The relation between childhood obesity and adenotonsillar hypertrophy

Abstract

Childhood obesity is a common and significant public health problem all over the world. As a well-known fact obese children have an increased risk of obesity-associated comorbidities, including obstructive sleep apnea, diabetes, and cardiovascular disorders at an earlier age compared to their normal weight peers. They also have an increased risk of poor self-esteem, greater body dissatisfaction, and increased peer teasing that lead to a lower health-related quality of life. While the presence of adenoid hypertrophy and increased rate of obstructive sleep apnea frequently co-exists in majority of cases. We have limited knowledge about the effect of adenotonsillar hypertrophy on development of childhood obesity. In this study, we aimed to investigate the association between obesity, presence of adenotonsillar hypertrophy and the quality of life parameters in obese children as measured by the OSA-18 quality of life questionnaire. Fifty obese children aged between 3 and 18 years and 50 age- and gender-matched otherwise children were enrolled to the study. All subjects were routinely examined by the otolaryngologist before enrollment. The size of adenoid hypertrophy was measured using lateral cephalometric radiographs. The tonsils were also graded using the schema recommended by Brodsky et al. We used OSA-18 questionnaires to evaluate the subjects' quality of life issues. We found, 34 % of obese group had tonsillar hypertrophy while the rate was 6 % in control group. Similarly 16 % of obese group had tonsillar hypertrophy compared to only 4 % in non-obese group. It was also noted that total OSA-18 scores of obese group were significantly higher than those of non-obese group. In subgroup analysis of obese group, total OSA-18 score of obese subjects with either adenoid and/or tonsillar hypertrophy was significantly higher than that of obese subjects without adenoid or tonsillar hypertrophy. As the related literature suggests that the impact of adenotonsillar size on OSA symptoms is prominent especially in children under 7 years of age, but its impact on the development of childhood obesity is still controversial. Our results revealed a possible relation between adenotonsillar hypertrophy and obesity rates. Further studies on larger populations should be planned to better define the real impact of adenotonsillar hypertrophy in obese children.

Risk factors for children requiring adenotonsillectomy and their impact on postoperative complications: a retrospective analysis of 2000 patients

“…They were lighter and had a lower BMI compared with controls. Some studies have reported higher weights and higher BMI's in patients with OSA, which might indicate that the reason for OSA in these children was more related to obesity than to adenotonsillar hypertrophy . Others have reported lower age, weight and BMI at the time of surgery in children with OSA, possibly because the children were failing to thrive or the symptoms and signs were being noticed earlier due to their severity .…”

Study of Sleep Disorders among Young Children Using Hindi Translated and Validated Version of Pediatric Sleep Questionnaire

“…Adenotonsillar hypertrophy and obesity are the important predictors of OSA among children, and most of the time they are coexistent. [24] In addition to mimicking ADHD, OSA has been found to have multiple metabolic and cardiovascular complications among children. Studies have reported that OSA among children leads to lipid peroxidation; [25] increment of proinflammatory markers in body, for example, interleukin 6, interleukin 18, plasminogen activating factor, high-sensitivity-C reactive protein; [26,27] insulin resistance; [28] endothelial dysfunction; [29] and an increase in blood pressure.…”

Evaluation of Body Mass Index of 3–10-year-old Children with Adenotonsillar Hypertrophy, who Referred to Khatamolanbia Hospital during 2017–2018

“…Among the 312 studied patients, 70.2% were male and 29.8% were female. Obviously, in different studies, the proportion of these communities is also different [12], [14], [15], and the reason for this difference is the sampling in different study communities, the population under study, and the male and female populations of different geographic areas. As noted in the findings section, sex was significantly associated with BMI percentile and height.…”