Association of Obstructive Sleep Apnea with Nonalcoholic Fatty Liver Disease: Evidence, Mechanism, and Treatment

IF 3 2区医学 Q2 CLINICAL NEUROLOGY

Nature and Science of Sleep Pub Date : 2024-07-08 DOI:10.2147/nss.s468420

Lingling Wang, Huiguo Liu, Ling Zhou, Pengdou Zheng, Hai Li, Huojun Zhang, Wei Liu

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Abstract

Abstract: Obstructive sleep apnea (OSA), a common sleep-disordered breathing condition, is characterized by intermittent hypoxia (IH) and sleep fragmentation and has been implicated in the pathogenesis and severity of nonalcoholic fatty liver disease (NAFLD). Abnormal molecular changes mediated by IH, such as high expression of hypoxia-inducible factors, are reportedly involved in abnormal pathophysiological states, including insulin resistance, abnormal lipid metabolism, cell death, and inflammation, which mediate the development of NAFLD. However, the relationship between IH and NAFLD remains to be fully elucidated. In this review, we discuss the clinical correlation between OSA and NAFLD, focusing on the molecular mechanisms of IH in NAFLD progression. We meticulously summarize clinical studies evaluating the therapeutic efficacy of continuous positive airway pressure treatment for NAFLD in OSA. Additionally, we compile potential molecular biomarkers for the co-occurrence of OSA and NAFLD. Finally, we discuss the current research progress and challenges in the field of OSA and NAFLD and propose future directions and prospects.

Keywords: intermittent hypoxia, hypoxia-inducible factor 1 alpha, nonalcoholic fatty liver disease, oxidative stress, dyslipidemia, leptin resistance

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阻塞性睡眠呼吸暂停与非酒精性脂肪肝的关系：证据、机制和治疗

摘要：阻塞性睡眠呼吸暂停（OSA）是一种常见的睡眠呼吸障碍疾病，以间歇性缺氧（IH）和睡眠片段为特征，与非酒精性脂肪肝（NAFLD）的发病机制和严重程度有关。据报道，由 IH 介导的异常分子变化，如缺氧诱导因子的高表达，参与了异常病理生理状态，包括胰岛素抵抗、异常脂质代谢、细胞死亡和炎症，从而介导了非酒精性脂肪肝的发展。然而，IH 与非酒精性脂肪肝之间的关系仍有待全面阐明。在这篇综述中，我们讨论了 OSA 和 NAFLD 之间的临床相关性，重点研究了 IH 在 NAFLD 发展过程中的分子机制。我们仔细总结了评估持续气道正压治疗对 OSA 非酒精性脂肪肝疗效的临床研究。此外，我们还整理了 OSA 和 NAFLD 并发症的潜在分子生物标志物。关键词：间歇性缺氧；低氧诱导因子 1α；非酒精性脂肪肝；氧化应激；血脂异常；瘦素抵抗。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.