This longitudinal observational study aims to validate ultrasound-based tongue markers related to tongue characteristics, including fat accumulation, morphologic and mechanical properties of the tongue in children and adolescents with obesity. Participants are assessed at baseline and after completion of a standardized 30-week inpatient weight-loss rehabilitation program at the Zeepreventorium (De Haan, Belgium). Tongue ultrasound parameters are examined in relation to anthropometric characteristics and obstructive sleep apnea condition.
This prospective observational cohort study investigates ultrasound-based tongue characteristics in children and adolescents with obesity. Participants undergo standardized submental tongue ultrasound examinations at baseline and after completion of a 30-week inpatient multidisciplinary weight-loss rehabilitation program. Ultrasound measures include tongue morphology, fat-related imaging biomarkers, and mechanical properties assessed using shear-wave elastography. Anthropometric data and validated sleep-disordered breathing questionnaires are collected in parallel. Measurement reliability is evaluated, and associations between ultrasound parameters, anthropometric characteristics, and sleep-related outcomes are explored.
Study Type
OBSERVATIONAL
Enrollment
100
Tongue ultrasound via a submental approach. This non-invasive, risk-free and harmless protocol will study both morphological and dynamic characteristics of the tongue.
ISEK-HE2B, av. Schalle 91
Brussels, Belgium
RECRUITINGZeepreventorium Koninklijke Baan 5
De Haan, Belgium
NOT_YET_RECRUITINGTongue stiffness
Tongue stiffness is measured by shear-wave elastography and expressed in kPa.
Time frame: at baseline and after 30-weeks weight loss program
Intraclass correlation coefficient, ICC
Intraclass correlation coefficient will be used to assess intra and inter-rater reliability of ultrasound markersUltrasound reliability and repeatability of tongue measurements will be assessed with intraclass correlation coefficients (ICC), along with their 95% confidence intervals. Each ultrasound measurement (tongue size and morphological parameters, echo intensity, stiffness, tissue attenuation imaging, tissue scatter distribution imaging, and fat fraction) in sagittal and coronal planes will be performed twice in fifteen participants by the principal investigator, with a 24-hour interval between examinations.
Time frame: Baseline
Tongue thickness
Tongue thickness (expressed in cm) will be measured with ultrasound as the perpendicular distance from the deep fascia of the geniohyoid muscle to the highest lingual dorsum in the midsagittal plane
Time frame: at baseline and after 30 weeks weight loss program
Echo Intensity
Echo intensity will be measured with ImageJ / Fiji software (ImageJ, US NIH, Bethesda, USA) and refers to the mean value of pixels of an area, based on a grey scale between 0 (black) and 255 (white)
Time frame: at baseline and after a 30 weeks weight loss program
Tissue Attenuation Imaging index
Attenuation will be measured with ultrasound and depicts the quantitative measurement of ultrasound attenuation in tissues. It is expressed as an attenuation coefficient in dB/cm/MHz.
Time frame: at baseline and after a 30 weeks weight loss program
OSA-18 questionnaire
The Obstructive Sleep Apnea - 18 questionnaire is specific to obstructive sleep apnea in children and will be used for correlation analysis. Quality of life is assessed using the Obstructive Sleep Apnea - 18 Quality of Life Survey (OSA-18), a validated questionnaire comprising 18 items. Total scores range from 18 to 126, with higher scores indicating poorer quality of life and greater disease impact, and lower scores reflecting better outcomes.
Time frame: Baseline and after a 30-weeks weight loss program
Weight
Weight will be measured with a Tanita scale and expressed in kg
Time frame: baseline and after a 30 weeks weight loss program
Height
Height will be measured with a stadiometer and expressed in cm
Time frame: Baseline and after a 30 weeks weight loss program
BMI Z score
BMI Z score will be calculated using combined weight, heigt, sex and age, in reference with CDC tables
Time frame: Baseline and after a 30-weeks weight loss program
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