Introduction: The role of enlarged adenoid tissue has been long discussed in terms of causes leading obstructive sleep apnea. Sleep disorders in children with adenoid vegetation impair quality and duration of REM sleep where GH secretion is higher. We also thought that cortisol that displays a circadian rhythm might be also affected by sleep disorders. For this purpose, we planned to determine presence of neurosecretory dysfunction (NSD), time and level of cortisol peak in the morning in children with adenoid vegetation.
Material and method: Patients with indication for surgery were identified by measuring grade of adenoid vegetation via flexible fiberoptic endoscope among patients who presented to ETN outpatient clinic. Blood samples were drawn by 20-min intervals after onset of deep sleep for GH measurements. In addition, blood samples were drawn for measurements of ACTH and cortisol, and thyroid function tests at 0700-0900 h.
Results: There were 29 boys (52.7%) and 26 girls (47.3%) with an age range of 512.5 years. Mean GH level was below 3 ng/ml in 32 (58%) of the patients, being consistent with neurosecretory dysfunction. Thyroid function tests were found to be within normal range in all patients, while peak cortisol levels were found to be below 18 μg/dl occurring at 0700 h. When 77.5% degree adenoid obstruction was used as cut-off value for prediction of NSD, sensitivity, specificity, positive predictive value and negative predictive value were calculated as 77, 74, 77, 27%, respectively. Accuracy rate was found as 56%.
Conclusion: We concluded that likelihood of NSD and related growth retardation can be higher in cases with adenoid vegetation grade of 77.5%. We think that early surgical treatment should be come order in cases with adenoid vegetation and that this can be further clarified by larger studies.
20 - 22 Sep 2014
European Society for Paediatric Endocrinology