Improvements in blood IGF-1 and skeletal age following adenotonsillectomy for growth delay in children with obstructive sleep apnea

Yuma Yoshioka; Shoji Matsune; Kuwon Sekine; Mariko Ishida; Nozomu Wakayama; Satoshi Yamaguchi; Kimihiro Okubo

doi:10.1016/j.anl.2023.09.002

Improvements in blood IGF-1 and skeletal age following adenotonsillectomy for growth delay in children with obstructive sleep apnea

Auris Nasus Larynx. 2024 Apr;51(2):236-241. doi: 10.1016/j.anl.2023.09.002. Epub 2023 Oct 8.

Authors

Yuma Yoshioka¹, Shoji Matsune², Kuwon Sekine², Mariko Ishida², Nozomu Wakayama², Satoshi Yamaguchi², Kimihiro Okubo³

Affiliations

¹ Department of Otolaryngology, Nippon Medical School, Musashi Kosugi Hospital, Kanagawa, Japan. Electronic address: yuma-s@nms.ac.jp.
² Department of Otolaryngology, Nippon Medical School, Musashi Kosugi Hospital, Kanagawa, Japan.
³ Department of Otolaryngology, Nippon Medical School, Tokyo, Japan.

PMID: 37813729
DOI: 10.1016/j.anl.2023.09.002

Abstract

Objective: In children with obstructive sleep apnea (OSA) who underwent adenotonsillectomy (AT), we measured body height and weight using standard deviation (SD) scores, insulin-like growth factor 1 (IGF-1), and skeletal age using carpal radiography. We then compared these values before and after surgery with the aim of investigating postoperative improvements in growth hormone (GH) deficiency.

Methods: Subjects comprised 35 children between 2 and 9 years of age (21 boys, 14 girls; mean age, 5.85 ± 1.75 years). Respiratory event index (REI), 3 % oxygen desaturation index (3 % ODI), height SD score, body mass index (BMI) percentile, blood IGF-1 level, and skeletal age from carpal radiographs were measured before surgery and both 3 and 12 months after surgery, and compared.

Results: Height SD score improved significantly from preoperatively (-0.44 ± 1.13) to both 3 months postoperatively (-0.22 ± 1.14) and 12 months postoperatively (-0.13 ± 0.94). However, no significant improvement in height SD score was seen from 3 months to 12 months after AT. BMI percentile improved significantly from preoperatively (35.6 ± 26.7) to both 3 months postoperatively (44.7 ± 26.5) and 12 months postoperatively (49.1 ± 22.15), with significant improvement also seen from 3 months to 12 months after AT. SD score for IGF-1 showed significant improvement from before (-0.57 ± 1.00) to 12 months after surgery (-0.12 ± 0.89). No significant improvement in the difference between skeletal and chronological ages was seen from before to after surgery, but the number of patients for whom skeletal age normalized from before to after surgery increased significantly (74.3 % vs. 94.3 %), and the number with advanced or delayed skeletal age decreased significantly (25.7 % vs. 5.7 %) CONCLUSION: Early improvements can be obtained with surgical treatment in children with OSA who have short height and poor weight gain due to GH deficiency.

Keywords: Growth delay; Growth hormone; IGF-1; Pediatric sleep apnea; Skeletal age.

Publication types

Review

MeSH terms

Adenoidectomy
Age Determination by Skeleton
Child
Child, Preschool
Female
Humans
Infant
Insulin-Like Growth Factor I
Male
Sleep Apnea, Obstructive* / surgery
Tonsillectomy*

Substances

Insulin-Like Growth Factor I