Growth measures, IGF-1 and IGFBP-3 before and after adenotonsillectomy

ABSTRACT

Adenotonsillar hypertrophy [ATH] is associated with growth interruption during childhood. Its pathophysiological mechanism is unclear. The purpose of this prospective study was to evaluate whether surgical treatment of adenotonsillar hypertrophy affects the circulating concentrations of insulin-like growth factor-1 [IGF-1] and IGF-binding protein 3 [IGFBP-3] along with their standard deviation scores [SDS] adjusted to age which are more important in evaluating growth in childhood. Prepubertal children [15 males and 10 females] aged 4-10 years [mean age 6.2 +/- 3.2 years] who had chronic recurrent hypertrophic adenotonsillitis with obstructive symptoms and 25 healthy children [12 boys and 13 girls] [range 3-10 years] with a mean age of 7.4 +/- 2.5 years as control had the same measurements including Weight, height, body mass index BMI [kg/m2], IGF-1 and IGFBP-3 levels and their standard deviation scores were evaluated before and 12 months after adenotonsillectomy but once during the first examination in the control group. All parameters showed significant difference between control and studied group except weight, BMI and IGFBP-3. Both weight and height SD scores of healthy children were higher than those of children with ATH before adenotonsillectomy [P < 0.05 for both], and were also significant after adenotonsillectomy. The preoperative and postoperative serum levels of IGF-I and IGFBP-3 were compared. There was highly significant increase in IGF-I. The mean serum IGF-1 level increased from 273.1 +/- 301.3 to 659.3 +/- 402 ng/ml [p < 0.001]. Mean pre- and postoperative IGFBP-3 levels did not differ between the control and study groups. Adenotonsillectomy is a curative way to treat children with faltering growth caused by ATH