Shelton K E, Woodson H, Gay S, Suratt P M
Department of Internal Medicine, University of Virginia Health Science Center, Charlottesville 22908.
Am Rev Respir Dis. 1993 Aug;148(2):462-6. doi: 10.1164/ajrccm/148.2.462.
Although most patients with obstructive sleep apnea (OSA) are obese, it is not known how obesity contributes to airway collapse during sleep. The purpose of this study was to determine whether the volume of adipose tissue adjacent to the pharyngeal airway in humans is related to the degree of OSA. We studied 30 subjects, nine without OSA and 21 with OSA; two subjects were studied before and after weight loss. Adipose tissue was detected with magnetic resonance imaging using T1-weighted spin echo sequences. The volume of adipose tissue adjacent to the upper airway was determined by measuring the volume of all pixels in the intensity range of adipose tissue within the region bounded by the ramus of the mandible, the spine, the anterior border of the soft palate, and the hard palate. Polysomnography was performed with conventional techniques. All subjects had a collection of adipose tissue adjacent to the upper airway; the volume of this adipose tissue correlated with the number of apneas plus hypopneas per hour of sleep (r = 0.59, p < 0.001). Both patients who lost weight and had fewer apneas and hypopneas had a marked decrease in the pharyngeal adipose tissue volume. We conclude that adipose tissue is deposited adjacent to the pharyngeal airway in patients with OSA and that the volume of this tissue is related to the presence and degree of OSA.
尽管大多数阻塞性睡眠呼吸暂停（OSA）患者肥胖，但尚不清楚肥胖如何导致睡眠期间气道塌陷。本研究的目的是确定人类咽部气道附近的脂肪组织体积是否与OSA的程度相关。我们研究了30名受试者，其中9名无OSA，21名有OSA；两名受试者在减肥前后进行了研究。使用T1加权自旋回波序列通过磁共振成像检测脂肪组织。通过测量在下颌支、脊柱、软腭前缘和硬腭所界定区域内脂肪组织强度范围内所有像素的体积，来确定上气道附近脂肪组织的体积。采用传统技术进行多导睡眠图检查。所有受试者在上气道附近均有脂肪组织聚集；该脂肪组织的体积与每小时睡眠中的呼吸暂停加呼吸浅促次数相关（r = 0.59，p < 0.001）。减肥且呼吸暂停和呼吸浅促次数减少的患者，其咽部脂肪组织体积均显著减小。我们得出结论，OSA患者的咽部气道附近存在脂肪组织沉积，且该组织的体积与OSA的存在及程度相关。
