title: Adenotonsillectomy outcomes regarding bone age and osteocalcin in treatment of obstructive sleep apnea syndrome in children.
abstract: BACKGROUND
  To investigate the effect of adenotonsillectomy (AT) on bone development, quality of life and polysomnography evaluation in children with obstructive sleep apnea syndrome (OSA).
  
  
  METHODS
  Preoperative and postoperative (6 months) physical examination, PSG, bone age (BA) and osteocalcin (OC) evaluation were performed on the selected OSA children (n=92) and the healthy children (n=87). The OSA children were also scored based on the OSA 18-item questionnaire. A two-year follow-up was conducted to evaluate BA and OC changes.
  
  
  RESULTS
  After AT, 81 (88.04%) OSA children recovered completely, eight (8.70%) achieved remarkable improvements, and three (3.26%) achieved moderate improvements. In the OSA children, postoperative OSA 18-item score and the scores of the five domains were significantly higher than preoperative ones. Compared with the preoperative, body mass index (BMI), weight for age Z-sores, height for age Z-sores, weight for height Z-sores and BMI Z-score in the OSA group 6 months after the operation were significantly increased, but no significant difference was detected between the OSA and the control group. The changes of BA and chronological age in the OSA group were significantly different from those in the control group. Two years after AT, BA between the two groups was no longer significantly different. Preoperative serum OC in the OSA group was lower than that in the control group, but increased to normal levels 6 months after AT. Correlation analysis showed serum OC levels were negatively correlated with apnea hyponea index, obstructive apnea index, arousal index, and lowest oxygen saturation.
  
  
  CONCLUSIONS
  After AT, bone growth and development in children with OSA recovered gradually, and the serum OC levels decreased to the normal level. Therefore, preventive measures and positive treatments should be applied to minimize the negative effects of OSA in children.
authors.affiliation: Department of Pediatric Internal Medicine, Linyi People's Hospital, Linyi, China.
authors.forename: Qing-Biao
authors.initials: QB
authors.lastname: Zhang
authors.affiliation: Department of Pediatric Internal Medicine, Linyi People's Hospital, Linyi, China.
authors.forename: Yin-Feng
authors.initials: YF
authors.lastname: Li
authors.affiliation: Department of Pediatric Surgery, Linyi People's Hospital, No.27 East Jiefang Road, Linyi, 276003, China. limingxiu0829@163.com.
authors.forename: Ming-Xiu
authors.initials: MX
authors.lastname: Li
authors.affiliation: Department of Breast Surgery, Linyi Cancer Hospital, Linyi, China.
authors.forename: Ling-Yu
authors.initials: LY
authors.lastname: Kong
authors.affiliation: Department of Pediatric Surgery, Linyi People's Hospital, No.27 East Jiefang Road, Linyi, 276003, China.
authors.forename: Liang-Fu
authors.initials: LF
authors.lastname: Jiang
authors.affiliation: Department of Pediatric Internal Medicine, Linyi People's Hospital, Linyi, China.
authors.forename: Hui-Wei
authors.initials: HW
authors.lastname: Feng
authors.affiliation: Department of Pediatric Internal Medicine, Linyi People's Hospital, Linyi, China.
authors.forename: Xian-Liang
authors.initials: XL
authors.lastname: Fan
mesh_terms: D000233:Adenoidectomy / Q000379:methods*; D000365:Age Determination by Skeleton; D000367:Age Factors; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D002681:China; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D015675:Osteocalcin / Q000097:blood*; D017286:Polysomnography / Q000379:methods; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis* / Q000601:surgery*; D014068:Tonsillectomy / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D015675:Osteocalcin
keywords: OSA-18 score; obstructive sleep apnea syndrome; osteocalcin; polysomnography