The effect of adenotonsillectomy on serum insulin-like growth factor-I andgrowth in children with obstructive sleep apnea syndrome

Objective: Obstructive sleep apnea syndrome (OSAS) in children is frequentl y associated with growth interruption. The objective of this study was to e valuate the effect of OSAS and adenotonsillectomy on the insulin-like growt h factor-I (IGF-I) axis in children. Study design: Thirteen prepubertal children (mean age, 6.0 +/- 2.8 years) w ere studied before and after adenotonsillectomy (T&A). Weight, height, over night polysomnography, and IGF-I and IGF-binding protein-3 levels were eval uated before and 3 to 12 months after T&A. The children's weights and heigh ts were monitored for 18 months. Results: The respiratory disturbance index improved from 7.8 +/- 9.1 events /h to 1.0 +/- 2.1 events/h after T&A (P < .02). Slow-wave sleep increased f rom 29.1% +/- 7.2% to 34.6% +/- 9.8% after T&A (P < .02). The weight standa rd deviation score increased from 0.86 +/- 1 to 1.24 +/- 0.9, 18 months aft er T&A (P < .01). Serum IGF-I levels increased from 146.3 +/- 76.2 ng/mL be fore T&A to 210.3 +/- 112.5 ng/mL after surgery (P < .01), but IGF-binding protein-3 levels did not change significantly. Conclusion: The respiratory improvement after T&A in children with OSAS is associated with a significant increase in serum IGF-I levels and weight. We conclude that the IGF-I axis is affected in children with OSAS.