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Upper airway structure and body fat composition in obese children with obstructive sleep apnea syndrome

Raanan Arens1, Sanghun Sin, Kiran Nandalike

  • 1Division of Respiratory and Sleep Medicine, Children's Hospital at Montefiore, 3415 Bainbridge Avenue, Bronx, NY 10467, USA. rarens@montefiore.org.

American Journal of Respiratory and Critical Care Medicine
|October 12, 2010
PubMed

Insights

Obese children with obstructive sleep apnea syndrome (OSAS) show enlarged upper airway lymphoid tissues, independent of obesity. Increased fat deposits were also noted but not directly linked to OSAS severity.

Area of Science:

  • Pediatric Endocrinology
  • Sleep Medicine
  • Otolaryngology

Background:

  • Obstructive sleep apnea syndrome (OSAS) in obese children lacks well-defined etiological mechanisms.
  • Understanding anatomical risk factors is crucial for managing pediatric OSAS.

Purpose of the Study:

  • To identify anatomical risk factors for OSAS in obese children.
  • To compare these factors with obese children without OSAS.

Main Methods:

  • Magnetic resonance imaging (MRI) assessed upper airway structures and body fat composition.
  • Paired analysis compared subjects with and without OSAS.
  • Regression models evaluated the effect of BMI Z-score as a modifier.

Main Results:

  • Subjects with OSAS had smaller oropharynx and larger adenoids, tonsils, and retropharyngeal nodes compared to controls.
  • Lymphoid tissue size correlated with OSAS severity; BMI Z-score did not modify this relationship.
  • Parapharyngeal and abdominal visceral fat pads were larger in OSAS subjects, but not associated with OSAS severity or BMI Z-score.

Conclusions:

  • Upper airway lymphoid hypertrophy is a significant factor in obese children with OSAS.
  • The hypertrophy's independence from obesity suggests alternative causative mechanisms.
  • While increased fat deposits were observed, their direct association with OSAS severity or obesity remains unclear.
Abstract

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