{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T17:14:09Z","timestamp":1791220449401,"version":"4.1.0"},"reference-count":40,"publisher":"The Endocrine Society","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2013,9,1]]},"abstract":"<jats:sec><jats:title>Context:<\/jats:title><jats:p>Adenotonsillar tissue hypertrophy and obstructive sleep apnea have been reported during short-term GH treatment in children with Prader-Willi syndrome (PWS).<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective:<\/jats:title><jats:p>We conducted an observational study to evaluate the effects of long-term GH therapy on sleep-disordered breathing and adenotonsillar hypertrophy in children with PWS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design:<\/jats:title><jats:p>This was a longitudinal observational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients and Methods:<\/jats:title><jats:p>We evaluated 75 children with genetically confirmed PWS, of whom 50 fulfilled the criteria and were admitted to our study. The patients were evaluated before treatment (t0), after 6 weeks (t1), after 6 months (t2), after 12 months (t3), and yearly (t4\u2013t6) thereafter, for up to 4 years of GH therapy. The central apnea index, obstructive apnea hypopnea index (OAHI), respiratory disturbance index, and minimal blood oxygen saturation were evaluated overnight using polysomnography. We evaluated the adenotonsillar size using a flexible fiberoptic endoscope.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results:<\/jats:title><jats:p>The percentage of patients with an OAHI of &amp;gt;1 increased from 3 to 22, 36, and 38 at t1, t4, and t6, respectively (\u03c72 = 12.2; P &amp;lt; .05). We observed a decrease in the respiratory disturbance index from 1.4 (t0) to 0.8 (t3) (P &amp;lt; .05) and the central apnea index from 1.2 (t0) to 0.1 (t4) (P &amp;lt; .0001). We had to temporarily suspend treatment for 3 patients at t1, t4, and t5 because of severe obstructive sleep apnea. The percentage of patients with severe adenotonsillar hypertrophy was significantly higher at t4 and t5 than at t0. The OAHI directly correlated with the adenoid size (adjusted for age) (P &amp;lt; .01) but not with the tonsil size and IGF-1 levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion:<\/jats:title><jats:p>Long-term GH treatment in patients with PWS is safe; however, we recommend annual polysomnography and adenotonsillar evaluation.<\/jats:p><\/jats:sec>","DOI":"10.1210\/jc.2013-1831","type":"journal-article","created":{"date-parts":[[2013,7,27]],"date-time":"2013-07-27T07:16:01Z","timestamp":1374909361000},"page":"E1516-E1523","source":"Crossref","is-referenced-by-count":56,"title":["Growth Hormone Therapy and Respiratory Disorders: Long-Term Follow-up in PWS Children"],"prefix":"10.1210","volume":"98","author":[{"given":"Jenny","family":"Berini","sequence":"first","affiliation":[{"name":"Pediatric Unit (J.B., V.S.R., L.Ne., L.No., A.S.), Ospedale Del Ponte, Insubria University, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valeria","family":"Spica Russotto","sequence":"additional","affiliation":[{"name":"Pediatric Unit (J.B., V.S.R., L.Ne., L.No., A.S.), Ospedale Del Ponte, Insubria University, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Castelnuovo","sequence":"additional","affiliation":[{"name":"Otolaryngology Unit (P.C., G.P.), Ospedale di Circolo, Insubria University, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefania","family":"Di Candia","sequence":"additional","affiliation":[{"name":"Pediatric Unit (S.D.C., G.C.), Ospedale San Raffaele, 20132 Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Gargantini","sequence":"additional","affiliation":[{"name":"Pediatric Unit (L.G.), Ospedale di Treviglio, 24047 Treviglio (Bergamo), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graziano","family":"Grugni","sequence":"additional","affiliation":[{"name":"Division of Auxology (G.G.), Istituto Auxologico Italiano, 28922 Verbania, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Iughetti","sequence":"additional","affiliation":[{"name":"Pediatric Unit (L.I.), University of Modena e Reggio, 41124 Modena, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Nespoli","sequence":"additional","affiliation":[{"name":"Pediatric Unit (J.B., V.S.R., L.Ne., L.No., A.S.), Ospedale Del Ponte, Insubria University, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luana","family":"Nosetti","sequence":"additional","affiliation":[{"name":"Pediatric Unit (J.B., V.S.R., L.Ne., L.No., A.S.), Ospedale Del Ponte, Insubria University, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanni","family":"Padoan","sequence":"additional","affiliation":[{"name":"Otolaryngology Unit (P.C., G.P.), Ospedale di Circolo, Insubria University, 21100 Varese, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alba","family":"Pilotta","sequence":"additional","affiliation":[{"name":"Pediatric Unit (A.P.), Spedali Civili, 25123 Brescia, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuliana","family":"Trifir\u00f2","sequence":"additional","affiliation":[{"name":"Pediatric Unit (G.T.), Azienda Ospedaliera Salvini, 20024 Rho (Milan), Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giuseppe","family":"Chiumello","sequence":"additional","affiliation":[{"name":"Pediatric Unit (S.D.C., G.C.), Ospedale San Raffaele, 20132 Milan, 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