Histopathological image analysis of the human soft palate and its relationship to obesity

Abstract

Objective/Hypothesis: Although obesity is the major risk factor for obstructive sleep apnea (OSA), it has remained unclear on the relationship between upper airway remodeling and obesity. This study aimed to investigate the impact of obesity on both the overall and localized histopathological changes of the soft palate. Study Design: Retrospective study Methods: We measured body mass index (BMI, kg/m2) in 39 fresh human cadavers for autopsy and performed morphometric study of the soft palate. Overall histopathological changes were graded to acanthosis, chronic inflammation, ductal dilatation, fat deposition, myopathy and fibrosis. Quantitative analyses were conducted to measure total cross-sectional area (CSA), and palatal thickness and individual tissue thickness at multiple levels. Results: Grades of muscular fat deposition (β = 0.465, P = .031) and fibrosis (β = - 0.592, P = .001) were significantly associated with obesity. Total CSA of the soft palate was increased with higher weight (P = .039) and BMI (P = .053). Males had more thick palate than females at the proximal portions (P < .05). In males, thickness of stroma (β = 0.890, P = .0001) and glands (β = 0.471, P = .041) was significantly increased with obesity at the 50% level. In females, muscle thickness (β = 1.016, P = .046) was increased with obesity at the 75% level. Conclusions: Male has different morphology of the soft palate that may be more susceptible to obesity-related histopathological changes. Impact of obesity on the soft palates may be not homogenous and show difference to location.