Premium
Association between obstructive sleep apnea and non‐alcoholic fatty liver disease in pediatric patients: a meta‐analysis
Author(s) -
Chen LiDa,
Chen MengXue,
Chen GongPing,
Lin XueJun,
Huang JieFeng,
Zeng AiMing,
Huang YaPing,
Lin QiChang
Publication year - 2021
Publication title -
pediatric obesity
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.226
H-Index - 69
eISSN - 2047-6310
pISSN - 2047-6302
DOI - 10.1111/ijpo.12718
Subject(s) - medicine , fatty liver , obstructive sleep apnea , gastroenterology , confounding , meta analysis , obesity , population , steatohepatitis , nonalcoholic fatty liver disease , alanine aminotransferase , metabolic syndrome , subgroup analysis , disease , environmental health
Summary Background Some studies have reported a relationship between obstructive sleep apnea (OSA) and non‐alcoholic fatty liver disease (NAFLD) in pediatric population. However, this issue remains controversial. Objectives The purpose of the present study was to investigate the association between OSA and NAFLD in pediatric population. Methods We systematically searched PubMed, Web of Science, Embase for eligible studies. The data involving markers of NAFLD including alanine aminotransferase (ALT), aspartate aminotransferase (AST), hepatic inflammation, hepatic fibrosis of both OSA group and control group were extracted. Pooled standardised mean difference (SMD) and weighted mean difference (WMD) were appropriately calculated through a fixed or random‐effect model. Results Nine cross‐sectional studies with 1133 children and adolescents were included. OSA was significantly associated with ALT, AST, and NAFLD fibrosis stage, but not NAFLD inflammation grade. Subgroup analysis indicated that both mild OSA and severe OSA were significantly associated with elevated ALT and AST. Furthermore, in the studies with all main confounding factors (age, gender, and BMI) matched, OSA group had higher ALT and AST levels than control group. Conclusions This meta‐analysis suggested that OSA was associated with NAFLD evidenced by elevated liver enzymes and progressive hepatic fibrosis in pediatric population. Screening and monitoring of NAFLD in pediatric patients with obesity‐related OSA are necessary.