Abstract
PURPOSE: Snoring individuals, particularly those with obstructive sleep apnea (OSA), exhibit a higher prevalence of nonalcoholic fatty liver disease (NAFLD) and liver fibrosis. The objectives of this study were to explore potential screening biomarkers for NAFLD and liver fibrosis in the snoring population. METHODS: The research was carried out as a cross-sectional study at the Sleep Center of the First Affiliated Hospital of Fujian Medical University. All patients underwent FibroScan and overnight polysomnography (PSG). The 96-metabolism related proteins were detected using liquid chromatography-high resolution mass spectrometry (Oink Proteomics). RESULTS: A total of 59 NAFLD were found among the 87 snoring patients. A total of 12 proteins with differential expression levels were identified between non-NAFLD group and NAFLD group via Oink Proteomics. The correlation analysis revealed a close correlation between Cadherin 2 (CDH2) and NAFLD, liver fibrosis (with correlation coefficients of 0.394 and 0.383, respectively, both P < 0.05). The risk of NAFLD and liver fibrosis was much higher in snorers with higher levels of CHD2 compared with snorers with lower levels of CHD2 (both P < 0.05). A combination of CHD2, age, BMI, glucose, AHI and waistline presented the acceptable AUC for the detection of NAFLD and liver fibrosis in snoring patients (0.92, 95% CI: 0.86-0.98 and 0.81, 95% CI: 0.72-0.91, respectively, both p < 0.001). CONCLUSION: In snoring patients, higher level of CDH2 was identified as a risk factor for NAFLD and liver fibrosis; a combination of CDH2, age, BMI, glucose, AHI and waistline could act as a convenient and effective indicator for screening NAFLD and liver fibrosis. Future research should expand the sample size and conduct multicenter validation to further explore the value of CDH2.