Fat accumulation in the tongue is associated with male gender, abnormal upper airway patency and whole-body adiposity

Objective To examine associations between tongue adiposity with upper airway measures, whole-body adiposity and gender. We hypothesized that increased tongue adiposity is higher in males and positively associated with abnormal upper airway measures and whole-body adiposity. Methods We studied subjects who underwent whole-body positron emission tomography/computed tomography to obtain tongue attenuation (TA) values and cross-sectional area, pharyngeal length (PL) and mandibular plane to hyoid distance (MPH), as well as abdominal circumference, abdominal subcutaneous and visceral (VAT) adipose tissue areas, neck circumference (NC) and neck adipose tissue area. Metabolic syndrome was determined from available clinical and laboratory data. Results We identified 206 patients (104 females, 102 males) with mean age 56 ± 17 years and mean body mass index (BMI) 28 ± 6 kg/m² (range 16–47 kg/m²). Males had lower TA values (P = 0.0002) and higher upper airway measures (P < 0.0001) independent of age and BMI (P < 0.001). In all subjects, TA was negatively associated with upper airway measures (P < 0.001). TA was negatively associated with body composition parameters (all P < 0.0001), most notably with VAT (r = − 0.53) and NC (r = − 0.47). TA values were lower in subjects with metabolic syndrome (P < 0.0001). Conclusion Increased tongue adiposity is influenced by gender and is associated with abnormal upper airway patency and body composition parameters.