Short stature caused by obstructive apnoea during sleep.

Bate, Tom; Price, D A; Holme, Caitlin; McGucken, R B

doi:10.1136/adc.59.1.78

Cited by 58 publications

(28 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…5,[7][8][9][10][11] Recently, Bar et al 9 demonstrated a significant increase in weight and serum IGF-1 concentrations after surgical treatment of OSAS in 10 prepubertal children. In the present study, this was confirmed in 19 children operated on and assessed twice.…”

Section: Discussionmentioning

confidence: 99%

Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea

et al. 2002

View full text Add to dashboard Cite

ABSTRACT. Objective. 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 IGFbinding protein 3 (IGFBP-3) along with other growth parameters in children.Patients and Methods. 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.Results. 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.Conclusions. 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. Pediatrics 2002;109(4). URL: http://www.pediatrics.org/cgi/content/full/109/4/e55; snoring, obstructive sleep apnea, growth hormone, insulinlike growth factor-I, insulin-like growth factor-binding protein 3.ABBREVIATIONS. OSAS, obstructive sleep apnea syndrome; GH, growth hormone; IGF-I, insulin-like growth factor-I; IGFBP-3, insulin-like growth factor-binding protein 3; PS, primary snorer; EMG, electromyogram; OAHI, obstructive sleep apnea-hypopnea index; SDS, standard deviation score; BMI, body mass index; SWS, slow-wave sleep. S noring is relatively common in children, with the prevalence of regular snoring about 10% in preschool-aged subjects. 1-3 Obs...

show abstract

Section: Discussionmentioning

confidence: 99%

Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea

et al. 2002

View full text Add to dashboard Cite

show abstract

“…If OSAS is not associated with an increase in TEE, alternative explanations for improved growth and nutritional status after its resolution should be considered: there are many alternative hypotheses [1][2][3][4][5][6][7][8]. If the problem does have its origins in energy imbalance but hypermetabolism is ruled out, limits on energy "intake" might constrain growth/nutritional status in OSAS.…”

Section: Discussionmentioning

confidence: 99%

“…The cause of failure to thrive in children with OSAS is unknown. A number of features of OSAS might predispose children to growth and nutritional problems, including increased energy expenditure, anorexia or dysphagia as a result of adenotonsillar hypertrophy and/or recurrent infection, abnormal growth hormone secretion, and nocturnal hypoxia [5][6][7][8].…”

mentioning

confidence: 99%

Total energy expenditure in children with obstructive sleep apnoea syndrome

et al. 2001

View full text Add to dashboard Cite

Childhood obstructive sleep apnoea syndrome (OSAS) acts as a check on growth and nutritional status. An increase in sleeping energy expenditure has been proposed as a possible mechanism, but to date, no studies have determined whether energy requirements (total energy expenditure; TEE) are raised in OSAS. The aim of this study was to test the hypothesis that OSAS is associated with increased TEE.Eleven children (mean¡SD 5.8¡2.2 yrs of age) with OSAS confirmed by nocturnal polysomnography were each matched with a pair of healthy controls (n~22) of the same age and sex. TEE was measured using the doubly-labelled water method in all subjects. In 10/11 patients TEE was also measured after adenotonsillectomy and changes in TEE assessed.There was no significant difference in TEE between patients (mean¡SD 325¡44 kJ?kg -1 ?day -1 ) and controls (339¡48 kJ?kg -1 ?day -1 ), nor between patients and age-and sex-specific literature data on TEE, using the doubly-labelled water method. Differences in TEE within patients, before versus after surgery, were minor and not statistically significant.This study does not support the hypothesis that obstructive sleep apnoea syndrome in childhood is associated with increased energy requirements, and suggests that alternative explanations for the effect of this syndrome on growth and energy balance should be sought.

show abstract

“…Not only failure to thrive is more commonly recognized but also complications, namely insufficient weight and height gain have been well documented in these children and ''catch-up'' growth after A&T has been demonstrated [2][3][4]. Although many different reasons such as poor appetite and difficulties in feeding resulting in lower total caloric intake, nocturnal hypoxemia, and nocturnal respiratory acidosis have been implicated, exact etiology of the growth retardation is unknown [2,3,5,6]. Abnormal nocturnal growth hormone (GH) secretion and impaired GH action have also been suggested [4,7,8].…”

Section: Introductionmentioning

confidence: 99%

Changes in growth pattern, body composition and biochemical markers of growth after adenotonsillectomy in prepubertal children

Ersoy

Yücetürk

Taneli

et al. 2005

International Journal of Pediatric Otorhinolaryngology

View full text Add to dashboard Cite

Short stature caused by obstructive apnoea during sleep.

Abstract: SUMMARY A 5 year old girl presented to a growth clinic with short stature. Obstructive sleep apnoea was diagnosed. After tonsillectomy her symptoms were alleviated and her rate of growth increased from 4-0 cm/year to 13-6 cm/year.

Cited by 58 publications

References 6 publications

Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea

Growth and Biochemical Markers of Growth in Children With Snoring and Obstructive Sleep Apnea

Total energy expenditure in children with obstructive sleep apnoea syndrome

Changes in growth pattern, body composition and biochemical markers of growth after adenotonsillectomy in prepubertal children

Contact Info

Product

Resources

About