Jugé Lauriane, Olsza Ida, Knapman Fiona L, Burke Peter G R, Brown Elizabeth C, Stumbles Emma, Bosquillon de Frescheville Anne France, Gandevia Simon C, Eckert Danny J, Butler Jane E, Bilston Lynne E
Neuroscience Research Australia, Sydney, NSW, Australia.
University of New South Wales, Sydney, NSW, Australia.
Sleep. 2021 Dec 10;44(12). doi: 10.1093/sleep/zsab192.
To investigate the effect of upper airway fat composition on tongue inspiratory movement and obstructive sleep apnea (OSA).
Participants without or with untreated OSA underwent a 3T magnetic resonance imaging (MRI) scan. Anatomical measurements were obtained from T2-weighted images. Mid-sagittal inspiratory tongue movements were imaged using tagged MRI during wakefulness. Tissue volumes and percentages of fat were quantified using an mDIXON scan.
Forty predominantly overweight participants with OSA were compared to 10 predominantly normal weight controls. After adjusting for age, BMI, and gender, the percentage of fat in the tongue was not different between groups (analysis of covariance [ANCOVA], p = 0.45), but apnoeic patients had a greater tongue volume (ANCOVA, p = 0.025). After adjusting for age, BMI, and gender, higher OSA severity was associated with larger whole tongue volume (r = 0.51, p < 0.001), and greater dilatory motion of the anterior horizontal tongue compartment (r = -0.33, p = 0.023), but not with upper airway fat percentage. Higher tongue fat percentage was associated with higher BMI and older age (Spearman r = 0.43, p = 0.002, and r =0.44, p = 0.001, respectively), but not with inspiratory tongue movements. Greater inspiratory tongue movement was associated with larger tongue volume (e.g. horizontal posterior compartment, r = -0.44, p = 0.002) and smaller nasopharyngeal airway (e.g. oblique compartment, r = 0.29, p = 0.040).
Larger tongue volume and a smaller nasopharynx are associated with increased inspiratory tongue dilation during wakefulness in people with and without OSA. This compensatory response was not influenced by higher tongue fat content. Whether this is also true in more obese patient populations requires further investigation.
探讨上气道脂肪成分对舌吸气运动及阻塞性睡眠呼吸暂停（OSA）的影响。
未患OSA或未经治疗的OSA参与者接受3T磁共振成像（MRI）扫描。从T2加权图像获取解剖学测量数据。在清醒状态下，使用标记MRI对矢状面中部的舌吸气运动进行成像。使用mDIXON扫描对组织体积和脂肪百分比进行量化。
将40名主要为超重的OSA参与者与10名主要为正常体重的对照组进行比较。在调整年龄、体重指数（BMI）和性别后，两组之间舌部脂肪百分比无差异（协方差分析[ANCOVA]，p = 0.45），但呼吸暂停患者的舌体积更大（ANCOVA，p = 0.025）。在调整年龄、BMI和性别后，OSA严重程度越高，全舌体积越大（r = 0.51，p < 0.001），舌前水平部分的扩张运动越大（r = -0.33，p = 0.023），但与上气道脂肪百分比无关。舌脂肪百分比越高，与BMI越高和年龄越大相关（斯皮尔曼r分别为0.43，p = 0.002和r = 0.44，p = 0.001），但与舌吸气运动无关。更大的舌吸气运动与更大的舌体积相关（如水平后段，r = -0.44，p = 0.002）和更小的鼻咽气道相关（如斜段，r = 0.29，p = 0.040）。
无论是否患有OSA，更大的舌体积和更小的鼻咽部与清醒状态下吸气时舌扩张增加有关。这种代偿反应不受舌脂肪含量增加的影响。在更肥胖的患者群体中是否也是如此需要进一步研究。
