A Bidirectional Association Between Obstructive Sleep Apnea and Metabolic-Associated Fatty Liver Disease

Obesity is considered a twentieth-century epidemic and is a growing concern among health professionals. Obesity and its complications contribute to multiple chronic illnesses , such as type 2 diabetes (T2D), metabolic syndrome , obstructive sleep apnea (OSA), malignancy , and cardiovascular and liver diseases. In the last two decades, a bidirectional association between OSA and metabolic-associated fatty liver disease (MAFLD), independent of obesity, has been established. Both conditions have similar risk factors and metabolic comorbidities that may imply a common disease pathway. This review compiles the evidence and delineates the relationship between OSA and MAFLD from a clinical and diagnostic aspect.