儿童扁桃体切除术对成人身高的影响——英国生物银行研究
Impact of Childhood Tonsillectomy on Adult Height-A Study of the UK Biobank.
作者信息
Gong Wendan, Psychogios Ioannis, Hu Yihan, Li Shangjun, Chen Wenwen, Su Jiaming, Song Huan, Xiao Xue, Zhang Zhe, Huang Yi, Fang Fang
机构信息
Department of Otolaryngology-Head & Neck Surgery First Affiliated Hospital of Guangxi Medical University Nanning Guangxi China.
Key Laboratory of Early Prevention and Treatment for Regional High-Frequency Tumor (Guangxi Medical University), Ministry of Education Nanning Guangxi China.
出版信息
Laryngoscope Investig Otolaryngol. 2025 Jul 26;10(4):e70213. doi: 10.1002/lio2.70213. eCollection 2025 Aug.
OBJECTIVES
Previous studies have suggested a postoperative "catch-up growth" in children undergoing tonsillectomy. Given the tonsils' crucial role in early immune development, examining long-term effects is imperative. This study aims to investigate the impact of tonsillectomy in early life on adult height and height disparity.
METHODS
Using data from the UK Biobank, we compared individuals with a childhood tonsillectomy to individuals without such an experience, after matching them individually by age and sex. We used standing height measured at recruitment to the UK Biobank as attained adult height, polygenic risk score (PRS) for height as a proxy for genetically determined height, and height deviation and height deficit as proxies for height disparity. We assessed the association of tonsillectomy with these outcomes, using a linear mixed-effect model or conditional logistic regression, after multivariable adjustment.
RESULTS
Individuals with a childhood tonsillectomy had a slightly higher attained adult height (mean: 169.0 cm; standard deviation [SD] 9.23) compared to their age- and sex-matched comparators (mean: 168.5 cm; SD 9.30). After multivariable adjustment, childhood tonsillectomy was associated with a marginally higher attained adult height (: 0.34; 95% confidence interval [CI]: 0.26-0.41), a positive height deviation (: 1.7; 95% CI: 1.4-2.1), and lower odds of height deficit (odds ratio [OR]: 0.89; 95% CI: 0.87-0.92), but not PRS for height (: -0.24; 95% CI: -0.50 to 0.03). The first three associations were more pronounced among individuals with a lower PRS for height, compared to those with a higher PRS for height. The magnitude of the associations for adult height and height deviation also appeared to decrease with increasing age at surgery.
CONCLUSIONS
Individuals with childhood tonsillectomy did not demonstrate height disparity as adults, compared to individuals without such a procedure or relative to their genetically determined height.
LEVEL OF EVIDENCE
目的
既往研究提示，接受扁桃体切除术的儿童术后会出现“追赶生长”。鉴于扁桃体在早期免疫发育中起关键作用，因此有必要研究其长期影响。本研究旨在探讨儿童期扁桃体切除术对成人身高及身高差异的影响。
方法
利用英国生物银行的数据，我们将有儿童期扁桃体切除术经历的个体与无此经历的个体进行比较，年龄和性别进行个体匹配。我们将在加入英国生物银行时测量的站立身高作为成人身高，用身高多基因风险评分（PRS）作为遗传决定身高的替代指标，用身高偏差和身高不足作为身高差异的替代指标。在多变量调整后，我们使用线性混合效应模型或条件逻辑回归评估扁桃体切除术与这些结果之间的关联。
结果
与年龄和性别匹配的对照者相比，有儿童期扁桃体切除术经历的个体成人身高略高（平均：169.0厘米；标准差[SD]9.23）（平均：168.5厘米；SD 9.30）。多变量调整后，儿童期扁桃体切除术与成人身高略高（β：0.34；95%置信区间[CI]：0.26 - 0.41）、正身高偏差（β：1.7；95%CI：1.4 - 2.1）以及身高不足几率较低（比值比[OR]：0.89；95%CI：0.87 - 0.92）相关，但与身高PRS无关（β： - 0.24；95%CI： - 0.50至0.03）。与身高PRS较高的个体相比，前三个关联在身高PRS较低的个体中更为明显。成人身高和身高偏差关联的程度似乎也随着手术年龄的增加而降低。
结论
与未接受该手术的个体或与其遗传决定的身高相比，有儿童期扁桃体切除术经历的个体成年后未表现出身高差异。
证据水平
3级。
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