中枢性性早熟女童维生素D水平分析  

Analysis of Vitamin D Levels in Girls with Central Precocious Puberty

作　　者：张萌 杨利琦[2] ZHANG Meng;YANG Li-qi(Graduate School of Anhui Medical University,Hefei 230032,Anhui,China;Department of Pediatric,the Second Affilited Hospital of Anhui Medical University,Hefei 230601,Anhui,China)

机构地区：[1]安徽医科大学研究生学院,安徽合肥230032 [2]安徽医科大学第二附属医院儿科,安徽合肥230601

出　　处：《医学信息》2023年第4期108-112,共5页Journal of Medical Information

摘　　要：目的探究中枢性性早熟女童维生素D水平及其临床意义。方法选取2018年11月-2021年11月在安徽医科大学第二附属医院儿科诊断为中枢性性早熟(CPP)的202例女童为研究对象,检测其身高、体重、体质指数(BMI)、第二性征发育水平、空腹血糖、空腹胰岛素、胰岛素抵抗指数(HOMA-IR)、胆固醇(TC)、甘油三酯(TG)、胰岛素样生长因子-1(IGF-1)、游离甲状腺素(FT_(4))、25-羟维生素D[25-(OH)D_(3)]、促卵泡生成素(FSH)、促黄体生成素(LH)、LH及FSH峰值水平,检查骨龄、子宫、卵巢容积,根据25-(OH)D_(3)水平将其分为充足组(38例)、不足组(81例)、缺乏组(83例),比较CPP女童不同骨龄-年龄、BMI、检测季节、乳房Tanner分期及HOMA-IR的25-(OH)D_(3)水平分布,分析3组女童性发育指标的差异,分析25-(OH)D_(3)与BMI、HOMA-IR、IGF-1、FT_(4)、LH、LHmax、LHmax/FSHmax、子宫容积、骨龄-年龄的相关性。结果不同BMI、检测季节、性发育水平及HOMA-IR的CPP女童25-(OH)D_(3)营养状况比较,差异有统计学意义(P<0.05);缺乏组LH、LHmax、LHmax/FSHmax、子宫容积均高于充足组,LHmax、LHmax/FSHmax、骨龄-年龄、卵巢容积、子宫容积高于不足组,差异有统计学意义(P<0.05);充足组与不足组LH、LHmax、LHmax/FSHmax、骨龄-年龄、卵巢容积、子宫容积比较,差异无统计学意义(P>0.05);25-(OH)D_(3)水平与BMI、HOMA-IR、IGF-1、LH、LHmax、LHmax/FSHmax、子宫容积、骨龄-年龄呈负相关(r=-0.288、-0.177、-0.288、-0.243、-0.221、-0.258、-0.259、-0.159),与FT_(4)呈正相关(r=0.279)。结论CPP女童存在25-(OH)D_(3)不足,25-(OH)D_(3)水平与CPP女童的BMI、HOMA-IR、IGF-1、FT_(4)有关,可能影响其性发育进程。Objective To investigate the vitamin D level and its clinical significance in girls with central precocious puberty.Methods A total of 202 girls diagnosed with central precocious puberty(CPP)from November 2018 to November 2021 at the Department of Pediatrics,the Second Affiliated Hospital of Anhui Medical University were selected for the study and tested for height,weight,body mass index(BMI),secondary sexual characteristics development level,fasting glucose,fasting insulin,insulin resistance index(HOMA-IR),cholesterol(TC),triglycerides(TG),insulin-like growth factor-1(IGF-1),free thyroxine(FT_(4)),25-hydroxyvitamin D[25-(OH)D_(3)],folliculopoietin(FSH),luteinizing hormone(LH),LH and peak FSH levels,examination of bone age,uterus and ovarian volume.According to the 25-(OH)D_(3) level,they were divided into 25-(OH)D_(3) sufficient group(38 cases),insufficient group(81 cases)and deficient group(83 cases).The differences of sexual development indexes among the three groups were analyzed,and the correlation between 25-(OH)D_(3) and BMI,HOMA-IR,IGF-1,FT_(4),LH,LHmax,LHmax/FSHmax,uterine volume,bone age-age was analyzed.Results There were significant differences in 25-(OH)D_(3) nutritional status among CPP girls with different BMI,detection season,sexual development level and HOMA-IR(P<0.05).LH,LHmax,LHmax/FSHmax and uterine volume in the deficiency group were higher than those in the sufficient group,LHmax,LHmax/FSHmax,bone age-age,ovarian volume and uterine volume were higher than those in the insufficient group,and the differences were statistically significant(P<0.05).There was no significant difference in LH,LHmax,LHmax/FSHmax,bone age-age,ovarian volume and uterine volume between the sufficient group and the insufficient group(P>0.05).25-(OH)D_(3) levels were negatively correlated with BMI,HOMA-IR,IGF-1,LH,LHmax,LHmax/FSHmax,uterine volume,bone age-age(r=-0.288,-0.177,-0.288,-0.243,-0.221,-0.258,-0.259,-0.159),and positively correlated with FT_(4)(r=0.279).Conclusion CPP girls have 25-(OH)D_(3) deficiency.25-(OH)

关 键 词：中枢性性早熟 维生素D 女童 

分 类 号：R725.8[医药卫生—儿科]