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Title: Impact of obstructive sleep apnea on liver fat accumulation according to sex and visceral obesity
Authors: Toyama, Yoshiro
Tanizawa, Kiminobu  kyouindb  KAKEN_id
Kubo, Takeshi  kyouindb  KAKEN_id
Chihara, Yuichi
Harada, Yuka
Murase, Kimihiko
Azuma, Masanori
Hamada, Satoshi
Hitomi, Takefumi  kyouindb  KAKEN_id
Handa, Tomohiro
Oga, Toru
Chiba, Tsutomu
Mishima, Michiaki
Chin, Kazuo
Author's alias: 外山, 善朗
谷澤, 公伸
久保, 武
濱田, 哲
人見, 健文
半田, 知宏
小賀, 徹
千葉, 勉
三嶋, 理晃
陳, 和夫
Issue Date: 15-Jun-2015
Publisher: Public Library of Science
Journal title: PLOS ONE
Volume: 10
Issue: 6
Thesis number: e0129513
Abstract: Rationale: Associations between obstructive sleep apnea (OSA) and liver fat accumulation have been frequently investigated because both morbidities are common. Visceral fat was reported to be closely related to OSA and liver fat accumulation. Recently, sex differences in the association between OSA and mortality have gained much attention. Objectives: To investigate the associations among OSA, liver fat accumulation as determined by computed tomography, and visceral fat area and their sex differences. Methods: Studied were 188 males and 62 females who consecutively underwent polysomnography and computed tomography. Results: Although the apnea-hypopnea index was positively correlated with liver fat accumulation in the total males, none of the OSA-related factors was independently associated with liver fat accumulation in either the total male or female participants in the multivariate analyses. When performing subanalyses using a specific definition for Japanese of obesity or visceral obesity (body mass index (BMI) ≥25 kg/m<sup>2</sup> or visceral fat area ≥100 cm<sup>2</sup>), in only males without visceral obesity, percent sleep time with oxygen saturation <90%, in addition to BMI, insulin resistance, and serum triglyceride values, was independently correlated with liver fat accumulation (R<sup>2</sup> = 15.1%, P<0.001). In males, percent sleep time of oxygen saturation <90% was also a determining factor for alanine aminotransferase values regardless of visceral fat area. In contrast, OSA was not associated with liver fat accumulation or alanine aminotransferase values in females whether or not visceral obesity was absent. Conclusions: Sex differences in the visceral fat-dependent impact of OSA on liver fat accumulation existed. Although the mechanisms are not known and ethnic differences may exist in addition to the specific criteria of visceral obesity in Japan, the treatment of male patients with OSA might be favorable from the viewpoint of preventing liver fat accumulation and liver dysfunction even in patients without obvious visceral fat accumulation.
Rights: © 2015 Toyama et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
DOI(Published Version): 10.1371/journal.pone.0129513
PubMed ID: 26076443
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