Association between obstructive sleep apnea and metabolic fatty liver disease in the US population: a study based on the 2017-2018 NHANES database.

Abstract

Abstract BACKGROUND We included participants aged 18 years or older from the 2017–2018 National Health and Nutrition Examination Survey (NHANES).METHODS The association between obstructive sleep apnea (OSA) score and metabolic fatty liver disease (MAFLD) was assessed using weighted univariate and multivariate logistic regression and restricted cubic spline (RCS). Interaction and subgroup analyses and sensitivity analyses were also performed to assess the stability of the results.RESULTS Of the 4263 participants in this study, the mean age was 46.59 years, of which 2175 (51.02%) were female and 2379 (55.81%) had metabolic fatty liver disease. In multivariate logistic regression analyses, metabolic fatty liver was positively associated with metabolic fatty liver in all models except education and aspartate aminotransferase. Multivariable-adjusted restricted triple spline analysis in women showed a linear association between OSA.MAP score and risk of MAFLD (linear p < 0.001), with a median OSA.MAP of 0. 241.In the OSA.MAP score of (0.635,0.998], the OR (95% CI) for women was 7.94 (2.54,24.80). In subgroup analyses, OSA risk scores (< 0.5 low risk, >=0.5 high-risk groups) were associated with sex (interaction P = 0.06), age (interaction P = 0.01), and smoking (interaction P = 0.03). In sensitivity analyses, the association between OSA symptoms and metabolic fatty liver remained stable after adjusting for AST and education or performing up to three-quartile category sensitivity analyses.CONCLUSION Metabolic fatty liver severity may be related to the degree of OSA symptoms. This association was particularly found in female participants.