Children who experience chronic sleep disordered breathing (SDB) because of adenotonsillar hypertrophy may present with retarded growth, say UK and US researchers. In a systematic review and meta-analysis of 20 studies, the authors analysed the outcomes pre- and post-adenotonsillectomy for standardised height and weight, and the serum biomarkers insulin-like growth factor 1 (IGF1) and IGF binding protein 3. The results showed that height, weight and both serum biomarkers increased significantly after adenotonsillectomy. The authors comment that there are some limitations to the study, including a paucity of literature, and no suitable trials of surgery versus no surgery (“watchful waiting”) were identified for inclusion in the analysis. They also discuss problems inherent in the use of serum biomarkers, for which it is difficult to find accepted reference ranges for healthy children. Despite these limitations, the researchers conclude that their findings support the association between SDB and growth failure, and that the condition should be considered by clinicians in their investigations for growth failure and short stature in children.
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