title: Does adenotonsillectomy alter IGF-1 and ghrelin serum levels in children with adenotonsillar hypertrophy and failure to thrive? A prospective study.
abstract: OBJECTIVE
  Adenotonsillar hypertrophy (ATH) contributes to upper airway obstruction and recurrent tonsillitis in children. The aim of this study was to evaluate the effect of adenotonsillectomy on serum IGF-1 and ghrelin levels in children with ATH failure to thrive.
  
  
  METHODS
  Forty pre-pubertal children with more than 5 years of age (6.57 ± 1.284 years) suffering from ATH, sleep disorder breathing, snoring, open mouth breathing and growth retardation were studied. Blood samples were taken eight hours after fasting and weight and height were measured by SECA instrument. Blood samples were centrifuged immediately and the extracted sera were stored at -70 °C in Eppendorf vials. IGF-1 and ghrelin were measured by ELISA kit. Patients with adenotonsillectomy indication underwent adenotonsillectomy and serum levels of IGF-1 and ghrelin were measured 12 months after operation.
  
  
  RESULTS
  Weight, height and BMI were increased significantly after operation (P < 0.001). Serum IGF-1 and ghrelin levels increased significantly after operation compared to before operation (P < 0.001).
  
  
  CONCLUSIONS
  Growth retardation in children with adenotonsillar hypertrophy is related to lower serum IGF-1 levels. Ghrelin levels increase before the meals and ghrelin increases hunger and food intake. The results obtained from our study confirmed that weight, height and BMI increase significantly following adenotonsillectomy; this could in turns prevent undesirable and irreversible physiological changes that occur due to adenotonsillar hypertrophy. Adenotonsillectomy in children with adenotonsillar hypertrophy and failure to thrive increases IGF-1 and Ghrelin serum levels which might contribute to the improvement in the growth pattern of the children.
authors.affiliation: Pediatric Health Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Yalda
authors.initials: Y
authors.lastname: Jabbari Moghaddam
authors.forename: Samad E J
authors.initials: SE
authors.lastname: Golzari
authors.forename: Lida
authors.initials: L
authors.lastname: Saboktakin
authors.forename: Mir Hojjat
authors.initials: MH
authors.lastname: Seyedashrafi
authors.forename: Babak
authors.initials: B
authors.lastname: Sabermarouf
authors.forename: Heidar Ali Esmaeili
authors.initials: HA
authors.lastname: Gavgani
authors.forename: Amir Ghorbani
authors.initials: AG
authors.lastname: Haghjo
authors.forename: Alireza
authors.initials: A
authors.lastname: Lotfi
authors.forename: Kamyar
authors.initials: K
authors.lastname: Ghabili
mesh_terms: D000233:Adenoidectomy / Q000379:methods; D000234:Adenoids / Q000473:pathology / Q000601:surgery*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D001827:Body Height; D002648:Child; D015331:Cohort Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005183:Failure to Thrive / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D054439:Ghrelin / Q000032:analysis / Q000097:blood*; D006130:Growth Disorders / Q000097:blood*; D006801:Humans; D006984:Hypertrophy / Q000473:pathology / Q000601:surgery; D007334:Insulin-Like Growth Factor I / Q000032:analysis / Q000378:metabolism*; D008297:Male; D014066:Palatine Tonsil / Q000473:pathology / Q000601:surgery*; D011182:Postoperative Care; D011300:Preoperative Care; D011446:Prospective Studies; D014068:Tonsillectomy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D015415:Biomarkers; D054439:Ghrelin; D007334:Insulin-Like Growth Factor I
keywords: Adenotonsillar hypertrophy; Adenotonsillectomy; Ghrelin; IGF-1