Wijga Alet H, Scholtens Salome, Wieringa Marjan H, Kerkhof Marjan, Gerritsen Jorrit, Brunekreef Bert, Smit Henriette A
National Institute for Public Health and the Environment, Centre for Prevention and Health Services Research, PO Box 1, 3720 BA, Bilthoven, Netherlands.
Pediatrics. 2009 Apr;123(4):1095-101. doi: 10.1542/peds.2008-1502.
Studies among patients have shown accelerated weight gain after (adeno)tonsillectomy. Whether (adeno)tonsillectomy is also a risk factor for the development of overweight is unknown. We investigated the association between (adeno)tonsillectomy and the subsequent development of overweight in the general population.
The study population consisted of 3963 children participating in the Dutch Prevention and Incidence of Asthma and Mite Allergy birth cohort. Data on weight and height, adenoidectomy and tonsillectomy, and covariates (gender, birth weight, maternal education, maternal overweight, maternal smoking during pregnancy, breastfeeding, and smoking in the home) were obtained from annual questionnaires completed by the parents. In addition to the questionnaire data, weight and height were measured by the investigators when the children were 8 years old.
(Adeno)tonsillectomy between 0 and 7 years of age was significantly associated with overweight and obesity at age 8. Overweight at the age of 2 years was not associated with increased risk of (adeno)tonsillectomy in later years, indicating that the association between (adeno)tonsillectomy and overweight was not explained by preexisting overweight. Longitudinal data on weight and height in the years before and after surgery suggest that (adeno)tonsillectomy forms a turning point between a period of growth faltering and a period of catch-up growth, which might explain the increased risk to develop overweight after the operation.
Children who undergo (adeno)tonsillectomy are at increased risk to develop overweight in the years after surgery.
针对患者的研究表明,(腺)扁桃体切除术后体重加速增加。(腺)扁桃体切除术是否也是超重发生的危险因素尚不清楚。我们调查了(腺)扁桃体切除术与普通人群中随后超重发生之间的关联。
研究人群包括3963名参与荷兰哮喘与螨虫过敏预防及发病率出生队列研究的儿童。体重和身高、腺样体切除术和扁桃体切除术以及协变量(性别、出生体重、母亲教育程度、母亲超重、孕期母亲吸烟、母乳喂养以及家中吸烟情况)的数据来自家长每年填写的问卷。除问卷数据外,研究人员在儿童8岁时测量了他们的体重和身高。
0至7岁时进行的(腺)扁桃体切除术与8岁时的超重和肥胖显著相关。2岁时超重与后期(腺)扁桃体切除术风险增加无关,这表明(腺)扁桃体切除术与超重之间的关联并非由既往超重所解释。手术前后数年的体重和身高纵向数据表明,(腺)扁桃体切除术是生长发育迟缓期和追赶生长期之间的一个转折点,这可能解释了术后超重风险增加的原因。
接受(腺)扁桃体切除术的儿童在术后数年发生超重的风险增加。