Novel screening model of obstructive sleep apnea for snorers with suspected NAFLD undergoing liver sonography

BMC Pulmonary Medicine

Yu-Chieh Weng¹  Yang-Bor Lu¹  Yung-Ning Huang¹  Ming-Shao Tsai²  Hui-Shan Hsieh³  Hsiung-Ying Huang⁴  Pei-Ting Cheng⁵ 

[1] Department of Digestive Disease, Xiamen Chang Gung Hospital, Xiamen, China;Hepatobiliary and Pancreatic Unit, Xiamen Chang Gung Hospital, Xiamen, China;Department of Otolaryngology–Head and Neck Surgery, Chiayi Chang Gung Memorial Hospital, No. 6, Sec. W., Jiapu Rd., 613, Puzi City, Chiayi County, Taiwan;College of Medicine, Chang Gung University, Taoyuan, Taiwan;Department of Otolaryngology–Head and Neck Surgery, Sleep Center, Xiamen Chang Gung Hospital, No. 123 Avenue Xiafei, Haicang District, 361028, Xiamen, Fujian, China;Department of Pulmonary and Critical Care Medicine, Sleep Center, Xiamen Chang Gung Hospital, Xiamen, China;Formosa Biomedical Technology Corp., Taipei, Taiwan;

关键词: Obstructive sleep apnea;    Elastography;    Fatty liver;    Steatosis;    Screen;   

DOI  :  10.1186/s12890-021-01759-1

来源: Springer

【 摘 要 】

Background/aimsGiven the increased incidence of obstructive sleep apnea (OSA) among patients with nonalcoholic fatty liver disease (NAFLD), noninvasive screening methods are urgently needed to screen for OSA risk in these patients when conducting an office-based assessment of hepatic steatosis. Therefore, we investigated the controlled attenuation parameter (CAP) and hepatic steatosis index (HSI) in patients with and without OSA and developed screening models to detect OSA.MethodsWe retrospectively reviewed the medical records of all adult snorers with suspected NAFLD undergoing liver sonography between June 2017 and June 2020. Records encompassed CAP and HSI data as well as data collected during in-hospital full-night polysomnography. The multivariate logistic regression models were constructed to explore the predictors of OSA risk. Furthermore, model validation was performed based on the medical records corresponding to the July 2020–June 2021 period.ResultsA total of 59 patients were included: 81.4% (48/59) were men, and the mean body mass index (BMI) was 26.4 kg/m2. Among the patients, 62.7% (37/59) and 74.6% (44/59) (detected by the HSI and CAP, respectively) had NAFLD, and 78% (46/59) were diagnosed with OSA on the basis of polysomnography. Three screening models based on multivariate analysis were established. The model combining male sex, a BMI of > 24.8, and an HSI of > 38.3 screened for OSA risk the most accurately, with an area under the receiver operating characteristic curve of 0.81 (sensitivity: 78%; specificity: 85%; and positive and negative predictive values: 95% and 52%, respectively) in the modeling cohort. An accuracy of 70.0% was achieved in the validation group.ConclusionsThe combination screening models proposed herein provide a convenient, noninvasive, and rapid screening tool for OSA risk and can be employed while patients receive routine hepatic check-ups. These models can assist physicians in identifying at-risk OSA patients and thus facilitate earlier detection and timely treatment initiation.

【 授权许可】

CC BY