CPAP attenuates severity of nonalcoholic fatty liver disease in children
Treating sleep apnoea/nocturnal hypoxia in children using continuous positive airway pressure (CPAP) appears to improve the severity of nonalcoholic fatty liver disease (NAFLD), according to a recent study.
Researchers recruited nine paediatric patients with biopsy-confirmed NAFLD and obstructive sleep apnoea/nocturnal hypoxia. Blood samples were collected to measure concentrations of serum markers of NAFLD severity.
Participants were treated with CPAP for an average duration of 89±62 days with a mean usage per day of 296±126 minutes. The overall adherence was 73±24 percent. As expected, CPAP significantly improved total sleep time (p=0.002), the apnoea-hypopnoea index (p=0.03) and oxygen nadir (p=0.03). Mean scores in the Paediatric Daytime Sleepiness Scale did not significantly change.
Following CPAP treatment, significant improvements in biomarkers of liver injury were observed. For instance, the mean concentration of serum alanine aminotransferase significantly decreased (91±29 to 69±19 IU/L; p=0.02) while aspartate aminotransferase showed a trend toward improvement (60±17 to 51±12 IU/L; p=0.2).
Changes in serum biomarkers were not attributable to a reduction in body mass index, which increased significantly after CPAP (29.5±2.9 to 31.1±3.0 kg/m2; p=0.048).
There was likewise a significant drop in the mean concentrations of adiponectin (7.7±2.4 to 6.1±2.2; p=0.006) and urine F(2)-isoprostanes normalized to urine creatinine (654±191 to 352±157; p=0.02).
“These results further implicate obstructive sleep apnoea as a trigger of oxidative stress and injury that may promote the progression of paediatric [nonalcoholic steatohepatitis]. Therefore, treatment with CPAP may be a potential therapy for preventing the progression of NAFLD,” said researchers.