A multivariate analysis by Sung et al. also found an association between LTH and LPR in OSA patients due to damage to and chronic inflammation of the lymphoid tissues caused by exposure to gastrin and pepsin.29However, this study showed no significant association between LTH and OSA parameters alone, which might imply that the thickness and size of the lingual tonsils do not necessarily relate to OSA severity. This evidence concerns the gene GAST and obstructive sleep apnea syndrome.