P16 MASLD & OSA in the bariatric population: prevalence, predictors & outcomes

<h3>Background</h3> Obesity is a growing global epidemic affecting over one billion people. It is associated with a number of deleterious health sequelae, such as obstructive sleep apnea (OSA) and metabolic dysfunction-associated steatotic liver disease (MASLD). Emerging evidence suggests that the hypoxic and pro-inflammatory environment of OSA may contribute to MASLD development and progression. This study aimed to quantify the prevalence of OSA and MASLD in a bariatric cohort, explore whether OSA severity correlates with MASLD severity, and assess the impact of variables like HbA1c and gender. <h3>Methods</h3> A total of 71 patients from the St. Vincent’s Hospital Group who underwent bariatric surgery between February 2018 and April 2024 were included. All patients had preoperative polysomnography and intraoperative liver biopsies. Liver histology was scored using the NAFLD Activity Score (NAS) and Kleiner fibrosis staging, while OSA was graded according to the American Academy of Sleep Medicine (AASM) criteria. <h3>Results</h3> OSA was diagnosed in 94.4% of patients; MASLD was present in 85.9%, with 18.3% having metabolic dysfunction-associated steatohepatitis (MASH). Higher AHI and ODI scores correlated with more severe OSA, however gender, age, BMI, and HbA1c were not predictive of OSA severity. Interestingly, MASLD prevalence appeared to decrease with increasing OSA severity, though this may reflect limitations due to small sample size. <h3>Conclusion</h3> OSA and MASLD are highly prevalent in bariatric patients. Traditional risk factors did not correlate with OSA severity in this cohort. While OSA severity did not increase MASLD prevalence, it was linked to more advanced disease in affected individuals.