For individuals with obesity and obstructive sleep apnea (OSA), a reduction in tongue fat associated with weight loss correlates with improvement in the apnea-hypopnea index (AHI), according to a study published online January in the American Journal of Respiratory and Critical Care Medicine.

Stephen H. Wang, from the Albert Einstein College of Medicine in New York City, and colleagues examined the impact of weight loss on upper airway anatomy in 67 individuals with obesity and OSA. Participants underwent a sleep study and upper airway and abdominal magnetic resonance imaging before and after weight loss intervention (intensive lifestyle modification or bariatric surgery).

The researchers observed significant associations between weight loss and reductions in tongue fat, pterygoid, and total lateral wall volumes. Strong associations were seen between reductions in tongue fat and reductions in AHI; after controlling for weight loss, the results persisted. The primary upper airway mediator of the relationship between weight loss and AHI improvement was reduction in tongue fat volume.

"These results elucidate, in part, the mechanism by which weight loss improves OSA, and provide targets for potential new therapies in lieu of weight loss," the authors write.

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