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World J Gastroenterol. Nov 21, 2022; 28(43): 6099-6108
Published online Nov 21, 2022. doi: 10.3748/wjg.v28.i43.6099
Management of non-alcoholic fatty liver disease patients with sleep apnea syndrome
Wei Sheng, Guang Ji, Li Zhang
Wei Sheng, Guang Ji, Li Zhang, Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai 200032, China
Author contributions: Sheng W performed the literature review and wrote the manuscript; Zhang L and Ji G conceptualized the idea, and critically reviewed and revised the manuscript; and all authors have read and approved the final manuscript.
Supported by the Project of Shanghai Hospital Development Center, No. SHDC2020CR4044.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Li Zhang, MD, PhD, Senior Scientist, Institute of Digestive Diseases, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, No. 725 South Wanping Road, Shanghai 200032, China. zhangli.hl@163.com
Received: September 24, 2022
Peer-review started: September 24, 2022
First decision: October 18, 2022
Revised: October 20, 2022
Accepted: November 6, 2022
Article in press: November 6, 2022
Published online: November 21, 2022
Processing time: 53 Days and 2.1 Hours
Abstract

Nonalcoholic fatty liver disease (NAFLD) is strongly associated with sleep apnea syndrome (SAS). Many NAFLD patients have SAS, and obstructive sleep apnea hypopnea syndrome is also considered to be an independent risk factor for NAFLD, as it contributes to the progression of NAFLD via oxidative stress, lipid peroxidation, inflammation, and insulin resistance. This review aims to provide some recommendations for the management of NAFLD patients with SAS, including diet, exercise, weight loss, and continuous positive airway pressure. This review also highlights the importance of effective strategies in NAFLD prevention and treatment.

Keywords: Nonalcoholic fatty liver disease; Sleep apnea syndrome; Obesity; Obstructive sleep apnea hypopnea syndrome; Continuous positive airway pressure; Management

Core Tip: Nonalcoholic fatty liver disease (NAFLD) is strongly associated with sleep apnea syndrome (SAS). This minireview presents the relationship between NAFLD and SAS; addresses the role of obesity, insulin resistance, and oxidative stress, and emphasizes the management of NAFLD with SAS, which mainly includes lifestyle interventions and continuous positive airway pressure therapy. This review also highlights the importance of effective strategies in NAFLD prevention and treatment.