Endocrine Abstracts

JOINT1148

Background: Adenotonsillectomy (AT) is one of the most common pediatric surgeries, primarily indicated for obstructive sleep apnea (OSA) and recurrent infections. Although effective, prior studies have mainly examined the association between AT and short-term weight gain, with limited focus on the potential for long-term obesity following the procedure.

Objective: This study aimed to investigate the long-term association between AT and BMI changes, focusing on a 10-year follow-up in a large, nationwide cohort.

Methods: This retrospective cohort study utilized Clalit Health Services’ electronic medical records. A total of 2,166 pediatric patients (aged 0-18) were included, with 1,083 children undergoing AT, matched 1:1 to a control group based on sex, ethnicity, and birth year. Baseline BMI and BMI Z-scores were recorded prior to surgery, with follow-up measurements collected over a 10-year period. To minimize bias, children with severe chronic conditions and diseases known to affect weight regulation were excluded. This ensured that BMI changes reflected the impact of surgery rather than underlying medical factors. Statistical analyses included propensity score matching and inverse probability weighting to adjust for potential confounders such as socioeconomic status and preoperative health conditions.

Results: At baseline, BMI values were comparable between groups, with no statistically significant differences (mean BMI Z-score: 0.14±1.31). At the 10-year follow-up, children in the AT group demonstrated a significantly higher mean BMI Z-score (0.65±1.45) compared to the control group (0.43±1.44, P<0.001). The proportion of children classified as obese increased from 12% to 26% in the AT group, compared to an increase from 12% to 22% in the control group (P=0.04). Furthermore, the odds ratio (OR) for developing overweight or obesity in the AT group was 1.23 (95% CI: 1.01, 1.50; P<0.001). Growth curve analysis revealed that weight gain in the AT group followed a distinct pattern, occurring in phases rather than as a continuous trend, highlighting a sustained post-surgical weight increase.

Conclusion: This study is among the few to highlight the long-term association between AT and the risk of obesity. The findings emphasize the importance of ongoing follow-up and comprehensive support for children undergoing AT to help mitigate potential weight gain.