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Panminerva Medica 2020 Apr 23

DOI: 10.23736/S0031-0808.20.03904-X

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

Beyond the growth delay in children with sleep-related breathing disorders: a systematic review

Marco ZAFFANELLO 1 , Giorgio PIACENTINI 1, Stefania LA GRUTTA 2

1 Department of Surgical Sciences, Dentistry, Gynecology and Pediatrics, University of Verona, Verona, Italy; 2 National Research Council of Italy, Institute for Research and Biomedical Innovation, Palermo, Italy


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INTRODUCTION: The availability of high-quality studies on the association between sleep-disordered breathing in children and delayed growth associated with the hormonal profile recorded before surgery and at follow-up is limited.
EVIDENCE ACQUISITION: Medline PubMed, Scopus and WebOfScience databases were searched for relevant publications published between January 2008 to January 2020 and a total of 261 potentially eligible studies were identified.
EVIDENCE SYNTHESIS: Following review 19 papers were eligible for inclusion: seven reported a significant post- surgical increase in growth regardless of initial weight status, type of surgery, type of study design, and length of follow-up period. The only high-quality study was a randomized controlled trial that found an increased risk of OSAS relapse in overweight children. Twelve studies reported the significant increase in growth parameters showing that IGF-1, IGFBP-3, and ghrelin may boost growth after surgery.
CONCLUSIONS: The current systematic review demonstrates a scarcity of high quality studies on growth delay in children with sleep-disordered breathing. Significant catch-up growth after surgery in the short term and changes in IGF-1, IGFBP-3, ghrelin, and leptin levels has been reported in most published studies.


KEY WORDS: Adenotonsillar hypertrophy; Adenotonsillectomy; Failure to thrive; Growth delay; Biochemical marker; Obstructive sleep apnea syndrome; Sleep-disordered breathing

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