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The effect of adenotonsilectomy on ghrelin, leptin, IGF-1 levels and growth parameters in children with adenotonsillar hypertrophy

  • Nergis Salman EMAIL logo , Gulfer Ozturk , Istemihan Akin , Saffet Kilicaslan , Fatma Demirel and Namik Delibas
Published/Copyright: May 22, 2014

Abstract

Aim: The purpose of this study was to search for the effects of adenotonsillectomy (A&T) on height, weight, and body mass index (BMI), as well as changes in ghrelin, leptin, and insulin-like growth factor 1 (IGF-1) levels in children with adenotonsillar hypertrophy (ATH)-related sleep-disordered breathing (SDB).

Methods: A study cohort of 39 children clinically diagnosed with ATH-related SDB was included in this study. Twenty-three healthy children were included as controls. Height and weight standard deviation scores (SDS) and ghrelin, leptin, and IGF-1 levels of the controls were determined once; in the study group, they were determined preoperatively and in the third month postoperatively.

Results: Preoperative IGF-1 (ng/mL) and ghrelin (pg/mL) levels were significantly higher in the patients than in the controls (322.51±113.10 vs. 256.96±176.73, p<0.05 and 106.08±9.75 vs. 80.11±28.50, p<0.001, respectively). The preoperative height and weight SDS values of the patients were lower than those of the controls (–0.67±1.36 vs. 0.13±1.13, p<0.05 and –0.38±1.35 vs. –0.20±1.29, respectively). The patients’ postoperative height and weight SDS values were significantly higher than their preoperative values (–0.05±1.08 vs. –0.67±1.36, p<0.0001 and 0.00±1.28 vs. –0.38±1.35, p<0.0001, respectively). The mean postoperative IGF-1 levels also were significantly higher than preoperative levels (386.05±130.06 vs. 322.51±113.10, p<0.05, respectively).

Conclusion: Plasma IGF-1 levels are lower in malnourished children, and plasma ghrelin levels are decreased after acute oral food intake and are increased in cachexia and fasting. Therefore, increased serum IGF-1 levels, height and weight SDS values, and decreased ghrelin levels detected postoperatively are useful parameters that help to monitor the development of children with adequate oral intakes.


Corresponding author: Nergis Salman, MD, Department of Otorhinolaryngology, Ankara Children’s Hematology and Oncology Training and Research Hospital, 06110, Diskapi, Ankara/Turkey, Phone: +90 312 596 97 10, Fax: +90 312 347 23 30, E-mail:

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Received: 2013-9-11
Accepted: 2014-4-11
Published Online: 2014-5-22
Published in Print: 2014-9-20

©2014 by De Gruyter

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