Daar Ghaniya, Sarı Kamran, Gencer Zeliha Kapusuz, Ede Hüseyin, Aydın Reha, Saydam Levent
Department of Pediatrics, Faculty of Medicine, Bozok University, Adnan Menderes Bulvarı No:44, 66200, Yozgat, Turkey.
Department of Otorhinolaryngology, Faculty of Medicine, Bozok University, Yozgat, Turkey.
Eur Arch Otorhinolaryngol. 2016 Feb;273(2):505-9. doi: 10.1007/s00405-015-3554-4. Epub 2015 Feb 10.
Childhood obesity is a common and significant public health problem all over the world. As a well-known fact obese children have an increased risk of obesity-associated comorbidities, including obstructive sleep apnea, diabetes, and cardiovascular disorders at an earlier age compared to their normal weight peers. They also have an increased risk of poor self-esteem, greater body dissatisfaction, and increased peer teasing that lead to a lower health-related quality of life. While the presence of adenoid hypertrophy and increased rate of obstructive sleep apnea frequently co-exists in majority of cases. We have limited knowledge about the effect of adenotonsillar hypertrophy on development of childhood obesity. In this study, we aimed to investigate the association between obesity, presence of adenotonsillar hypertrophy and the quality of life parameters in obese children as measured by the OSA-18 quality of life questionnaire. Fifty obese children aged between 3 and 18 years and 50 age- and gender-matched otherwise children were enrolled to the study. All subjects were routinely examined by the otolaryngologist before enrollment. The size of adenoid hypertrophy was measured using lateral cephalometric radiographs. The tonsils were also graded using the schema recommended by Brodsky et al. We used OSA-18 questionnaires to evaluate the subjects' quality of life issues. We found, 34 % of obese group had tonsillar hypertrophy while the rate was 6 % in control group. Similarly 16 % of obese group had tonsillar hypertrophy compared to only 4 % in non-obese group. It was also noted that total OSA-18 scores of obese group were significantly higher than those of non-obese group. In subgroup analysis of obese group, total OSA-18 score of obese subjects with either adenoid and/or tonsillar hypertrophy was significantly higher than that of obese subjects without adenoid or tonsillar hypertrophy. As the related literature suggests that the impact of adenotonsillar size on OSA symptoms is prominent especially in children under 7 years of age, but its impact on the development of childhood obesity is still controversial. Our results revealed a possible relation between adenotonsillar hypertrophy and obesity rates. Further studies on larger populations should be planned to better define the real impact of adenotonsillar hypertrophy in obese children.
儿童肥胖是全球普遍且严重的公共卫生问题。众所周知，肥胖儿童相较于体重正常的同龄人，在更早的年龄就有更高的肥胖相关合并症风险，包括阻塞性睡眠呼吸暂停、糖尿病和心血管疾病。他们还更有可能出现自卑、对身体更不满意以及受到同伴更多嘲笑的情况，这些都会导致与健康相关的生活质量下降。虽然在大多数情况下，腺样体肥大和阻塞性睡眠呼吸暂停发生率增加常常同时存在。但我们对腺样体扁桃体肥大对儿童肥胖发展的影响了解有限。在本研究中，我们旨在通过OSA - 18生活质量问卷来调查肥胖、腺样体扁桃体肥大的存在与肥胖儿童生活质量参数之间的关联。50名年龄在3至18岁的肥胖儿童和50名年龄及性别匹配的其他儿童被纳入研究。所有受试者在入组前均由耳鼻喉科医生进行常规检查。使用头颅侧位X线片测量腺样体肥大的大小。扁桃体也按照Brodsky等人推荐的标准进行分级。我们使用OSA - 18问卷来评估受试者的生活质量问题。我们发现，肥胖组中有34%的儿童有扁桃体肥大，而对照组这一比例为6%。同样，肥胖组中有16%的儿童有腺样体肥大，而非肥胖组仅为4%。还注意到肥胖组的OSA - 18总分显著高于非肥胖组。在肥胖组的亚组分析中，有腺样体和/或扁桃体肥大的肥胖受试者的OSA - 18总分显著高于没有腺样体或扁桃体肥大的肥胖受试者。正如相关文献所表明的，腺样体扁桃体大小对OSA症状的影响在7岁以下儿童中尤为突出，但其对儿童肥胖发展的影响仍存在争议。我们的结果揭示了腺样体扁桃体肥大与肥胖率之间可能存在的关系。应该计划对更多人群进行进一步研究，以更好地确定腺样体扁桃体肥大对肥胖儿童的实际影响。
