Obesity & OSA: Understanding the Importance of Tongue Fat and Metabolic Function

描述(申请人提供)：睡眠呼吸暂停是一种常见的疾病，发病率很高，至少影响4%的中年男性和2%的中年女性。肥胖被认为是阻塞性睡眠呼吸暂停的最重要的危险因素，但我们不知道肥胖是如何导致睡眠呼吸暂停的。并不是所有的肥胖者都有睡眠呼吸暂停。这项建议的重点是通过检查舌头的组织特性和生物行为来了解肥胖和阻塞性睡眠呼吸暂停之间的关系。特别是，我们将使用高清晰度体积自旋回波磁共振成像、Dixon脂肪和水分成像以及磁共振波谱检查睡眠呼吸暂停患者和体重匹配对照组患者减肥前后的舌部代谢功能。减重将在一半的受试者和一半的受试者中通过医学和外科手术实现。准确了解肥胖如何影响上呼吸道功能是至关重要的，这样我们才能确定睡眠呼吸暂停患者更好的治疗方案和预防策略。这一建议是基于总体假设，即与体重匹配的对照组相比，睡眠呼吸暂停患者的舌头脂肪更多，新陈代谢活动更强。我们的具体目标是：1)比较无呼吸暂停患者和体重匹配对照组的舌和其他上呼吸道软组织结构的组织特性和代谢功能；以及2)确定这些结构在体重减轻后的组织特性和代谢功能的差异。我们的资源包括先进的静态和动态磁共振成像技术、新颖的体积计算机图形图像分析范例、世界知名的PET成像中心以及睡眠呼吸暂停生物统计、多导睡眠图、上呼吸道成像、减肥研究、Pcrit和舌力测量方面的专业知识，将使我们能够实现特定目标。 与公共健康相关：在这个国家，肥胖症正在达到流行的程度。肥胖是阻塞性睡眠呼吸暂停的最大风险因素，阻塞性睡眠呼吸暂停是一种以打鼾声、白天嗜睡和睡眠期间呼吸道关闭为特征的疾病。这笔赠款旨在了解肥胖和睡眠呼吸暂停之间的关系，以便我们能够确定针对这种疾病的最佳治疗策略。

DESCRIPTION (provided by applicant): Sleep apnea is a common disorder with significant morbidity that affects at least 4% of middle-aged males and 2% of middle-aged females. Obesity is thought to be the most important risk factor for obstructive sleep apnea yet we do not understand how obesity predisposes to sleep apnea. Not all obese subjects have sleep apnea. The focus of this proposal is directed towards understanding the relationship between obesity and obstructive sleep apnea by examining tissue properties and the biologic behavior of the tongue. In particular we will examine tongue fat with high definition volumetric spin echo MRI, Dixon imaging for fat and water and MR spectroscopy and the metabolic function of the tongue with PET imaging in patients with sleep apnea and weight matched controls before and after weight loss. Weight loss will be achieved medically in half the subjects and surgically in half of the subjects. It is critical to understand exactly how obesity affects upper airway function in order for us to determine better treatment options and preventive strategies for patients with sleep apnea. This proposal is based on the overall hypotheses that patients with sleep apnea will have more fat in the tongue and increased metabolic activity of the tongue as compared to weight matched controls. Our specific aims are: 1) To compare the tissue properties and metabolic function of the tongue and other upper airway soft tissue structures in apneics and weight-matched controls without apnea; and 2) to determine the differences in the tissue properties and metabolic function of the these structures after weight loss. Our resources, which include advanced static and dynamic MR imaging techniques, novel volumetric computer graphics image analysis paradigms, a world renown PET imaging center and expertise in sleep apnea biostatistics, polysomnography, imaging the upper airway, weight loss studies, Pcrit and tongue force measurements will allow us to achieve our specific aims. PUBLIC HEALTH RELEVANCE: Obesity is reaching epidemic proportions in this country. Obesity is the biggest risk factor for obstructive sleep apnea, a condition characterized by snoring, daytime sleepiness and airway closure during sleep. This grant is designed to understand the relationship between obesity and sleep apnea so that we can determine optimal treatment strategies for this disorder.