The effect of adenotonsillectomy on serum insulin-like growth factor-I and growth in children with obstructive sleep apnea syndrome.
OBJECTIVE
Obstructive sleep apnea syndrome (OSAS) in children is frequently associated with growth interruption. The objective of this study was to evaluate the effect of OSAS and adenotonsillectomy on the insulin-like growth factor-I (IGF-I) axis in children.


METHODS
Thirteen prepubertal children (mean age, 6.0 +/- 2.8 years) were studied before and after adenotonsillectomy (T&A). Weight, height, overnight polysomnography, and IGF-I and IGF-binding protein-3 levels were evaluated before and 3 to 12 months after T&A. The children's weights and heights were monitored for 18 months.


RESULTS
The respiratory disturbance index improved from 7.8 +/- 9.1 events/h to 1.0 +/- 2.1 events/h after T&A (P <.02). Slow-wave sleep increased from 29.1% +/- 7.2% to 34.6% +/- 9.8% after T&A (P <.02). The weight standard deviation score increased from 0.86 +/- 1 to 1. 24 +/- 0.9, 18 months after T&A (P <.01). Serum IGF-I levels increased from 146.3 +/- 76.2 ng/mL before T&A to 210.3 +/- 112.5 ng/mL after surgery (P <.01), but IGF-binding protein-3 levels did not change significantly.


CONCLUSIONS
The respiratory improvement after T&A in children with OSAS is associated with a significant increase in serum IGF-I levels and weight. We conclude that the IGF-I axis is affected in children with OSAS.
Department of Pediatrics, Soroka Medical Center of Kupat Holim Klalit, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
A
A
Bar
A
A
Tarasiuk
Y
Y
Segev
M
M
Phillip
A
A
Tal
D000233:Adenoidectomy; D002648:Child; D002675:Child, Preschool; D005260:Female; D006128:Growth; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D007223:Infant; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000378:metabolism; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D015999:Multivariate Analysis; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000150:complications / Q000601:surgery*; D014068:Tonsillectomy
D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I