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

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.