Obstructive sleep apnea is associated with liver disease: a population-based cohort study

• A population-based study was used to assess the liver disease of people with obstructive sleep apnea (OSA).
• There was over a four-fold risk of liver diseases observed among people with OSA.
• Non-alcoholic fatty liver disease and viral hepatitis both need to be monitored in people with OSA.

BackgroundThe association between obstructive sleep apnea (OSA) and the risk of liver disease is unclear. Moreover, population-based studies on the risk of liver disease among people with OSA have not yet been conducted. This study aimed to investigate the risk of subsequent development of liver disease among people with OSA.MethodsUsing Taiwan National Health Insurance claims data, this study collected subjects from a cohort of 17,374 people with OSA who were diagnosed between 2000 and 2008. A control group of 69,496 people was selected from the same database and matched by age, gender, urbanization, income, and date of initial admission. All subjects were followed up until 2010. Liver disease incidence and risk were calculated.ResultsThe overall risk of liver disease among people with OSA was significantly higher than in the control group (aHR = 5.52, p < 0.001). Non-alcoholic fatty liver disease, cirrhosis, and hepatitis C had significant aHRs of 5.29, 7.50, and 7.19 (all at p < 0.001), respectively. In contrast, hepatitis B had the smallest aHR of 3.71.ConclusionsThe risk of liver disease was more than five times higher among people with OSA compared with the control group; this was particularly for cirrhosis and hepatitis C. Liver disease is thus a very important health issue among people with OSA.