Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea
The pathophysiological mechanisms of growth impairment frequently associated with the obstructive sleep apnea syndrome (OSAS) in children are poorly defined. The main objective of this study was to evaluate whether nighttime upper airway obstruction attributable to adenotonsillar hypertrophy and sub...
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| Veröffentlicht in: | Pediatrics (Evanston) 2002-04, Vol.109 (4), p.e55-e55 |
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| creator | Nieminen, Peter Lopponen, Tuija Tolonen, Uolevi Lanning, Peter Knip, Mikael Lopponen, Heikki |
| description | The pathophysiological mechanisms of growth impairment frequently associated with the obstructive sleep apnea syndrome (OSAS) in children are poorly defined. The main objective of this study was to evaluate whether nighttime upper airway obstruction attributable to adenotonsillar hypertrophy and subsequent surgical treatment affect the circulating concentrations of insulin-like growth factor-I (IGF-I) and IGF-binding protein 3 (IGFBP-3) along with other growth parameters in children.
We initially studied 70 children (mean age: 5.8 years; range: 2.4-10.5 years) admitted to a university hospital because of clinical symptoms of OSAS. Their sleep was monitored with a 6-channel computerized polygraph. Data on anthropometry and circulating concentrations of IGF-I and IGFBP-3 were generated and compared with corresponding characteristics in control children (N = 35). Thirty children with an obstructive apnea-hypopnea index (OAHI) of 1 or more were categorized as children with OSAS (mean OAHI: 5.4 [95% confidence interval for mean (CI): 3.8-6.9]), whereas 40 children with an OAHI of 2 underwent adenotonsillectomy attributable to OSAS and were reassessed 6 months later together with 34 nonoperated children with OAHI |
| doi_str_mv | 10.1542/peds.109.4.e55 |
| format | Article |
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We initially studied 70 children (mean age: 5.8 years; range: 2.4-10.5 years) admitted to a university hospital because of clinical symptoms of OSAS. Their sleep was monitored with a 6-channel computerized polygraph. Data on anthropometry and circulating concentrations of IGF-I and IGFBP-3 were generated and compared with corresponding characteristics in control children (N = 35). Thirty children with an obstructive apnea-hypopnea index (OAHI) of 1 or more were categorized as children with OSAS (mean OAHI: 5.4 [95% confidence interval for mean (CI): 3.8-6.9]), whereas 40 children with an OAHI of <1 were considered as primary snorers (PS) (mean OAHI 0.13 [95% CI: 0.05-0.21]). Nineteen children with OAHI >2 underwent adenotonsillectomy attributable to OSAS and were reassessed 6 months later together with 34 nonoperated children with OAHI <2.
There were no initial differences in relative height and weight for height between the 3 groups of children. No differences were observed in peripheral IGF-I concentrations, but both OSAS and PS children had reduced peripheral IGFBP-3 levels. The operated children with initial OSAS experienced a highly significant reduction in their OAHI from 7.1 (95% CI: 5.1-9.1) to 0.37 (95% CI: 0.2-0.95). Weight-for-height, body mass index, body fat mass, and fat-free mass increased during the follow-up in the operated children with OSAS, whereas only fat-free mass and relative height increased in the PS children. Both the IGF-I and the IGFBP-3 concentrations increased significantly in the operated children, whereas no significant changes were seen in the PS children.
These observations indicate that growth hormone secretion is impaired in children with OSAS and PS. Respiratory improvement after adenotonsillectomy in children with OSAS results in weight gain and restored growth hormone secretion.</description><identifier>ISSN: 0031-4005</identifier><identifier>EISSN: 1098-4275</identifier><identifier>DOI: 10.1542/peds.109.4.e55</identifier><identifier>PMID: 11927728</identifier><identifier>CODEN: PEDIAU</identifier><language>eng</language><publisher>United States: Am Acad Pediatrics</publisher><subject>Adenoidectomy ; Anthropometry ; Child ; Child, Preschool ; Female ; Follow-Up Studies ; Growth ; Humans ; Infant ; Insulin-Like Growth Factor Binding Protein 3 - metabolism ; Insulin-Like Growth Factor I - metabolism ; Male ; Pediatrics ; Sleep Apnea, Obstructive - complications ; Sleep Apnea, Obstructive - physiopathology ; Sleep Apnea, Obstructive - surgery ; Snoring - complications ; Snoring - physiopathology ; Tonsillectomy ; Weight Gain</subject><ispartof>Pediatrics (Evanston), 2002-04, Vol.109 (4), p.e55-e55</ispartof><rights>Copyright National Library of Medicine - MEDLINE Abstracts Apr 2002</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c357t-3ce780af27c449a83b0994bcf509aaa9764c4c19a617d72b021c5fc2fd1494793</citedby><cites>FETCH-LOGICAL-c357t-3ce780af27c449a83b0994bcf509aaa9764c4c19a617d72b021c5fc2fd1494793</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/11927728$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nieminen, Peter</creatorcontrib><creatorcontrib>Lopponen, Tuija</creatorcontrib><creatorcontrib>Tolonen, Uolevi</creatorcontrib><creatorcontrib>Lanning, Peter</creatorcontrib><creatorcontrib>Knip, Mikael</creatorcontrib><creatorcontrib>Lopponen, Heikki</creatorcontrib><title>Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea</title><title>Pediatrics (Evanston)</title><addtitle>Pediatrics</addtitle><description>The pathophysiological mechanisms of growth impairment frequently associated with the obstructive sleep apnea syndrome (OSAS) in children are poorly defined. The main objective of this study was to evaluate whether nighttime upper airway obstruction attributable to adenotonsillar hypertrophy and subsequent surgical treatment affect the circulating concentrations of insulin-like growth factor-I (IGF-I) and IGF-binding protein 3 (IGFBP-3) along with other growth parameters in children.
We initially studied 70 children (mean age: 5.8 years; range: 2.4-10.5 years) admitted to a university hospital because of clinical symptoms of OSAS. Their sleep was monitored with a 6-channel computerized polygraph. Data on anthropometry and circulating concentrations of IGF-I and IGFBP-3 were generated and compared with corresponding characteristics in control children (N = 35). Thirty children with an obstructive apnea-hypopnea index (OAHI) of 1 or more were categorized as children with OSAS (mean OAHI: 5.4 [95% confidence interval for mean (CI): 3.8-6.9]), whereas 40 children with an OAHI of <1 were considered as primary snorers (PS) (mean OAHI 0.13 [95% CI: 0.05-0.21]). Nineteen children with OAHI >2 underwent adenotonsillectomy attributable to OSAS and were reassessed 6 months later together with 34 nonoperated children with OAHI <2.
There were no initial differences in relative height and weight for height between the 3 groups of children. No differences were observed in peripheral IGF-I concentrations, but both OSAS and PS children had reduced peripheral IGFBP-3 levels. The operated children with initial OSAS experienced a highly significant reduction in their OAHI from 7.1 (95% CI: 5.1-9.1) to 0.37 (95% CI: 0.2-0.95). Weight-for-height, body mass index, body fat mass, and fat-free mass increased during the follow-up in the operated children with OSAS, whereas only fat-free mass and relative height increased in the PS children. Both the IGF-I and the IGFBP-3 concentrations increased significantly in the operated children, whereas no significant changes were seen in the PS children.
These observations indicate that growth hormone secretion is impaired in children with OSAS and PS. Respiratory improvement after adenotonsillectomy in children with OSAS results in weight gain and restored growth hormone secretion.</description><subject>Adenoidectomy</subject><subject>Anthropometry</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Growth</subject><subject>Humans</subject><subject>Infant</subject><subject>Insulin-Like Growth Factor Binding Protein 3 - metabolism</subject><subject>Insulin-Like Growth Factor I - metabolism</subject><subject>Male</subject><subject>Pediatrics</subject><subject>Sleep Apnea, Obstructive - complications</subject><subject>Sleep Apnea, Obstructive - physiopathology</subject><subject>Sleep Apnea, Obstructive - surgery</subject><subject>Snoring - complications</subject><subject>Snoring - physiopathology</subject><subject>Tonsillectomy</subject><subject>Weight Gain</subject><issn>0031-4005</issn><issn>1098-4275</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2002</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpdkEtLxDAURoMoOj62LiW4cNeapMmkWY6DL1BcqLiSkKa3NmNfJq2D_96ODoy4ug_OPVw-hI4piang7LyDPMSUqJjHIMQWmox9GnEmxTaaEJLQiBMi9tB-CAtCCBeS7aI9ShWTkqUT9Hrt22VfYtPk-MK1toTaWVPhe-PfwQfcFnhNuAbPS1flHhr84sbFY9N617z9nD5kofeD7d0n4McKoMOzrgFziHYKUwU4WtcD9Hx1-TS_ie4erm_ns7vIJkL2UWJBpsQUTFrOlUmTjCjFM1sIoowxSk655ZYqM6UylywjjFpRWFbklCsuVXKAzn69nW8_Bgi9rl2wUFWmgXYIWlIhRwkbwdN_4KIdfDP-phlLEz5VP7b4F7K-DcFDoTvvauO_NCV6lbpepT4OSnM9pj4enKytQ1ZDvsHXMW-MpXsrl87DyuBM750Nf9qN8RtBPI5f</recordid><startdate>20020401</startdate><enddate>20020401</enddate><creator>Nieminen, Peter</creator><creator>Lopponen, Tuija</creator><creator>Tolonen, Uolevi</creator><creator>Lanning, Peter</creator><creator>Knip, Mikael</creator><creator>Lopponen, Heikki</creator><general>Am Acad Pediatrics</general><general>American Academy of Pediatrics</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7TS</scope><scope>7U9</scope><scope>H94</scope><scope>K9.</scope><scope>M7N</scope><scope>NAPCQ</scope><scope>U9A</scope><scope>7X8</scope></search><sort><creationdate>20020401</creationdate><title>Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea</title><author>Nieminen, Peter ; Lopponen, Tuija ; Tolonen, Uolevi ; Lanning, Peter ; Knip, Mikael ; Lopponen, Heikki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c357t-3ce780af27c449a83b0994bcf509aaa9764c4c19a617d72b021c5fc2fd1494793</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2002</creationdate><topic>Adenoidectomy</topic><topic>Anthropometry</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Growth</topic><topic>Humans</topic><topic>Infant</topic><topic>Insulin-Like Growth Factor Binding Protein 3 - metabolism</topic><topic>Insulin-Like Growth Factor I - metabolism</topic><topic>Male</topic><topic>Pediatrics</topic><topic>Sleep Apnea, Obstructive - complications</topic><topic>Sleep Apnea, Obstructive - physiopathology</topic><topic>Sleep Apnea, Obstructive - surgery</topic><topic>Snoring - complications</topic><topic>Snoring - physiopathology</topic><topic>Tonsillectomy</topic><topic>Weight Gain</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nieminen, Peter</creatorcontrib><creatorcontrib>Lopponen, Tuija</creatorcontrib><creatorcontrib>Tolonen, Uolevi</creatorcontrib><creatorcontrib>Lanning, Peter</creatorcontrib><creatorcontrib>Knip, Mikael</creatorcontrib><creatorcontrib>Lopponen, Heikki</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>Physical Education Index</collection><collection>Virology and AIDS Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Pediatrics (Evanston)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nieminen, Peter</au><au>Lopponen, Tuija</au><au>Tolonen, Uolevi</au><au>Lanning, Peter</au><au>Knip, Mikael</au><au>Lopponen, Heikki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea</atitle><jtitle>Pediatrics (Evanston)</jtitle><addtitle>Pediatrics</addtitle><date>2002-04-01</date><risdate>2002</risdate><volume>109</volume><issue>4</issue><spage>e55</spage><epage>e55</epage><pages>e55-e55</pages><issn>0031-4005</issn><eissn>1098-4275</eissn><coden>PEDIAU</coden><abstract>The pathophysiological mechanisms of growth impairment frequently associated with the obstructive sleep apnea syndrome (OSAS) in children are poorly defined. The main objective of this study was to evaluate whether nighttime upper airway obstruction attributable to adenotonsillar hypertrophy and subsequent surgical treatment affect the circulating concentrations of insulin-like growth factor-I (IGF-I) and IGF-binding protein 3 (IGFBP-3) along with other growth parameters in children.
We initially studied 70 children (mean age: 5.8 years; range: 2.4-10.5 years) admitted to a university hospital because of clinical symptoms of OSAS. Their sleep was monitored with a 6-channel computerized polygraph. Data on anthropometry and circulating concentrations of IGF-I and IGFBP-3 were generated and compared with corresponding characteristics in control children (N = 35). Thirty children with an obstructive apnea-hypopnea index (OAHI) of 1 or more were categorized as children with OSAS (mean OAHI: 5.4 [95% confidence interval for mean (CI): 3.8-6.9]), whereas 40 children with an OAHI of <1 were considered as primary snorers (PS) (mean OAHI 0.13 [95% CI: 0.05-0.21]). Nineteen children with OAHI >2 underwent adenotonsillectomy attributable to OSAS and were reassessed 6 months later together with 34 nonoperated children with OAHI <2.
There were no initial differences in relative height and weight for height between the 3 groups of children. No differences were observed in peripheral IGF-I concentrations, but both OSAS and PS children had reduced peripheral IGFBP-3 levels. The operated children with initial OSAS experienced a highly significant reduction in their OAHI from 7.1 (95% CI: 5.1-9.1) to 0.37 (95% CI: 0.2-0.95). Weight-for-height, body mass index, body fat mass, and fat-free mass increased during the follow-up in the operated children with OSAS, whereas only fat-free mass and relative height increased in the PS children. Both the IGF-I and the IGFBP-3 concentrations increased significantly in the operated children, whereas no significant changes were seen in the PS children.
These observations indicate that growth hormone secretion is impaired in children with OSAS and PS. Respiratory improvement after adenotonsillectomy in children with OSAS results in weight gain and restored growth hormone secretion.</abstract><cop>United States</cop><pub>Am Acad Pediatrics</pub><pmid>11927728</pmid><doi>10.1542/peds.109.4.e55</doi></addata></record> |
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| subjects | Adenoidectomy Anthropometry Child Child, Preschool Female Follow-Up Studies Growth Humans Infant Insulin-Like Growth Factor Binding Protein 3 - metabolism Insulin-Like Growth Factor I - metabolism Male Pediatrics Sleep Apnea, Obstructive - complications Sleep Apnea, Obstructive - physiopathology Sleep Apnea, Obstructive - surgery Snoring - complications Snoring - physiopathology Tonsillectomy Weight Gain |
| title | Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea |
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