The Effects of Tonsillectomy and Adenoidectomy on Serum IGF‐I and IGFBP3 Levels in Children

Yılmaz, Mustafa; Hoşal, Ali Şefik; Oğuz, H.; Yordam, Nurşen; Kaya, Sefa

doi:10.1097/00005537-200205000-00026

Cited by 50 publications

(46 citation statements)

References 19 publications

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“…Two other studies also found higher IGF1 and IG-FBP3 values post T&A. 39,40 In our study, besides IGF1, GH values were also determined in 18 subjects, under basal conditions. Contrary to expectations, the basal GH values tended to be higher pre-op although not statistically significant.…”

Section: Discussionsupporting

confidence: 75%

Chronic autoimmune thyroid disease in children and adolescents in the years 1999-2004 in Lower Silesia, Poland

Żak¹,

Noczyńska²,

Wasikówa³

et al. 2005

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The aim of the study was to analyze data related to chronic autoimmune thyroid disease at diagnosis and at follow-up of children and adolescents in Lower Silesia in the years 1999-2004. Age, gender, incidence of thyroid disease in the family, clinical presentation, hormonal findings, levels of thyroid antibodies, results of ultrasonography, and fine needle aspiration biopsy (FNAB) were recorded. 100 children, 10 boys and 90 girls, were included in the analysis. The mean age at diagnosis was 12.3±2.3 years and at last examination 14.9±1.9 years. At diagnosis, increased levels of TSH without overt hypothyroidism was observed in 26 children. In 11 children hyperthyroidism was detected whereas 63 children were euthyroid. An increased level of thyroid peroxidase antibodies was observed in 65% of the children. Ultrasonography was characteristic for Hashimotos thyroiditis in all patients. Fine needle biopsy was performed when there were diagnostic difficulties (35% children). Thus, in all the children the diagnosis of Hashimotos thyroiditis was ascertained either by high antibody titer or FNAB. Associated diseases were observed in 33% of the children. Thyroid disease in the family was present in 25% of the children. There was a gradual decline in the number of new cases presented from 1999 to 2004. The reason for this decline remains speculative.

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Section: Discussionsupporting

confidence: 75%

Chronic autoimmune thyroid disease in children and adolescents in the years 1999-2004 in Lower Silesia, Poland

Żak¹,

Noczyńska²,

Wasikówa³

et al. 2005

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“…[1][2][3][4][5] Adenotonsillar hypertrophy is the primary cause of OSAS in children, and is usually treated with adenotonsillectomy (AT). AT has been reported to accelerate weight [6][7][8][9][10][11][12][13][14] in children with baseline failure to thrive (FTT), 1,3,4,15 normal weight patients, 9,11,14,[16][17][18][19][20] obese individuals, 9,13,16,21,22 and infants. 10 The majority of studies also have demonstrated an increase in the height growth rate after AT for OSAS, 3,6,11,17,23,24 but other studies reported no significant differences.…”

Section: (Continued On Last Page)mentioning

confidence: 99%

Growth After Adenotonsillectomy for Obstructive Sleep Apnea: An RCT

et al. 2014

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BACKGROUND AND OBJECTIVES: Adenotonsillectomy for obstructive sleep apnea syndrome (OSAS) may lead to weight gain, which can have deleterious health effects when leading to obesity. However, previous data have been from nonrandomized uncontrolled studies, limiting inferences. This study examined the anthropometric changes over a 7-month interval in a randomized controlled trial of adenotonsillectomy for OSAS, the Childhood Adenotonsillectomy Trial. METHODS: A total of 464 children who had OSAS (average apnea/hypopnea index [AHI] 5.1/hour), aged 5 to 9.9 years, were randomized to Early Adenotonsillectomy (eAT) or Watchful Waiting and Supportive Care (WWSC). Polysomnography and anthropometry were performed at baseline and 7-month follow-up. Multivariable regression modeling was used to predict the change in weight and growth indices. RESULTS: Interval increases in the BMI z score (0.13 vs 0.31) was observed in both the WWSC and eAT intervention arms, respectively, but were greater with eAT (P < .0001). Statistical modeling showed that BMI z score increased significantly more in association with eAT after considering the influences of baseline weight and AHI. A greater proportion of overweight children randomized to eAT compared with WWSC developed obesity over the 7-month interval (52% vs 21%; P < .05). Race, gender, and follow-up AHI were not significantly associated with BMI z score change. CONCLUSIONS: eAT for OSAS in children results in clinically significant greater than expected weight gain, even in children overweight at baseline. The increase in adiposity in overweight children places them at further risk for OSAS and the adverse consequences of obesity. Monitoring weight, nutritional counseling, and encouragement of physical activity should be considered after eAT for OSAS.

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“…Pudemos observar em outra série que há uma melhora significativa da mastigação e deglutição 7 que podem facilitar a ingesta alimentar, entretanto outros autores observaram que a ingesta calórica antes e após a adenoamigdalectomia é semelhante 15 . Cita-se ainda a relação com a baixa saturação sangüínea noturna de oxigênio, acidose noturna e aumento do gasto energético resultado do aumento do trabalho respiratório 16 . Estudos recentes mostram que 34 a 61% das crianças com hipertrofia adenoamigdaliana que são submetidas a cirurgia apresentam graus variáveis de hipoxemia e distúrbios do sono que não são normais 8 .…”

Section: Discussionunclassified

“…A apnéia do sono, por provocar despertares freqüentes, está associada a uma liberação irregular da secreção do hormônio de crescimento (GH), interferindo no crescimento. 8 Observa-se após a adenoamigdalectomia um aumento da secreção do GH 8,16 assim como de IGF-I (Insulin-like Growth Factor -fator de crescimento semelhante à insulina) e IGFBP3 (Fator de crescimento semelhante à insulina ligado à proteína transportadora B3). Este fator é responsável pelo efeito anabólico do GH 16 .…”

Section: Discussionunclassified

Crescimento pôndero-estatural de crianças após adenoamigdalectomia

Francesco

Junqueira

Frizzarini

et al. 2003

Rev. Bras. Otorrinolaringol.

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A hiperplasia adenoamigdaliana é a principal causa de obstrução das vias aéreas superiores em crianças, sendo muitas vezes associada à apnéia do sono. Esta, por sua vez, resulta em uma série de comprometimentos: baixo rendimento escolar, cor pulmonale, distúrbios de comportamento não específicos, hiperatividade, sonolência diurna, distração e atrasos de desenvolvimento, sendo o déficit pôndero-estatural o mais grave. A adenoamigdalectomia é o tratamento de escolha. O objetivo deste trabalho é mensurar o crescimento e desenvolvimento das crianças antes e depois da adenoamigdalectomia através da comparação dos percentis pré e pós operatórios. Forma de Estudo: Clínico prospectivo randomizado. Material e Método: Cinquenta e cinco crianças de 2 a 12 anos, com histó-ria de obstrução das vias aéreas superiores por hiperplasia adenoamigdaliana foram submetidas a exame antropométrico (peso e altura), antes e 6 meses após a adenoamigdalectomia. Os dados foram transformados em percentil para peso e altura, de acordo com a idade e comparados através de análise estatísti-ca. Resultados: No pré-operatório, encontramos a seguinte distribuição para o percentil altura: 78,2%, abaixo de p75 e para peso 70,9% abaixo de p50. No pós-operatório observouse melhor distribuição das crianças: para altura 34,6% abaixo de p75, 32,8% entre p75-95 e 32,6% para p95 e acima e para peso: 35,5% abaixo de p50, 36,4% para p50-95 e 29,1% acima de p95. Conclusão: Observou-se uma melhora considerável do desenvolvimento pôndero-estatural das crianças após a adenoamigdalectomia. Tonsi l and adenoid hyperplasia is one of the most common causes of upper airway obstruction in children; and generally comes along with sleep apnea. It is usually associated to poor school performance, non-specific behavioral disturbs, hyperactivity, daytime sleepiness, distraction and failure to thrive. This one is a very serious consequence for the child. The purpose of this study is to compare height and weight percentiles before and after surgery. Study Design: Clinical prospective randomized. Material and Method: We studied 55 children (male and female) from 2 to 12 years old; with upper airway obstruction due to tonsil and adenoid hyperplasia. All of them were measured (height and weight) before and 6 months after adenotonsillectomy. Height and weight percentiles were plotted in graphics and compared with statistical analysis. Results. Before surgery, the majority of the children, 78.2% were under p75 for height and 70.9% were under p50 for weight. Three months after surgery there was a better distribution of the children throughout the percentil ranges. For height: 34.6% were under p75; 32.85 were between p75-95 and 32.6% were above p95. For weight 35.5% were under p50; 36.4% were under p50-95 and 29.1% were above p95. Conclusion: After surgery, children presented an improvement in their height and weight percentiles. They develop better after the treatment of upper airway obstruction, with T&A surgery. Rev Bras Otorrinolaringol. V.69, n.2, 193-6, mar./abr. 2003 Ren...

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The Effects of Tonsillectomy and Adenoidectomy on Serum IGF‐I and IGFBP3 Levels in Children

Abstract: 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.

Cited by 50 publications

References 19 publications

Chronic autoimmune thyroid disease in children and adolescents in the years 1999-2004 in Lower Silesia, Poland

Chronic autoimmune thyroid disease in children and adolescents in the years 1999-2004 in Lower Silesia, Poland

Growth After Adenotonsillectomy for Obstructive Sleep Apnea: An RCT

Crescimento pôndero-estatural de crianças após adenoamigdalectomia

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