Associations between Adenotonsillar Hypertrophy, Age, and Obesity in Children with Obstructive Sleep Apnea.docVIP

Associations between Adenotonsillar Hypertrophy, Age, and Obesity in Children with Obstructive Sleep Apnea 1,2,3 1 4,5 4,6 1,4* Kun-Tai Kang , Chen-Han Chou , Wen-Chin Weng , Pei-Lin Lee , Wei-Chung Hsu 1 Department of Otolaryngology, National Taiwan University Hospital, Taipei, Taiwan, R.O.C., 2 Department of Otolaryngology, Taipei Hospital, Ministry of Health and Welfare, New Taipei City, Taiwan, R.O.C., 3 Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan, R.O.C., 4 Sleep Center, National Taiwan University Hospital, Taipei, Taiwan, 5 Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan, R.O.C., 6 Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan, R.O.C. Abstract Objective: To investigate the contributions of adenoid and tonsil size to childhood obstructive sleep apnea (OSA) and the interactions between adenotonsillar hypertrophy, age, and obesity in children with OSA. Methods: In total, 495 symptomatic patients were recruited. The patients were assigned to four groups according to age：toddler (age 1-3, n=42), preschool (age 3-6, n=164), school (age 6-12, n=200), and adolescence (age 12-18, n=89). All subjects had tonsil size graded by otolaryngologists, adenoid size determined on lateral radiographs (Fujioka method), and a full-night polysomnography. The apnea-hypopnea index (AHI), adenoid size, and tonsil size were compared in obese and non-obese children in the four age groups. Adjusted odds ratios (ORs) and 95% confidence interval (CI) of adenotonsillar hypertrophy and OSA risk were estimated by multi-logistic regression. Results: The AHI was positively related to tonsil grade (r=0.33, p 0.001) and aden