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

肥胖

• 批准号: 7689181
• 负责人: Richard J. Schwab
• 金额: $ 61.73万
• 依托单位: UNIVERSITY OF PENNSYLVANIA
• 依托单位国家: 美国
• 财政年份: 2008
• 资助国家: 美国
• 起止时间: 2008-09-20 至 2012-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7689181
• 关键词: Accounting; Address; Affect; Age; Apnea; Arrhythmia; Arts; Behavior; Biometry; Body Weight decreased; Cardiovascular system; Computer Graphics; Country; Data; Deposition; Disease; Epidemic; Ethnic Origin; Fatty acid glycerol esters; Female; Financial compensation; Fostering; Gender; Grant; Hypertension; Image; Image Analysis; Imaging Techniques; Lateral; Lead; Link; MRI Scans; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Measurement; Measures; Metabolic; Methods; Morbidity - disease rate; Muscle; Myocardial Infarction; Obesity; Obstructive Sleep Apnea; Odds Ratio; Patients; Physiological; Polysomnography; Positron-Emission Tomography; Prevention strategy; Property; Protocols documentation; Public Health; Research; Resources; Risk; Risk Factors; Secondary to; Sleep; Sleep Apnea Syndromes; Snoring; Soft Palate; Stroke; Structure; Techniques; Tissues; Tongue; Visceral; Wakefulness; Water; Weight; Weight Gain; Woman; abdominal fat; base; case control; craniofacial; design; indexing; male; men; metabolic abnormality assessment; middle age; muscle form; neuromuscular; novel; pharyngeal critical pressure; public health relevance; reconstruction; soft tissue; tongue volume; treatment strategy; vehicular accident

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.

描述（由申请人提供）：睡眠呼吸暂停是一种发病率很高的常见疾病，影响至少 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最重要的危险因素，但我们不了解肥胖如何导致睡眠呼吸暂停。并非所有肥胖受试者都患有睡眠呼吸暂停。该提案的重点是通过检查组织特性和舌头的生物学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，我们将通过高清体积自旋回波 MRI、脂肪和水的 Dixon 成像以及 MR 光谱检查舌头脂肪，并通过 PET 成像检查减肥前后睡眠呼吸暂停患者和体重匹配对照患者的舌头代谢功能。一半的受试者将通过药物减肥，一半的受试者将通过手术减肥。准确了解肥胖如何影响上呼吸道功能至关重要，以便我们为睡眠呼吸暂停患者确定更好的治疗方案和预防策略。该提议基于总体假设，即与体重匹配的对照相比，睡眠呼吸暂停患者的舌头中脂肪较多，舌头的代谢活动增加。我们的具体目标是： 1) 比较呼吸暂停患者和无呼吸暂停的体重匹配对照中舌头和其他上呼吸道软组织结构的组织特性和代谢功能； 2）确定减肥后这些结构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 MR 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学、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我们的具体目标。 公共卫生相关性：肥胖在这个国家已达到流行病的程度。肥胖是阻塞性睡眠呼吸暂停的最大危险因素，这种疾病的特点是打鼾、白天嗜睡和睡眠时气道闭合。这笔赠款旨在了解肥胖与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。