Pathophysiology of OSAS in Obese Children 8-17 Years Old

描述(申请人提供)：肥胖是当今儿科医生最关心的健康问题。在美国，几乎20%的儿童的体重指数(BMI)=95%的标准。纽约市的肥胖率特别高，2002-2003年西班牙裔儿童肥胖率达到31%，非裔美国儿童肥胖率达到23%。儿童肥胖相关的最重要风险之一是阻塞性睡眠呼吸暂停综合征(OSAS)，报告的患病率在46-59%之间，而普通儿科人口的患病率为2%。反过来，阻塞性睡眠呼吸暂停综合征会导致儿童严重的心血管疾病和认知疾病。然而，肥胖儿童OSAS的病理生理机制以及为什么一些肥胖儿童患有OSAS而另一些儿童没有，目前仍不清楚。加速的体细胞生长可能会影响呼吸道的大小和气道的溃散性。我们的儿科研究团队拥有睡眠、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、核磁共振和生物力学领域的专家，将使用新的非侵入性方法研究导致8-17岁市中心肥胖儿童OSAS的解剖、功能和机械机制。我们的主要焦点将是确定肥胖与OSAS相关的解剖和功能危险因素，这些因素对区分哪些肥胖儿童将患有或不会患有OSAS或发展为OSAS具有预测价值。此外，我们将确定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最关心的健康问题。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)。这项研究将利用生理学研究，结合新颖的成像和计算机方法，确定与8-17岁市中心儿童肥胖和阻塞性睡眠呼吸暂停综合征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.