Changes in serum levels of IGF-1 and in growth following adenotonsillectomy in children.

OBJECTIVE

Adenotonsillar hypertrophy can cause upper airway obstruction and may be associated with growth delay in children. The objective of this study was to evaluate the long-term effects of adenotonsillectomy on height, weight, and body mass index (BMI) in children with sleep-disordered breathing (SDB).

METHODS

Fifty-two children (mean age 6.2+/-2.3 years) clinically diagnosed with SDB were enrolled. Children were diagnosed and scheduled for adenotonsillectomy (T&A) based on their responses to the validated, 22-item Sleep Related Breathing Disorder (SRDB) scale and a physical examination that showed adenotonsillar hypertrophy. Weight, height, and BMI were evaluated before and 5 years after T&A. Serum levels of insulin-like growth factor-1 (IGF-1) were measured before and 1 month after T&A.

RESULTS

Serum levels of IGF-1 were significantly higher at 1 month after T&A compared to before T&A (p<0.001). Thirty children (58%) returned for follow-up testing 5 years later. Their Z scores (standard deviation scores) for weight, height, and BMI of 30 children were significantly higher 5 years after T&A compared to before T&A (p<0.01).

CONCLUSION

Children with SDB who undergo adenotonsillectomy show significant, long-term increases in weight, height and BMI, as well as a significant increase in serum levels of IGF-1.