Pathophysiology of OSAS in Obese Children 8-17 Years Old

描述（由申请人提供）：肥胖是当今儿科医生的头号健康问题。在美国，几乎有20%的儿童的身体质量指数(BMI) = 95百分位标准。纽约市的肥胖率特别高，2002-2003年西班牙裔儿童和非裔美国儿童的肥胖率分别达到31%和23%。对儿童来说，与肥胖相关的最重要的风险之一是阻塞性睡眠呼吸暂停综合征（OSAS），据报道其患病率在46% -59%之间，而普通儿科人群的患病率为2%。反过来，OSAS又会导致儿童显著的心血管和认知疾病。然而，肥胖儿童阻塞性睡眠呼吸暂停的病理生理机制以及为什么有些肥胖儿童患有阻塞性睡眠呼吸暂停而有些儿童没有的原因尚不清楚。加速的躯体生长可能损害气道的大小以及气道的溃散性。我们的儿科研究团队拥有睡眠、肺脏学、公共卫生、营养和青少年医学方面的专业知识，加上流行病学和生物统计学、MRI和生物力学领域的专家，将使用新颖的无创方法研究导致8-17岁市中心肥胖儿童OSAS的解剖、功能和力学机制。我们的主要重点将是确定与肥胖相关的OSAS解剖和功能风险因素，这些因素对区分肥胖儿童是否患有或发展为OSAS具有预测价值。此外，我们将确定腺扁桃体切除术和体重变化（体重减轻和体重增加）如何改变上述提出的导致这组儿童OSAS的机制。项目简介：肥胖是当今儿科医生关注的头号健康问题。肥胖儿童最重要的相关风险之一是阻塞性睡眠呼吸暂停综合征（OSAS）。本研究将利用生理学研究结合新型成像和计算机化方法，确定与8-17岁市中心儿童肥胖和OSAS相关的解剖和功能危险因素。

DESCRIPTION (provided by applicant): Obesity is the number one health concern for pediatricians today. Almost 20% of children in the United Sates have a body mass index (BMI) = 95th percentile standard. The prevalence of obesity in New York City is particularly high and reached 31% in Hispanic and 23% in African American children in 2002-2003. One of the most important obesity-associated risks for children is obstructive sleep apnea syndrome (OSAS), with a reported prevalence rate between 46-59% compared with 2% in the general pediatric population. OSAS in turn, contributes to significant cardiovascular and cognitive morbidities in children. However, the pathophysiology of OSAS in obese children and why some obese children have OSAS while others do not is still unknown. Accelerated somatic growth may compromise airway size as well as airway collapsibility. Our team of pediatric researchers with expertise in sleep, pulmonology, public health, nutrition, and adolescent medicine, coupled with experts in the field of epidemiology and biostatistics, MRI, and biomechanics will study the anatomical, functional, and mechanical mechanisms leading to OSAS in inner city obese children 8-17 years of age using novel non-invasive methodologies. Our main focus will be to determine the anatomic and functional risk factors relating obesity to OSAS that have predictive value for distinguishing between obese children who will or will not have or develop OSAS. Further, we will determine how adenotonsillectomy and weight changes (both weight loss and weight gain) modify the above proposed mechanisms leading to OSAS in this group of children. Project Narrative: Obesity is the number one health concern for pediatricians today. One of the most important associated risks for obese children is obstructive sleep apnea syndrome (OSAS). This study will determine the anatomic and functional risk factors related to obesity and OSAS in inner city children 8-17 years of age using physiological studies coupled with novel imaging and computerized methodology.