Nonalcoholic steatohepatitis in bariatric patients with a diagnosis of obstructive sleep apnea

Toby N. Weingarten, Carlos Bernardo Mantilla, James M. Swain, Michael L. Kendrick, Jeff M. Oberhansley, Robert J. Burcham, Tarsila C R Ribeiro, Kymberly D. Watt, Darrell R. Schroeder, Bradly J. Narr, Juraj Sprung

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Objective: To study a possible association between obstructive sleep apnea (OSA) severity, managed with noninvasive ventilation, and nonalcoholic steatohepatitis (NASH) in bariatric surgical patients. Methods: Medical records of 218 bariatric surgical patients who underwent liver biopsy were reviewed. OSA severity was determined from preoperative polysomnography (apnea-hypopnea index (AHI) ≤ 15 no/mild OSA vs. AHI ≥ 16 moderate/severe OSA). Patients diagnosed with OSA were prescribed noninvasive ventilation. Patients were categorized according to liver histopathology into 3 groups: i) no liver disease or simple steatosis, ii) mild NASH (steatosis with necroinflammation and mild fibrosis (stage 0-1)), and iii) advanced NASH (steatosis with necroinflammation and more advanced fibrosis (stage ≥ 2)). Results: 125 patients (57%) had no/mild OSA, and 93 (43%) had moderate/severe OSA. There was no difference in serum aminotransferases between patients by OSA severity classification. There was a high prevalence of hepatic histopathological abnormalities: 84% patients had steatosis, 57% had necroinflammation, 34% had fibrotic changes, and 14% had advanced NASH. There was no association between severity of NASH and severity of OSA. Conclusions: There is no association between stage of steatohepatitis and OSA severity among morbidly obese patients managed with noninvasive ventilation.

Original languageEnglish (US)
Pages (from-to)587-596
Number of pages10
JournalObesity Facts
Volume5
Issue number4
DOIs
StatePublished - Sep 2012

Fingerprint

Bariatrics
Obstructive Sleep Apnea
sleep
Noninvasive Ventilation
Apnea
Liver
Fibrosis
Non-alcoholic Fatty Liver Disease
Polysomnography
Fatty Liver
Transaminases
Medical Records
Liver Diseases
Disease

Keywords

  • Fatty liver disease
  • Metabolic syndrome
  • Steatohepatitis

ASJC Scopus subject areas

  • Physiology (medical)
  • Health(social science)

Cite this

Weingarten, T. N., Mantilla, C. B., Swain, J. M., Kendrick, M. L., Oberhansley, J. M., Burcham, R. J., ... Sprung, J. (2012). Nonalcoholic steatohepatitis in bariatric patients with a diagnosis of obstructive sleep apnea. Obesity Facts, 5(4), 587-596. https://doi.org/10.1159/000342677

Nonalcoholic steatohepatitis in bariatric patients with a diagnosis of obstructive sleep apnea. / Weingarten, Toby N.; Mantilla, Carlos Bernardo; Swain, James M.; Kendrick, Michael L.; Oberhansley, Jeff M.; Burcham, Robert J.; Ribeiro, Tarsila C R; Watt, Kymberly D.; Schroeder, Darrell R.; Narr, Bradly J.; Sprung, Juraj.

In: Obesity Facts, Vol. 5, No. 4, 09.2012, p. 587-596.

Research output: Contribution to journalArticle

Weingarten, TN, Mantilla, CB, Swain, JM, Kendrick, ML, Oberhansley, JM, Burcham, RJ, Ribeiro, TCR, Watt, KD, Schroeder, DR, Narr, BJ & Sprung, J 2012, 'Nonalcoholic steatohepatitis in bariatric patients with a diagnosis of obstructive sleep apnea', Obesity Facts, vol. 5, no. 4, pp. 587-596. https://doi.org/10.1159/000342677
Weingarten, Toby N. ; Mantilla, Carlos Bernardo ; Swain, James M. ; Kendrick, Michael L. ; Oberhansley, Jeff M. ; Burcham, Robert J. ; Ribeiro, Tarsila C R ; Watt, Kymberly D. ; Schroeder, Darrell R. ; Narr, Bradly J. ; Sprung, Juraj. / Nonalcoholic steatohepatitis in bariatric patients with a diagnosis of obstructive sleep apnea. In: Obesity Facts. 2012 ; Vol. 5, No. 4. pp. 587-596.
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abstract = "Objective: To study a possible association between obstructive sleep apnea (OSA) severity, managed with noninvasive ventilation, and nonalcoholic steatohepatitis (NASH) in bariatric surgical patients. Methods: Medical records of 218 bariatric surgical patients who underwent liver biopsy were reviewed. OSA severity was determined from preoperative polysomnography (apnea-hypopnea index (AHI) ≤ 15 no/mild OSA vs. AHI ≥ 16 moderate/severe OSA). Patients diagnosed with OSA were prescribed noninvasive ventilation. Patients were categorized according to liver histopathology into 3 groups: i) no liver disease or simple steatosis, ii) mild NASH (steatosis with necroinflammation and mild fibrosis (stage 0-1)), and iii) advanced NASH (steatosis with necroinflammation and more advanced fibrosis (stage ≥ 2)). Results: 125 patients (57{\%}) had no/mild OSA, and 93 (43{\%}) had moderate/severe OSA. There was no difference in serum aminotransferases between patients by OSA severity classification. There was a high prevalence of hepatic histopathological abnormalities: 84{\%} patients had steatosis, 57{\%} had necroinflammation, 34{\%} had fibrotic changes, and 14{\%} had advanced NASH. There was no association between severity of NASH and severity of OSA. Conclusions: There is no association between stage of steatohepatitis and OSA severity among morbidly obese patients managed with noninvasive ventilation.",
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AU - Oberhansley, Jeff M.

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