Changes in serum levels of IGF-1 and in growth following adenotonsillectomy in children

Objective: Adenotonsillar hypertrophy can cause upper airway obstruction and may be associated with growth delay in children. The objective of this study was to evaluate the long-term effects of adenotonsillectomy on height, weight, and body mass index (BMI) in children with sleep-disordered breathing (SDB). Methods: Fifty-two children (mean age 6.2 ± 2.3 years) clinically diagnosed with SDB were enrolled. Children were diagnosed and scheduled for adenotonsillectomy (T&A) based on their responses to the validated, 22-item Sleep Related Breathing Disorder (SRDB) scale and a physical examination that showed adenotonsillar hypertrophy. Weight, height, and BMI were evaluated before and 5 years after T&A. Serum levels of insulin-like growth factor-1 (IGF-1) were measured before and 1 month after T&A. Results: Serum levels of IGF-1 were significantly higher at 1 month after T&A compared to before T&A (p < 0.001). Thirty children (58%) returned for follow-up testing 5 years later. Their Z scores (standard deviation scores) for weight, height, and BMI of 30 children were significantly higher 5 years after T&A compared to before T&A (p < 0.01). Conclusion: Children with SDB who undergo adenotonsillectomy show significant, long-term increases in weight, height and BMI, as well as a significant increase in serum levels of IGF-1.