The Effect of Adenotonsillectomy in the Production of IGF-1 (Insulin-like Growth Factor-1) in Children

Objective: Airway obstruction caused by adenotonsillar hypertrophy is the main cause of snoring and sleep apnea in children and often associated with several other signs and symptoms, including growth development. The objective of this study was to evaluate the effect of adenotonsillectomy in the production of IGF-1 (insulin-like growth factor-1) in children. Method: A total of 26 children of both sexes with adenotonsillar hypertrophy with formal indication for adenotonsillectomy (study group) and 21 control children (with indication for surgery for other reasons, eg, postectomy) were submitted to evaluation of peripheral blood IGF-1. The samples were taken immediately preoperatively and 30 days after surgery. Results: The preoperative levels of IGF-1 showed values within the normal range for age in both groups. Two children in the study group had values below normal for their age. The comparison of pre- and postoperative levels in children undergoing tonsillectomy showed a statistically significant increase (P < .01) by Student t test for paired samples. The 2 children with preoperative values below normal for age recovered normal levels of IGF-1 after surgery. Conclusion: The data from our study suggest that adenotonsillar hypertrophy, resulting in snoring and sleep apnea can affect negatively the production of circulating IGF-1, probably related to the disturbances of height and growth development, and demonstrate that adenotonsillectomy contributes to enhancing and restoring the values of IGF-1.