abnormal aminotransferase levels, and that aminotransferase levels correlated significantly with insulin resistance. Results from a single night of nasal CPAP treatment, as well as from other reports 3, 4, 5, 23, suggest that recurrent apnea and hypopnea with hypoxemia may aggravate hepatic dysfunction in these patients, as manifest by release of aspartate aminotransferase, a well-established
Acknowledgements
We are grateful to Tomoko Toki for manuscript preparation.
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2016, Physiology and BehaviorCitation Excerpt :This may further suggest that CPAP affects EI by targeting the homeostatic as opposed to hedonic regulation of EI. Indeed, CPAP may alter EI by normalizing levels of hunger/satiety hormones, as was reported after CPAP use for ghrelin [4,5,11,23] and leptin [2,5,6,24–29]. Based on reports of increased activation in brain regions involved in motivation and reward in response to food stimuli after sleep restriction [30], future investigations should extend beyond homeostatic/hormonal mechanisms to explore if and how CPAP treatment affects the hedonic and/or cognitive controls of food intake, using functional magnetic resonance imaging.
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This work was supported in part by grants from the Tahei Ueda Memorial Fund; the Japan Vascular Disease Research Foundation; the Japanese Ministry of Education, Culture, Sports, Science, and Technology; and the Japanese Ministry of Health, Labour and Welfare.