外周血维生素D与IGF-1、IGFBP-3交互作用在特发性矮小症发病中的意义探究  

The significance of interaction of peripheral blood vitamin D with IGF-1 and IGFBP-3 in the pathogenesis of idiopathic nanosomia

作　　者：许榛[1] 葛丽萍[2] 孙晶晶 罗丽丝 刘四香 凌昱[1] XU Zhen;GE Liping;SUN Jingjing;LUO Lisi;LIU Sixiang;LING Yu(Department of Child Health Care,Kunming Children’s Hospital,Kunming,Yunnan 650228,China;Department of Endocrinology,Kunming Children’s Hospital,Kunming,Yunnan 650228,China)

机构地区：[1]昆明市儿童医院儿童保健科,云南昆明650228 [2]昆明市儿童医院内分泌遗传代谢性疾病科,云南昆明650228

出　　处：《中国优生与遗传杂志》2024年第3期609-613,共5页Chinese Journal of Birth Health & Heredity

基　　金：云南省科技厅科技计划项目(202001BA070023-0376)。

摘　　要：目的探究外周血维生素D与胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3交互作用在特发性矮小症(ISS)发病中的意义。方法选取2021年5月至2023年3月昆明市儿童医院102例ISS患者作为观察组,另选取同期门诊健康体检正常的102例儿童作为对照组。比较两组临床资料及外周血25-(OH)D_(3)、IGF-1、IGFBP-3,Logistic回归分析外周血25-(OH)D_(3)、IGF-1、IGFBP-3与ISS发病的关联性,分析外周血25-(OH)D_(3)、IGF-1、IGFBP-3对特发性矮小症发病的交互作用,评价外周血25-(OH)D_(3)、IGF-1、IGFBP-3对ISS的诊断价值。结果两组性别、年龄、父亲及母亲身高比较差异无统计学意义(P>0.05);观察组身高、体质量及外周血25-(OH)D_(3)、IGF-1、IGFBP-3水平均较对照组低(P<0.05);Logistic回归分析显示,调整身高、体质量等其他混杂因素后,外周血25-(OH)D_(3)、IGF-1、IGFBP-3仍与ISS发病显著相关(P<0.05);外周血25-(OH)D_(3)与IGF-1、IGFBP-3相加交互模型分析显示,25-(OH)D_(3)与IGF-1水平、25-(OH)D_(3)与IGFBP-3水平同时下降均对ISS发病具有协同作用(P<0.05);外周血25-(OH)D_(3)、IGF-1、IGFBP-3联合诊断ISS的曲线下面积(AUC)值为0.913,明显高于各指标单独诊断AUC值(P<0.05)。结论外周血维生素D、IGF-1、IGFBP-3均为ISS发生影响因素,且外周血维生素D与IGF-1、IGFBP-3对ISS发生具有相加交互作用。Objective To investigate the significance of the interaction between peripheral blood vitamin D and insulin-like growth factor 1(IGF-1)and insulin-like growth factor binding protein 3(IGFBP-3)in the pathogenesis of idiopathic short stature(ISS).Methods A total of 102 ISS patients admitted to Kunming Children’s Hospital from May 2021 to March 2023 were selected as the observation group,and 102 healthy children who underwent physical examinations in the same period were selected as the control group.Compare the clinical data and peripheral blood levels of 25-(OH)D_(3),IGF-1,and IGFBP-3 between the two groups,conduct Logistic regression analysis on the correlation between peripheral blood levels of 25-(OH)D_(3),IGF-1,and IGFBP-3 and the onset of ISS,analyze the interaction between peripheral blood levels of 25-(OH)D_(3),IGF-1,and IGFBP-3 and the onset of idiopathic dwarfism,and evaluate the diagnostic value of peripheral blood levels of 25-(OH)D_(3),IGF-1,and IGFBP-3 for ISS.Results There was no statistically significant difference in gender,age,father and mother height between the two groups(P>0.05).The height,weight,and peripheral blood levels of 25-(OH)D_(3),IGF-1,and IGFBP-3 in the observation group were lower than those in the control group(P<0.05).Logistic regression analysis showed that after adjusting for other confounding factors such as height and weight,peripheral blood 25-(OH)D_(3),IGF-1,and IGFBP-3 were still significantly correlated with the onset of ISS(P<0.05).The analysis of the additive interaction model between peripheral blood 25-(OH)D_(3)and IGF-1,IGFBP-3 showed that the simultaneous decrease of 25-(OH)D_(3)and IGF-1 levels,as well as the simultaneous decrease of 25-(OH)D_(3)and IGFBP-3 levels,all had a synergistic effect on the onset of ISS(P<0.05).The area under the curve(AUC)value of the combined diagnosis of peripheral blood 25-(OH)D_(3),IGF-1,and IGFBP-3 for ISS was 0.913,which was significantly higher than the AUC value of each indicator alone(P<0.05).Conclusion Peripheral blood vitamin

关 键 词：特发性矮小症 维生素D 胰岛素样生长因子1 胰岛素样生长因子结合蛋白3 

分 类 号：R725[医药卫生—儿科]