血清维生素D、IGF-1水平在单纯乳房早发育向特发性中枢性性早熟转化中的临床价值  

Clinical value of serum levels of vitamin D and IGF-1 in the transformation from premature thelarche development to idiopathic central precocious puberty

作　　者：崔海静[1] 王霞[1] 张蔷[2] 刘征燕[3] 刘雪超[4] CUI Haijing;WANG Xia;ZHANG Qiang;LIU Zhengyan;LIU Xuechao(Department of Child Health/Department of Psychological Behavior,Children′s Hospital of Hebei Province,Shijiazhuang,Hebei 050000,China;Department of Endocrine and Genetic Metabolism,Children′s Hospital of Hebei Province,Shijiazhuang,Hebei 050000,China;Department of Pathology,Children′s Hospital of Hebei Province,Shijiazhuang,Hebei 050000,China;Department of Medical Laboratory,Children′s Hospital of Hebei Province,Shijiazhuang,Hebei 050000,China)

机构地区：[1]河北省儿童医院儿童保健科/心理行为科,河北石家庄050000 [2]河北省儿童医院内分泌遗传代谢科,河北石家庄050000 [3]河北省儿童医院病理科,河北石家庄050000 [4]河北省儿童医院医学检验科,河北石家庄050000

出　　处：《国际检验医学杂志》2022年第22期2711-2715,2721,共6页International Journal of Laboratory Medicine

基　　金：河北省医学科学研究课题计划(20190800)。

摘　　要：目的 探讨血清维生素D、胰岛素样生长因子-1(IGF-1)水平在单纯乳房早发育(PT)向特发性中枢性性早熟(ICPP)转化中的临床价值。方法 选取2014年3月至2019年1月于该院就诊的195例PT女童为研究对象,随访至2021年5月,根据随访期间PT是否转化为ICPP将女童分为转化组(53例)和非转化组(142例)。记录受试女童骨龄、乳房Tanner分期等一般资料。采用酶联免疫吸附试验检测IGF-1水平,采用电化学发光法检测血清维生素D水平及黄体生成素(LH)、卵泡刺激素(FSH)峰值。采用超声诊断仪检测卵巢容积、子宫长径、子宫横径、卵泡最大径。按发育乳房消退情况将女童分为完全消退组(135例)、反复增大组(39例)、持续不退组(21例),比较3组PT转化为ICPP的转化率。分析转化组血清维生素D、IGF-1水平与LH峰值、LH峰值/FSH峰值及超声指标的相关性,采用受试者工作特征(ROC)曲线分析血清维生素D、IGF-1单独和联合检测对PT向ICPP转化的预测价值,采用多因素Logistic回归模型分析PT向ICPP转化的影响因素。结果 与非转化组比较,转化组卵巢容积较大,子宫长径、卵泡最大径较长,LH峰值、LH峰值/FSH峰值、乳房Tanner分期BⅢ期患者比例、血清IGF-1水平较高,维生素D水平较低,差异均有统计学意义(P<0.05)。转化组血清维生素D水平与LH峰值、LH峰值/FSH峰值、卵巢容积、子宫长径、卵泡最大径、乳房Tanner分期、IGF-1均呈负相关(r<0,P<0.05),IGF-1水平与LH峰值、LH峰值/FSH峰值、卵巢容积、子宫长径、卵泡最大径、乳房Tanner分期均呈正相关(r>0,P<0.05)。完全消退组、反复增大组、持续不退组间PT转化为ICPP的转化率比较,差异有统计学意义(P<0.05)。维生素D、IGF-1单独和联合检测预测PT转化为ICPP的ROC曲线下面积分别为0.846、0.861、0.911,特异度别为72.5%、83.1%、69.7%,灵敏度分别为84.9%、75.5%、94.3%。低水平维生素D、高水平IGF-1及反�Objective To investigate the clinical value of serum levels of vitamin D and insulin-like growth factor-1(IGF-1) in the transformation from premature thelarche(PT) development to idiopathic central precocious puberty(ICPP).Methods A total of 195 girls with PT who were treated in this hospital from March 2014 to January 2019 were selected as the research subjects, and they were followed up until May 2021.According to whether PT was converted into ICPP during the follow-up period, the girls were divided into the transformation group(53 cases) and the non-transformation group(142 cases).The general information of the girls such as bone age and breast Tanner staging were recorded.Enzyme-linked immunosorbent assay was used to detect the level of IGF-1,and electrochemiluminescence method was used to detect the serum level of serum vitamin D and the peak value of luteinizing hormone(LH) and follicle-stimulating hormone(FSH).Ultrasonic diagnostic instrument was used to detect ovarian volume, uterine long diameter, uterine transverse diameter and maximum follicle diameter.The girls were divided into the complete regression group(135 cases),the repeated enlargement group(39 cases) and the persistent non-recession group(21 cases) according to the regression of developing breasts.The transformation rates of PT into ICPP among the three groups were compared.The correlations of serum levels of vitamin D and IGF-1 with LH peak, LH peak/FSH peak and ultrasound indicators in the transformation group were analyzed.The receiver operating characteristic(ROC) curve was used to analyze the single and combined detection of serum vitamin D and IGF-1 for the predictive value of the transformation of PT to ICPP.Multivariate logistic regression model was used to analyze the influencing factors of the transformation of PT to ICPP.Results Compared with the non-transformation group, the transformation group had larger ovarian volume, longer uterine length and maximum follicle diameter, higher LH peak, LH peak/FSH peak, proportion of breast Ta

关 键 词：单纯乳房早发育 特发性中枢性性早熟 转化 维生素D 胰岛素样生长因子-1 

分 类 号：R725.8[医药卫生—儿科]