Abstract：
BACKGROUND: Adenotonsillar hypertrophy (ATH) may present with growth retardation. Insulin-like growth factor 1 (IGF-1) mediates the anabolic effects of growth hormone (GH) on tissues. Most of the circulating IGF-1 molecules are bound to insulin-like growth factor-binding protein 3 (IGFBP-3). IGF-1 and IGFBP-3 serum levels reflect the levels of daily mean serum GH and are used as indices for evaluating the serum level of GH. This study aimed to determine the effect of adenotonsillectomy on IGF-1 and IGFBP-3 serum levels in patients with ATH or recurrent tonsillitis. Furthermore, we aimed to investigate the effect of adenotonsillectomy on growth indices such as weight and height.
METHODS: A total of 100 randomly selected children with a diagnosis of ATH or recurrent tonsillitis with a mean age of 10.2 ± 1.4 years (range, 3-17 years) were enrolled in the intervention group. Of those, 53 were boys and 47 were girls. The control group included 100 healthy children (62 boys and 38 girls) with a mean age of 8.5 ± 1.5 years (range, 4-15 years). Growth indices such as weight and height were measured and documented at the time of surgery and 6 months after the operation. Blood samples were taken preoperatively and repeated 6 months after adenotonsillectomy. The coated-tube immunoradiometric (IRMA) method was used to measure IGF-1 and IGFBP-3 levels.
RESULTS: Postoperative IGF-1 and IGFBP-3 serum levels as well as weight and height showed were significantly greater in comparison with preoperative measurements in both the intervention and control groups (P<0.001). At the end of study, the intervention group showed significantly greater changes from baseline in IGF-1 and IGFBP-3 serum levels, weight, and height in comparison with the control group (P< 0.001).
CONCLUSIONS: This study shows that adenotonsillectomy in children with ATH or recurrent tonsillitis increases IGF-1 and IGFBP-3 serum levels in comparison with preoperative levels by affecting the GH-IGF-1 axis, and subsequently leads to a faster increase in growth indices compared with healthy peers during the same period.
METHODS: A total of 100 randomly selected children with a diagnosis of ATH or recurrent tonsillitis with a mean age of 10.2 ± 1.4 years (range, 3-17 years) were enrolled in the intervention group. Of those, 53 were boys and 47 were girls. The control group included 100 healthy children (62 boys and 38 girls) with a mean age of 8.5 ± 1.5 years (range, 4-15 years). Growth indices such as weight and height were measured and documented at the time of surgery and 6 months after the operation. Blood samples were taken preoperatively and repeated 6 months after adenotonsillectomy. The coated-tube immunoradiometric (IRMA) method was used to measure IGF-1 and IGFBP-3 levels.
RESULTS: Postoperative IGF-1 and IGFBP-3 serum levels as well as weight and height showed were significantly greater in comparison with preoperative measurements in both the intervention and control groups (P<0.001). At the end of study, the intervention group showed significantly greater changes from baseline in IGF-1 and IGFBP-3 serum levels, weight, and height in comparison with the control group (P< 0.001).
CONCLUSIONS: This study shows that adenotonsillectomy in children with ATH or recurrent tonsillitis increases IGF-1 and IGFBP-3 serum levels in comparison with preoperative levels by affecting the GH-IGF-1 axis, and subsequently leads to a faster increase in growth indices compared with healthy peers during the same period.
摘要：
背景：扁桃体扁桃体肥大（ATH）可能表现为生长迟缓。胰岛素样生长因子1（IGF-1）介导生长激素（GH）对组织的合成代谢作用。大多数循环IGF-1分子与胰岛素样生长因子结合蛋白3（IGFBP-3）结合。IGF-1和IGFBP-3血清水平反映了日平均血清GH水平，并用作评估GH血清水平的指标。这项研究旨在确定腺样体扁桃体切除术对ATH或复发性扁桃体炎患者IGF-1和IGFBP-3血清水平的影响。此外，我们旨在研究扁桃体腺样体切除术对体重和身高等生长指标的影响。
方法：共随机选择100名诊断为ATH或复发性扁桃体炎的儿童，平均年龄为10.2±1.4岁（范围，3-17年）纳入干预组。其中,53个是男孩，47个是女孩。对照组包括100名健康儿童（62名男孩和38名女孩），平均年龄为8.5±1.5岁（范围，4-15年）。在手术时和手术后6个月测量并记录生长指数，例如体重和身高。术前采集血样，并在腺样体扁桃体切除术后6个月重复。使用包被管免疫放射（IRMA）方法测量IGF-1和IGFBP-3水平。
结果：术后IGF-1和IGFBP-3的血清水平以及体重和身高均明显高于干预组和对照组的术前测量值（P<0.001）。在研究结束时,干预组的IGF-1和IGFBP-3血清水平与基线相比变化明显，体重,身高与对照组比较(P<0.001)。
结论：这项研究表明，与ATH或复发性扁桃体炎儿童相比，腺样体扁桃体切除术通过影响GH-IGF-1轴，使IGF-1和IGFBP-3血清水平增加，随后导致同期与健康同行相比增长指数更快的增长。
方法：共随机选择100名诊断为ATH或复发性扁桃体炎的儿童，平均年龄为10.2±1.4岁（范围，3-17年）纳入干预组。其中,53个是男孩，47个是女孩。对照组包括100名健康儿童（62名男孩和38名女孩），平均年龄为8.5±1.5岁（范围，4-15年）。在手术时和手术后6个月测量并记录生长指数，例如体重和身高。术前采集血样，并在腺样体扁桃体切除术后6个月重复。使用包被管免疫放射（IRMA）方法测量IGF-1和IGFBP-3水平。
结果：术后IGF-1和IGFBP-3的血清水平以及体重和身高均明显高于干预组和对照组的术前测量值（P<0.001）。在研究结束时,干预组的IGF-1和IGFBP-3血清水平与基线相比变化明显，体重,身高与对照组比较(P<0.001)。
结论：这项研究表明，与ATH或复发性扁桃体炎儿童相比，腺样体扁桃体切除术通过影响GH-IGF-1轴，使IGF-1和IGFBP-3血清水平增加，随后导致同期与健康同行相比增长指数更快的增长。
