Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2018 Jun 19;18(1):196.
doi: 10.1186/s12887-018-1178-8.

Is there an association between vitamin D deficiency and adenotonsillar hypertrophy in children with sleep-disordered breathing?

Ji-Hyeon Shin  1 , Byung-Guk Kim  2 , Boo Young Kim  2 , Soo Whan Kim  2 , Sung Won Kim  2 , Hojong Kim  2
Affiliations

Is there an association between vitamin D deficiency and adenotonsillar hypertrophy in children with sleep-disordered breathing?

Ji-Hyeon Shin et al. BMC Pediatr. .

Abstract

Background: Low vitamin D levels have been linked to the risk of sleep-disordered breathing (SDB) in children. Although adenotonsillar hypertrophy (ATH) is the major contributor to childhood SDB, the relationship between ATH and serum vitamin D is uncertain. We therefore investigated the relationship between vitamin D levels and associated factors in children with ATH.

Methods: We reviewed data from all children with SDB symptoms who were treated from December 2013 to February 2014. Of these, 88 children whose serum vitamin D levels were measured were enrolled in the study. We divided the children into four groups based on adenoidal and/or tonsillar hypertrophy. We conducted a retrospective chart review to analyze demographic data, the sizes of tonsils and adenoids, serum 25-hydroxy-vitamin D [25(OH)D] level, body mass index (BMI), and allergen sensitization patterns.

Results: Children in the ATH group had a lower mean 25(OH)D level than did those in the control group (p < 0.05). Children with vitamin D deficiencies exhibited markedly higher frequencies of adenoidal and/or tonsillar hypertrophy than did those with sufficient vitamin D (p < 0.05). Spearman's correlation analysis identified an inverse correlation between serum 25(OH)D levels and age, tonsil and adenoid size, and height (all p < 0.05). In a multiple regression analysis, tonsil and adenoid size as well as BMI-z score, were associated with 25(OH)D levels after controlling for age, sex, height, and mite sensitization (p < 0.05).

Conclusions: Our results suggest that low vitamin D levels are linked to ATH. Both the sizes of the adenoids and tonsils and the BMI-z score were associated with the 25(OH)D level. Therefore, measurement of the serum 25(OH)D level should be considered in children with ATH and SDB symptoms.

Keywords: Adenoids; Body mass index; Child; Sleep-disordered breathing; Tonsils; Vitamin D.

PubMed Disclaimer

Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Institutional Review Board of Uijeongbu St. Mary’s Hospital (IRB policy No. UC15RISI0035). Since this study is a retrospective chart review study the need for written consent was formally waved by the IRB of Uijeongbu St. Mary’s Hospital.

Consent for publication

Not applicable

Competing interests

The authors declare that they have no competing interests.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Comparisons of frequencies of adenoid and/or tonsillar hypertrophy by serum 25(OH)D level. Vitamin D-deficient: 25(OH)D < 20 ng/mL; vitamin D-sufficient: 25(OH)D ≥ 20 ng/mL
Fig. 2
Fig. 2
Serum 25(OH)D levels in children with or without adenoid and/or tonsillar hypertrophy. *: p < 0.05
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Kobayashi R, Miyazaki S, Karaki M, Hoshikawa H, Nakata S, Hara H, et al. Obstructive sleep apnea in Asian primary school children. Sleep Breath. 2014;18:483–489. doi: 10.1007/s11325-013-0909-1. - DOI - PubMed
    1. Kaditis AG, Alonso Alvarez ML, Boudewyns A, Alexopoulos EI, Ersu R, Joosten K, et al. Obstructive sleep disordered breathing in 2- to 18-year-old children: diagnosis and management. Eur Respir J. 2016;47:69–94. doi: 10.1183/13993003.00385-2015. - DOI - PubMed
    1. Sedky K, Bennett DS, Carvalho KS. Attention deficit hyperactivity disorder and sleep disordered breathing in pediatric populations: a meta-analysis. Sleep Med Rev. 2014;18:349–356. doi: 10.1016/j.smrv.2013.12.003. - DOI - PubMed
    1. Waters KA, Chawla J, Harris MA, Dakin C, Heussler H, Black R, et al. Rationale for and design of the “POSTA” study: evaluation of neurocognitive outcomes after immediate adenotonsillectomy compared to watchful waiting in preschool children. BMC Pediatr. 2017;17:47. doi: 10.1186/s12887-016-0758-8. - DOI - PMC - PubMed
    1. Bouillon R. Comparative analysis of nutritional guidelines for vitamin D. Nat Rev Endocrinol. 2017;13:466–479. doi: 10.1038/nrendo.2017.31. - DOI - PubMed