血浆25羟基维生素D、性激素结合蛋白、Kiss肽在早期特发性中枢性性早熟女性患儿中的表达及与促性腺激素释放激素类似物疗效的相关性  

Expression of plasma 25 hydroxy vitamin D,sex hormone binding globulin and kisspeptin in early idiopathic central precocious puberty and their correlation with gonadotropin releasing hormone analogue efficacy

作　　者：李双全 李学超 吴春青 王建忠 LI Shuangquan;LI Xuechao;WU Chunqing;WANG Jianzhong(Department of Pediatrics,Maternal and Child Health Hospital of Qinhuangdao City,Qinhuangdao 066000,Hebei,China)

机构地区：[1]河北省秦皇岛市妇幼保健院儿科,河北秦皇岛066000

出　　处：《中国性科学》2021年第10期51-55,共5页Chinese Journal of Human Sexuality

基　　金：秦皇岛市科学技术研究与发展项目(201602A210)。

摘　　要：目的探讨血浆25羟基维生素D[25(OH)D]、性激素结合蛋白(SHBG)、Kiss肽(kisspeptin)在早期特发性中枢性性早熟(ICPP)女性患儿中的表达情况,以及其与应用促性腺激素释放激素类似物(GnRHa)治疗效果之间的相关性。方法选取2014年12月至2017年2月河北省秦皇岛市妇幼保健院诊治的43例早期ICPP女性患儿(观察组)作为研究对象。均给予GnRHa治疗。另选取同期在河北省秦皇岛市妇幼保健院体检的45例年龄匹配的健康女童作为对照组。检测并比较两组血浆25(OH)D、SHBG和kisspeptin蛋白表达水平。结果观察组血浆25(OH)D、SHBG较对照组明显降低,kisspeptin蛋白表达水平较对照组明显升高,差异具有统计学意义(P<0.05)。观察组治疗后的血浆25(OH)D、SHBG水平较治疗前明显升高,kisspeptin蛋白水平较治疗前明显降低,差异具有统计学意义(P<0.05)。血浆25(OH)D与身高、体重、骨龄(BA)、预测成年身高(PAH)呈明显正相关,与骨龄成熟速度骨龄和实际年龄差值比值(△BA/△CA)、线性生长速度(GV)及促性腺激素释放激素(GnRH)激发试验后促性腺激素水平呈负相关;SHBG与GnRH激发试验后促性腺激素水平呈明显负相关,与体重呈正相关;kisspeptin蛋白与GnRH激发试验后促性腺激素水平、身高、体重、PAH、BA均呈明显正相关,与△BA/△CA呈明显负相关(P<0.05)。结论ICPP女性患儿的血浆25(OH)D、SHBG水平明显降低,kisspeptin蛋白表达水平明显升高,其与女童ICPP的发生和发展有关。血浆25(OH)D、SHBG、kisspeptin蛋白可作为判断GnRHa治疗效果的指标,治疗前检测其表达水平能够为临床治疗方案的确定提供指导。Objective To investigate the expression of plasma 25 hydroxy vitamin D[25(OH)D],sex hormone binding globulin(SHBG)and kisspeptin in early idiopathic central precocious puberty(ICPP)and their correlation with gonadotropin releasing hormone analogue(GnRHa)efficacy.Methods 43 female children with early ICPP diagnosed and treated in Maternal and Child Health Hospital of Qinhuangdao City from December 2014 to February 2017 were selected as the study subjects(observation group).All patients were treated with GnRHa.45 healthy girls in the Hospital during the same period were selected as the control group.Plasma 25(OH)D,SHBG and Kisspeptin protein expression levels were detected and compared between the two groups.Results Plasma 25(OH)D and SHBG in observation group were significantly lower than those in control group,and kisspeptin protein expression level was significantly higher than that in control group,with statistical significance(P<0.05).The levels of plasma 25(OH)D and SHBG in the observation group were significantly increased after treatment,and the level of kisspeptin protein was significantly decreased after treatment,with statistical significance(P<0.05).Plas-ma 25(OH)D was positively correlated with height,body weight,bone age(BA)and predicted adult height(PAH),but negatively correlated with the ratio of difference between bone age and actual age(△BA/△CA),lin-ear growth rate(GV)and gonadotropin-releasing hormone(GnRH)stimulation test.The gonadotropin level of SH-BG was negatively correlated with GnRH stimulation test,and positively correlated with body weight.Kisspeptin protein was positively correlated with gonadotropin level,height,body weight,PAH and BA after GnRH stimulation test,and negatively correlated with△BA/△CA(P<0.05).Conclusions The levels of plasma 25(OH)D and SHBG in female children with ICPP were significantly decreased,and the expression level of kisspeptin was signifi-cantly increased,which was related to the occurrence and development of ICPP in girls.Plasma 25(OH)D,SHBG and Kisspe

关 键 词：特发性中枢性性早熟 促性腺激素释放激素类似物 25羟基维生素D 性激素结合蛋白 Kiss肽 

分 类 号：G479[文化科学—教育学]