Obesity is the number one health concern for pediatricians today. Almost 20% of children in the United Sates have a body mass index (BMI) = 95th percentile standard. The prevalence of obesity in New York City is particularly high and reached 31% in Hispanic and 23% in African American children in 2002-2003. One of the most important obesity-associated risks for children is obstructive sleep apnea syndrome (OSAS), with a reported prevalence rate between 46-59% compared with 2% in the general pediatric population. OSAS in turn, contributes to significant cardiovascular and cognitive morbidities in children. However, the pathophysiology of OSAS in obese children and why some obese children have OSAS while others do not is still unknown. Accelerated somatic growth may compromise airway size as well as airway collapsibility. Our team of pediatric researchers with expertise in sleep, pulmonology, public health, nutrition, and adolescent medicine, coupled with experts in the field of epidemiology and biostatistics, MRI, and biomechanics will study the anatomical, functional, and mechanical mechanisms leading to OSAS in inner city obese children 8-17 years of age using novel non-invasive methodologies. Our main focus will be to determine the anatomic and functional risk factors relating obesity to OSAS that have predictive value for distinguishing between obese children who will or will not have or develop OSAS. Further, we will determine how adenotonsillectomy and weight changes (both weight loss and weight gain) modify the above proposed mechanisms leading to OSAS in this group of children. Project Narrative: Obesity is the number one health concern for pediatricians today. One of the most important associated risks for obese children is obstructive sleep apnea syndrome (OSAS). This study will determine the anatomic and functional risk factors related to obesity and OSAS in inner city children 8-17 years of age using physiological studies coupled with novel imaging and computerized methodology.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
Research Project (R01)
Project #
5R01HD053693-05
Application #
8204797
Study Section
Respiratory Integrative Biology and Translational Research Study Section (RIBT)
Program Officer
Haverkos, Lynne
Project Start
2008-03-20
Project End
2013-12-31
Budget Start
2012-01-01
Budget End
2013-12-31
Support Year
5
Fiscal Year
2012
Total Cost
$510,032
Indirect Cost
$135,707
Name
Albert Einstein College of Medicine
Department
Pediatrics
Type
Schools of Medicine
DUNS #
110521739
City
Bronx
State
NY
Country
United States
Zip Code
10461
Sin, Sanghun; Wootton, David M; McDonough, Joseph M et al. (2014) Anterior nasal resistance in obese children with obstructive sleep apnea syndrome. Laryngoscope 124:2640-4
Pillai, Sophia; Nandalike, Kiran; Kogelman, Yelena et al. (2014) Severe obstructive sleep apnea in a child with melanocortin-4 receptor deficiency. J Clin Sleep Med 10:99-101
Luo, Haiyan; Sin, Sanghun; McDonough, Joseph M et al. (2014) Computational fluid dynamics endpoints for assessment of adenotonsillectomy outcome in obese children with obstructive sleep apnea syndrome. J Biomech 47:2498-503
Wootton, David M; Luo, Haiyan; Persak, Steven C et al. (2014) Computational fluid dynamics endpoints to characterize obstructive sleep apnea syndrome in children. J Appl Physiol (1985) 116:104-12
Udupa, Jayaram K; Odhner, Dewey; Zhao, Liming et al. (2014) Body-wide hierarchical fuzzy modeling, recognition, and delineation of anatomy in medical images. Med Image Anal 18:752-71
Parikh, Sanjay R; Sadoughi, Babak; Sin, Sanghun et al. (2013) Deep cervical lymph node hypertrophy: a new paradigm in the understanding of pediatric obstructive sleep apnea. Laryngoscope 123:2043-9
Muzumdar, Hiren; Arens, Raanan (2013) Physiological effects of obstructive sleep apnea syndrome in childhood. Respir Physiol Neurobiol 188:370-82
Nandalike, Kiran; Shifteh, Keivan; Sin, Sanghun et al. (2013) Adenotonsillectomy in obese children with obstructive sleep apnea syndrome: magnetic resonance imaging findings and considerations. Sleep 36:841-7
Arens, Raanan; Sin, Sanghun; Nandalike, Kiran et al. (2011) Upper airway structure and body fat composition in obese children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 183:782-7
Persak, Steven C; Sin, Sanghun; McDonough, Joseph M et al. (2011) Noninvasive estimation of pharyngeal airway resistance and compliance in children based on volume-gated dynamic MRI and computational fluid dynamics. J Appl Physiol 111:1819-27

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