血清维生素D水平与女童中枢性性早熟的相关性分析  

Correlation analysis between serum vitamin D level and central precocious puberty in girls

作　　者：娄永峥 徐亚男[2] 张萍萍[3] 潘婕文[4] 干冬梅 孙淑妮 LOU Yongzheng;XU Yanan;ZHANG Pingping;PAN Jiewen;GAN Dongmei;SUN Shuni(NICU,Ningbo Women and Children’s Hospital,Ningbo 315012,Zhejiang,China;Scientific Research Department,Ningbo Women and Children’s Hospital,Ningbo 315012,Zhejiang,China;Pediatric Endocrinology Department,Ningbo Women and Children’s Hospital,Ningbo 315012,Zhejiang,China;Central Laboratory of Birth Defects Prevention and Control,Ningbo Women and Children’s Hospital,Ningbo 315012,Zhejiang,China;Emergency Department,Ningbo Women and Children’s Hospital,Ningbo 315012,Zhejiang,China;Pediatric Cardiology Department,Ningbo Women and Children’s Hospital,Ningbo 315012,Zhejiang,China)

机构地区：[1]宁波市妇女儿童医院NICU,浙江宁波315012 [2]宁波市妇女儿童医院科研科,浙江宁波315012 [3]宁波市妇女儿童医院小儿内分泌科,浙江宁波315012 [4]宁波市妇女儿童医院出生缺陷实验室,浙江宁波315012 [5]宁波市妇女儿童医院急诊科,浙江宁波315012 [6]宁波市妇女儿童医院小儿心内科,浙江宁波315012

出　　处：《中国现代医生》2024年第3期16-20,共5页China Modern Doctor

基　　金：宁波市儿科学重点学科项目(2022-B17);宁波市科技计划项目(2019A610387)。

摘　　要：目的 探讨血清维生素D水平与女童中枢性性早熟(central precocious puberty,CPP)的相关性。方法 收集宁波市妇女儿童医院就诊的103名CPP女童(病例组)和行健康体检的53名健康女童(对照组)作为研究对象。运用化学发光法检测两组女童血清中25-羟维生素D_(3)[25(OH)D_(3)]水平,病例组女童测量体质量、身高。采用放射免疫法测定血清卵泡刺激素(follicle-stimulating hormone,FSH)及峰值、黄体生成素(luteinizing hormone,LH)及峰值、雌二醇(estradiol,E_(2))、催乳素(prolactin,PRL)、人绒毛膜促性腺激素(human chorionic gonadotropin,HCG)水平和甲状腺功能,计算LH峰值/FSH峰值。完善子宫附件B超检查,计算子宫容积和双侧卵巢体积。依据血清25(OH)D_(3)检测结果将病例组女童分为维生素D正常组和维生素D缺乏组,比较两组女童的激素水平、子宫及卵巢发育的差异。结果 病例组女童的血清25(OH)D_(3)水平低于对照组,维生素D缺乏率高于对照组,差异均有统计学意义(P<0.05)。维生素D缺乏组女童出现乳房结节年龄小于维生素D正常组(P<0.05);维生素D正常组与维生素D缺乏组女童的体质量、身高、体质量指数(body mass index,BMI)、子宫容积和左卵巢体积比较,差异无统计学意义(P>0.05);维生素D缺乏组女童的右卵巢体积显著大于维生素D正常组(P<0.05);维生素D正常组与维生素D缺乏组女童的血清FSH、LH、PRL、HCG水平及FSH峰值、甲状腺功能比较,差异无统计学意义(P>0.05);维生素D缺乏组女童的E_(2)水平、LH峰值、LH峰值/FSH峰值显著高于维生素D正常组(P<0.05)。25(OH)D_(3)与LH峰/FSH峰呈负相关(r=-0.197,P<0.05),与甲状腺功能、FSH、LH、PRL、E_(2)、HCG、FSH峰值和LH峰值相关性均不显著(P>0.05)。结论 维生素D缺乏与女童CPP的发生相关;维生素D缺乏可能导致性早熟发病年龄提前;维生素D缺乏可能影响下丘脑-垂体-性腺轴功能,女童生殖激素指标可相应Objective To investigate the correlation between serum vitamin D level and central precocious puberty(CPP)in girls.Methods A total of 103 girls(case group)with central precocious puberty from Ningbo Woman and Children’s Hospital and 53 healthy girls(control group)from health check-ups in Ningbo Women and Children’s Hospital were collected as subjects.The serum levels of 25-hydroxyvitamin D3[25(OH)D3]in the two groups were detected by chemiluminescence method.The weight and height of girls in the case group were measured.The serum levels of follicle-stimulating hormone(FSH)and its peak value,luteinizing hormone(LH)and its peak value,estradiol(E2),prolactin(PRL),human chorionic gonadotropin(HCG)and thyroid function were measured by radioimmunoassay.The peak value of LH/FSH was calculated.B ultrasound examination of uterine adnexa was completed to calculate uterine volume and bilateral ovarian volume.According to the results of serum 25-(OH)D3,girls in the case group were divided into normal vitamin D group and vitamin D deficiency group,and the differences of hormone levels,uterine and ovarian development between the two groups were compared.Results The serum level of 25-(OH)D3 in case group was lower than that in control group,and the vitamin D deficiency rate in case group was higher than that in control group,with statistical significance(P<0.05).The age of breast nodules in vitamin D deficiency group was lower than that in vitamin D normal group(P<0.05).There were no significant differences in body weight,height,body mass index(BMI),uterine volume and left ovarian volume between vitamin D normal group and vitamin D deficiency group(P>0.05),and the right ovarian volume in vitamin D deficiency group was significantly higher than that in vitamin D normal group(P<0.05).There were no significant differences in serum levels of FSH,LH,PRL,HCG,peak value of FSH and thyroid function between normal and deficient groups(P>0.05).The levels of E2,LH and LH/FSH in vitamin D deficiency group were significantly higher than

关 键 词：中枢性性早熟 女童 维生素D 

分 类 号：R725[医药卫生—儿科]