儿童身材发育缓慢与OC、β-CTX、IGF-1、IGFBP-3的相关性  

Correlation analysis between slow growth and OC,β-CTX,IGF-1 and IGFBP-3 in children

作　　者：宋晓龙 李玉芳 周建平[1] SONG Xiaolong;LI Yufang;ZHOU Jianping(Radioimmunoassay Center of Shaanxi Provincial People′s Hospital,Xi′an,Shaanxi 710068,China)

机构地区：[1]陕西省人民医院放免中心,陕西西安710068

出　　处：《检验医学与临床》2023年第14期2058-2061,2065,共5页Laboratory Medicine and Clinic

摘　　要：目的 探讨身材发育缓慢儿童血清骨代谢指标、胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)、生长激素(GH)水平及临床意义,为临床诊治儿童身材发育缓慢提供参考依据。方法 选取2022年1-8月该院收治的91例特发性矮小症(ISS)患儿作为ISS组,78例GH缺乏(GHD)患儿作为GHD组,另选取同期70例发育正常的儿童作为健康对照组,比较各组体质量指数(BMI)、骨龄指数(BAI)及血清IGF-1、IGFBP-3、GH、25-羟基维生素D[25(OH)VitD]、骨钙素(OC)、β-骨胶原交联(β-CTX)水平的差异。通过Pearson相关分析儿童身材发育缓慢与以上血清学指标及体格发育指标的相关性。结果 ISS组、GHD组身高、体质量、BAI、IGF-1、IGFBP-3、GH、OC水平均低于健康对照组,差异均有统计学意义(P<0.05);ISS组BMI、GH、IGF-1、IGFBP-3、OC、β-CTX水平均高于GHD组,差异均有统计学意义(P<0.05)。Pearson相关分析结果显示,血清IGF-1、IGFBP-3、GH、OC水平与患儿身高、体质量、BAI均呈正相关(P<0.05);血清25(OH)VitD水平与患儿身高、体质量、BMI、BAI均呈负相关(P<0.05);血清β-CTX水平与患儿身高、体质量均呈正相关(P<0.05)。受试者工作特征曲线(ROC曲线)分析结果显示,GH[ROC曲线下面积(AUC)=0.768,95%CI:0.698~0.838,P<0.001]、IGF-1(AUC=0.588,95%CI:0.502~0.675,P=0.048)、OC(AUC=0.648,95%CI:0.565~0.731,P=0.001)、β-CTX(AUC=0.658,95%CI:0.585~0.740,P<0.001)对鉴别ISS、GHD均有一定的诊断价值。多因素Logistic回归分析结果显示,GH、β-CTX水平升高是发生ISS的危险因素(P<0.05)。结论 血清GH、IGF-1、IGFBP-3及OC、β-CTX水平检测可评价儿童的骨骼发育情况,在ISS、GHD早期诊断及鉴别诊断中具有较好的临床应用价值。Objective To investigate the levels and clinical significance of serum bone metabolism markers,insulin-like growth factor-1(IGF-1),insulin-like growth factor binding protein-3(IGFBP-3),and growth hormone(GH)in children with slow stature,and to provide reference for clinical diagnosis and treatment of children with slow stature.Methods A total of 91 children with idiopathic short stature(ISS)admitted to the hospital from January to August 2022 were selected as ISS group,78 children with GH deficiency(GHD)as GHD group,and 70 children with normal development during the same period were selected as healthy control group.The body mass index(BMI),bone age index(BAI),serum IGF-1,IGFBP-3,GH,25-hydroxyvitamin D[25(OH)VitD],osteocalcin(OC),andβ-pyridinoline cross-linked(β-CTX)were compared among the 3 groups.Pearson correlation analysis was used to analyze the correlation between children with slow stature and the above serological indicators and physical development indicators.Results The height,weight,BAI,IGF-1,IGFBP-3,GH and OC levels of the ISS and GHD groups were lower than those of the healthy control group,and the differences were statistically significant(P<0.05).The levels of BMI,GH,IGF-1,IGFBP-3,OC andβ-CTX in ISS group were higher than those in GHD group,and the differences were statistically significant(P<0.05).Pearson correlation analysis showed that levels of serum IGF-1,IGFBP-3,GH,and OC were positively correlated with height,weight,and BAI(P<0.05).The level of serum 25(OH)VitD was negatively correlated with height,weight,BMI and BAI(P<0.05).The level of serumβ-CTX was positively correlated with the height and weight of children(P<0.05).The results of receiver operating characteristic curve(ROC curve)analysis showed that GH[area under ROC curve(AUC)=0.768,95%CI:0.698-0.838,P<0.001],IGF-1(AUC=0.588,95%CI:0.502-0.675,P=0.048),OC(AUC=0.648,95%CI:0.565-0.731,P=0.001),β-CTX(AUC=0.658,95%CI:0.585-0.740,P<0.001)had a certain diagnostic value in differentiating ISS from GHD.Multivariate Logistic regression anal

关 键 词：特发性矮小症 生长激素缺乏 骨钙素 β-骨胶原交联 相关性 

分 类 号：R72[医药卫生—儿科]