Study Objectives To investigate the effect of upper airway fat composition on tongue inspiratory movement and obstructive sleep apnea (OSA). Methods 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. Results 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). Conclusions 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.

中文翻译：

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上气道脂肪对清醒阻塞性睡眠呼吸暂停患者吸气时舌头扩张的影响

研究目的 探讨上气道脂肪成分对舌吸气运动和阻塞性睡眠呼吸暂停 (OSA) 的影响。方法 未治疗或未治疗 OSA 的参与者接受了 3T 磁共振成像 (MRI) 扫描。从 T2 加权图像获得解剖测量值。在清醒期间使用标记的 MRI 对中矢状吸气舌头运动进行成像。使用 mDIXON 扫描对组织体积和脂肪百分比进行量化。结果 将 40 名主要超重的 OSA 参与者与 10 名主要正常体重的对照者进行了比较。在调整了年龄、BMI 和性别后，舌中脂肪的百分比在各组之间没有差异（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） . 调整年龄、BMI、和性别，较高的 OSA 严重程度与较大的整个舌体积（r = 0.51，p < 0.001）和前水平舌室的更大扩张运动（r = -0.33，p = 0.023）相关，但与上气道无关脂肪百分比。较高的舌脂肪百分比与较高的 BMI 和年龄相关（分别为 Spearman r = 0.43，p = 0.002 和 r =0.44，p = 0.001），但与吸气时舌头运动无关。更大的吸气舌运动与更大的舌体积（例如水平后隔室，r = -0.44，p = 0.002）和更小的鼻咽气道（例如，斜隔室，r = 0.29，p = 0.040）相关。结论 较大的舌体积和较小的鼻咽与 OSA 患者和非 OSA 患者清醒时吸气时舌扩张增加有关。这种代偿反应不受较高的舌头脂肪含量的影响。这在更肥胖的患者群体中是否也是如此需要进一步调查。