Elevated Serum Aminotransferase Levels in Children at Risk for Obstructive Sleep Apnea

BackgroundFatty liver disease (FLD) is a highly prevalent condition in obese (Ob) children, who are at increased risk for obstructive sleep apnea (OSA). However, the contribution of OSA to FLD remains unknown.DesignProspective study.SettingPolysomnographic evaluation and assessment of plasma levels of insulin, glucose, and lipids, and liver function tests.ParticipantsA total of 518 consecutive snoring children 4 to 17 years of age who were being evaluated for habitual snoring and suspected OSA.ResultsA total of 376 children had body mass index z score of < 1.20 (non-Ob children), 3 children (<1%) had elevated serum aminotransferase (LFT) levels, and 248 had OSA (65.9%). Among the 142 overweight/Ob children, 46 had elevated LFT levels (32.4%); of these children, 42 had OSA (91.3%). In contrast, OSA was present in only 71.8% of Ob children without elevated LFT level (p < 0.01). Insulin resistance and hyperlipidemia were more likely to occur in children with FLD. Furthermore, FLD was improved after treatment of OSA in 32 of 42 Ob children (p < 0.0001).ConclusionIncreased liver enzyme levels are frequently found in Ob snoring children, particularly among those with OSA and/or metabolic dysfunction. Effective treatment of OSA results in improved liver function test results in the vast majority of these patients.