矮小儿童血清胰岛素样生长因子-1和瘦素水平的表达及临床意义  

Expression and clinical significance of the level of serum insulin-like growth factor-1 and leptin in children with short stature

作　　者：邱明慧[1] 董国庆[1] 

机构地区：[1]南方医科大学附属深圳妇幼保健院儿科,广东深圳518028

出　　处：《中国医药导报》2014年第18期38-40,43,共4页China Medical Herald

基　　金：广东省深圳市科技计划项目(编号201102098)

摘　　要：目的了解不同病因的矮小儿童血清胰岛素样生长因子-1(IGF-1)和瘦素水平变化,探讨IGF-1和瘦素在生长激素缺乏症(GHD)诊断中的价值。方法选择深圳市妇幼保健院就诊的矮小儿童96例,年龄5~11岁,根据身高低于同性别同年龄均值-2^-3SD,排除其他可致身材矮小疾病,根据生长激素激发试验,GH峰值<10 ng/mL为GHD者共67例(GHD组)、GH峰值≥10 ng/mL为特发性矮小(ISS)者共29例(ISS组),另选择同期体检的生长发育正常儿童23名作为对照组。采集所有研究对象的外周静脉血3 mL,分离血清后,使用双抗体一步夹心法酶联免疫吸附实验(ELISA)测定血清IGF-1、瘦素浓度。结果 GHD组血清IGF-1及瘦素水平[(45.7±19.02)μg/L、(4.25±0.63)mg/L]低于ISS组[(114.07±24.45)μg/L、(4.69±0.69)mg/L]和对照组[(164.61±46.22)μg/L、(6.27±0.89)mg/L]),组间比较,差异均有高度统计学意义(P<0.01);诊断GHD,IGF-1的敏感度为100%,特异度为98%;瘦素的敏感度为88%,特异度为71%。结论 IGF-1和瘦素的检测可能可作为筛查和诊断GHD有价值的指标,并对GHD与ISS的鉴别诊断也有着一定的临床意义。Objective To understand the levels of serum insulin-like growth factor-1 （IGF-1） and leptin and to discuss the value of IGF-1 and leptin in the diagnosis of growth hormone deficiency （GHD）. Methods A total of 96 patients were recruited in Shenzhen Maternity and Child Healthcare Hospital, whose height lower than -2-3SD of the same age and the same sex mean height, to rule out other diseases can cause short stature, according to growth hormone stim- ulation test, children with GHD whose GH peak 〈10 ng/mL were as GHD group （n=67）, children with idiopathic short stature （ISS） whose GH peak≥ 10 ng/mL were as ISS group （n=29）. The age of patients were at a range of 5-11 years, 23 children aged from 5 to 11 years old whose physical development were natural were chosen as control group. 3 mL peripheral blood of all subjects was chosen as the sample. The concentration of serum IGF-1 and leptin was measured by double antibody step clip art enzyme-linked immunosorbent assay （ELISA） method. Results The levels of serum IGF-1 and leptin in GHD group [（45.7±19.02） μg/L, （4.25±0.63） mg/L] were significantly lower than those of ISS group [（114.07±24.45）μg/L, （4.69±0.69） mg/L], and control group [（164.61±46.22） μg/L, （6.27±0.89） mg/L], the differences were highly statistically significant （P 〈 0.01）. The diagnostic sensitivity of the IGF-1 was 100%, and the specificity was 98%; the diagnostic sensitivity of the leptin was 88%, and specificity was 71%. Conclusion The detection of IGF- 1 and leptin can be used as the screening and diagnosis of GHD valuable indicators, and it also has a certain clinical significance to the differential diagnosis of GHD and the ISS.

关 键 词：胰岛素样生长因子-1 瘦素 生长激素缺乏症 特发性矮小 

分 类 号：R725[医药卫生—儿科]