title: The effects of tonsillectomy and adenoidectomy on serum IGF-I and IGFBP3 levels in children.
abstract: OBJECTIVE
  Obstructive adenoid and tonsillar hyperplasia may present with retardation of growth. Interruption of growth hormone-insulin-like growth factor I axis resulting from abnormal nocturnal growth hormone secretion is among the postulated causes. Growth hormone (GH) mediates its anabolic effects on tissues through insulin-like growth factor I (IGF-I). Most of the circulating IGF-I is bound to insulin-like growth factor binding protein 3 (IGFBP3). The objective of this study is to determine blood serum levels of IGF-I and IGFBP3 in patients with adenoid and tonsillar hypertrophy. Furthermore, we want to investigate the effect of tonsillectomy and adenoidectomy (T&A) on these levels.
  
  
  METHODS
  The blood serum levels of IGF-I and its binding protein IGFBP3 were examined in 41 randomly selected children with a diagnosis of upper airway obstruction resulting from hypertrophic tonsils and adenoids.
  
  
  METHODS
  Blood samples were taken preoperatively and repeated at 3 to 6 months (mean, 4.3 mo) following T&A operation. Coated-tube immunoradiometric assay (IRMA) method was used to analyze IGF-I and IGFBP3 levels.
  
  
  RESULTS
  Thirty-two of 41 children were eligible for the analysis. When the preoperative and postoperative results were compared, it was found that there was a statistically significant increase in serum IGF-I and IGFBP3 levels in these 32 children (P <.001). In 7 of the 32 patients, the preoperative serum IGF-I levels were below normal. Postoperatively these levels increased within normal range. This was also statistically significant (P = .016).
  
  
  CONCLUSIONS
  These findings revealed that obstructive adenoid and tonsillar hypertrophy may cause decreased serum IGF-I levels by affecting the GH-IGF-I axis, and T&A is an effective therapeutic measure in these patients.
authors.affiliation: Department of Otolaryngology-Head & Neck Surgery, Afyon Kocatepe University Faculty of Medicine, Turkey. denizy@aku.edu.tr
authors.forename: Mustafa Deniz
authors.initials: MD
authors.lastname: Yilmaz
authors.forename: A Sefik
authors.initials: AS
authors.lastname: Hoşal
authors.forename: Havva
authors.initials: H
authors.lastname: Oğuz
authors.forename: Nurşen
authors.initials: N
authors.lastname: Yordam
authors.forename: Sefa
authors.initials: S
authors.lastname: Kaya
mesh_terms: D000233:Adenoidectomy; D000234:Adenoids / Q000473:pathology; D000402:Airway Obstruction / Q000097:blood / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D006984:Hypertrophy; D018972:Insulin-Like Growth Factor Binding Protein 3 / Q000097:blood*; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology; D011183:Postoperative Complications / Q000097:blood; D014068:Tonsillectomy
chemical_list: D018972:Insulin-Like Growth Factor Binding Protein 3; D007334:Insulin-Like Growth Factor I