{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,3]],"date-time":"2026-03-03T23:22:41Z","timestamp":1772580161633,"version":"3.50.1"},"reference-count":37,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T00:00:00Z","timestamp":1640131200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biology"],"abstract":"<jats:p>Background: The aim of this observational cohort study was to explore the severity of liver disease in patients with suspected obstructive sleep apnea in Germany. Methods: Patients undergoing polysomnography or home sleep apnea testing (HSAT) as an evaluation for the presence of OSA were screened using vibration-controlled transient elastography (VCTE) and continuous attenuation parameter (CAP) with a Fibroscan \u00ae Mini 430. Clinical and laboratory data were collected following the overnight exam. Results: In total, 78 patients (28 female (35.9%), mean age 54.2 years) with OSA defined by an apnea-hypopnea-index &gt;5 events\/hour were included between OCT 2020 and APR 2021. Patients exhibited a high metabolic risk profile with 17% known diabetes mellitus type 2 (T2D), 62% arterial hypertension, 14% hyperlipidemia and 36% BMI &gt; 30 kg\/m2. The prevalence of steatosis defined by a CAP &gt; 280 dB\/m was 54%. The prevalence of at least significant fibrosis was 16% (E &gt; 9.0 kPa). Interestingly, patients with a snoring index above the median of 278\/h showed significantly higher CAP-values (p = 0.0002). In addition, the proportion of oxygen saturations below 90% (t90) correlated with CAP-values (p = 0.02), as well as metabolic risk factors including increased waist circumference (p = 0.005) and body mass index (BMI) (p = 0.035). On the other hand, the apnea-hypopnea-index (AHI) as a marker of OSA severity did not correlate with VCTE, CAP or laboratory parameters. Conclusion: Patients with moderate to severe OSA have a high prevalence of hepatic steatosis. The snoring index is an easy-to-use clinical tool to identify patients at risk for relevant liver disease within the larger group of patients with OSA.<\/jats:p>","DOI":"10.3390\/biology11010010","type":"journal-article","created":{"date-parts":[[2021,12,22]],"date-time":"2021-12-22T10:24:52Z","timestamp":1640168692000},"page":"10","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["The Snoring Index Identifies Risk of Non-Alcoholic Fatty Liver Disease in Patients with Obstructive Sleep Apnea Syndrome"],"prefix":"10.3390","volume":"11","author":[{"given":"Katharina","family":"Bahr","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7996-4034","authenticated-orcid":false,"given":"Perikles","family":"Simon","sequence":"additional","affiliation":[{"name":"Department of Sports Medicine, Johannes-Gutenberg-University, 55122 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Barbara","family":"Leggewie","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany"},{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Bonn, 53127 Bonn, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7299-7346","authenticated-orcid":false,"given":"Haralampos","family":"Gouveris","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Surgery, University Medical Center Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4224-4703","authenticated-orcid":false,"given":"J\u00f6rn","family":"Schattenberg","sequence":"additional","affiliation":[{"name":"Metabolic Liver Research Program, I. Department of Medicine, University Medical Center Mainz, 55131 Mainz, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,12,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"310","DOI":"10.1016\/S2213-2600(15)00043-0","article-title":"Prevalence of sleep-disordered breathing in the general population: The HypnoLaus study","volume":"3","author":"Heinzer","year":"2015","journal-title":"Lancet Respir. Med."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"1929","DOI":"10.1053\/j.gastro.2020.02.020","article-title":"Metabolic Inflammation-A Role for Hepatic Inflammatory Pathways as Drivers of Comorbidities in Nonalcoholic Fatty Liver Disease?","volume":"158","author":"Gehrke","year":"2020","journal-title":"Gastroenterology"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Bahr, K., Geisler, V., Huppertz, T., Groppa, S., Matthias, C., Gouveris, H., and Muthuraman, M. 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