Pathophysiology of OSAS in Obese Children 8-17 Years Old

8-17 岁肥胖儿童 OSAS 的病理生理学

• 批准号: 7588797
• 负责人: Raanan Arens
• 金额: $ 50.74万
• 依托单位: ALBERT EINSTEIN COLLEGE OF MEDICINE
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-03-20 至 2012-12-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7588797
• 关键词: 17 year old; Abdomen; Accounting; Adenoidal structure; Adolescence; Adolescent Medicine; Affect; African; African American; Americas; Anatomy; Apnea; Architecture; Area; Biomechanics; Biometry; Body Weight Changes; Body Weight decreased; Body mass index; Breathing; Cardiovascular system; Child; Childhood; Cognitive; Continuous Positive Airway Pressure; Coupled; Data; Development; Devices; Dimensions; Enrollment; Epidemiology; Fatty acid glycerol esters; Functional disorder; Growth; Health; Hispanics; Hour; Hypertrophy; Image; Length; Liquid substance; Magnetic Resonance Imaging; Measurement; Measures; Mechanics; Methodology; Monitor; Morbidity - disease rate; Morphology; Neck; New York City; Obesity; Obstructive Sleep Apnea; Operative Surgical Procedures; Patients; Phase; Physiological; Population; Predictive Value; Prevalence; Public Health; Pulmonology; Recruitment Activity; Relative (related person); Reporting; Research Design; Research Personnel; Resistance; Respiration; Risk; Risk Factors; Scheme; Severities; Sex Characteristics; Sleep; Structure; Tonsil; Visceral; Wakefulness; Weight Gain; Weight maintenance regimen; base; computerized; indexing; inner city; novel; novel strategies; nutrition; pediatrician; pharyngeal critical pressure; pressure; programs; respiratory; soft tissue; subcutaneous

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.

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20%的儿童的体重指数（BMI）=第95百分位标准。纽约市的肥胖患病率特别高，2002-2003年西班牙裔儿童和非洲裔美国儿童的肥胖患病率分别达到31%和23%。儿童最重要的肥胖相关风险之一是阻塞性睡眠呼吸暂停综合征（OSAS），据报道患病率在46-59%之间，而一般儿科人群的患病率为2%。OSAS反过来又会导致儿童的心血管和认知疾病。然而，肥胖儿童OSAS的病理生理学以及为什么一些肥胖儿童患有OSAS而另一些儿童则没有仍然未知。加速的体细胞生长可能会损害气道大小以及气道可扩张性。我们的儿科研究人员团队具有睡眠，肺病学，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，将使用新型非侵入性方法研究导致8-17岁内城肥胖儿童OSAS的解剖，功能和机械机制。我们的主要重点将是确定与肥胖OSAS相关的解剖学和功能性危险因素，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，我们将确定如何腺样体切除术和体重变化（体重减轻和体重增加）修改上述提出的机制，导致阻塞性睡眠呼吸暂停综合征在这组儿童。项目叙述：肥胖是当今儿科医生的头号健康问题。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）。这项研究将使用生理研究结合新型成像和计算机化方法来确定与8-17岁内城儿童肥胖和阻塞性睡眠呼吸暂停综合症相关的解剖和功能风险因素。