Adenotonsillectomy for obstructive sleep apnea syndrome led to clinically significant weight gain, even in children who were overweight at baseline, according to a first-in-kind randomized clinical trial published in the August issue of Pediatrics.
More than 52% of overweight children with obstructive sleep apnea syndrome (OSAS) who underwent adenotonsillectomy developed obesity within 7 months, compared with 21% of those randomized to watchful waiting and supportive care (P less than .05), reported Dr. Eliot S. Katz of Boston Children’s Hospital and his associates.
Based on those results, children who undergo adenotonsillectomy for OSAS should be monitored for weight changes, receive nutritional counseling, and be encouraged to exercise, the researchers said (Pediatrics 2014;134:282-9).
For the multicenter, single-blind clinical trial, the investigators randomized 464 children aged 5-9.9 years with OSAS to undergo either early adenotonsillectomy – defined as surgery within 4 weeks of randomization – or watchful waiting and supportive care.
Children classified as failing to thrive at baseline were more likely to attain a normal weight after adenotonsillectomy, compared with watchful waiting, although the difference was not statistically significant, Dr. Katz and his associates said.
The National Institutes of Health funded the study. One coauthor reported having served as a consultant for Zansors and receiving grants from Respironics/Phillips and Fisher-Paykel. The other authors reported no conflicts of interest.