短链脂肪酸在特发性矮小症儿童中的诊断价值  

Diagnostic value of short-chain fatty acids in children with idiopathic short stature

作　　者：朱敏 钱文秀 陆运新 陈开 范云霞 潘莉 ZHU Min;QIAN Wenxiu;LU Yunxin;CHEN Kai;FAN Yunxia;PAN Li(Department of Pediatrics,Changzhou Jintan First People′s Hospital,Changzhou,Jiangsu 213200,China;Department of Anesthesiology,Changzhou Jintan First People′s Hospital,Changzhou,Jiangsu 213200,China)

机构地区：[1]常州市金坛第一人民医院儿科,江苏常州213200 [2]常州市金坛第一人民医院麻醉科,江苏常州213200

出　　处：《检验医学与临床》2024年第13期1860-1863,1869,共5页Laboratory Medicine and Clinic

基　　金：江苏大学2023年度医教协同创新基金一般项目(JDYY2023041)。

摘　　要：目的分析短链脂肪酸(SCFAs)在特发性矮小症(ISS)儿童中的诊断价值。方法选取2022年1月至2023年6月在该院就诊的150例ISS患者作为ISS组。另选取同期在该院进行健康体检的70例儿童作为对照组。比较两组粪便SCAFs、乙酸、丙酸及丁酸水平。绘制受试者工作特征(ROC)曲线分析粪便SCFAs、乙酸、丙酸及丁酸对ISS的诊断价值。采用多因素Logistic回归分析ISS发生的危险因素。根据有无青春期发育延迟将ISS患儿划分为青春期发育延迟组与无青春期发育延迟组,并比较两组粪便SCFAs、乙酸、丙酸及丁酸水平。结果ISS组粪便SCFAs、乙酸、丙酸及丁酸水平均高于对照组,差异均有统计学意义(P<0.05)。ROC曲线分析结果显示,粪便SCFAs诊断ISS的最佳截断值为90.78μmol/L,曲线下面积(AUC)为0.843(95%CI:0.766~0.903),灵敏度、特异度分别为0.888、0.700;乙酸诊断ISS的最佳截断值为22.76μmol/g,AUC为0.889(95%CI:0.819~0.939),灵敏度、特异度分别为0.875、0.825;丙酸诊断ISS的最佳截断值为11.79μmol/g,AUC为0.872(95%CI:0.798~0.926),灵敏度、特异度分别为0.863、0.825;丁酸诊断ISS的最佳截断值为12.00μmol/g,AUC为0.850(95%CI:0.773~0.909),灵敏度、特异度分别为0.738、0.875。多因素Logistic回归分析结果显示,粪便SCFAs水平升高、乙酸水平升高、丙酸水平升高及丁酸水平升高均为ISS发生的独立危险因素(P<0.05)。150例ISS儿童中,青春期发育延迟55例,纳入青春期发育延迟组,无青春期发育延迟95例,纳入无青春期发育延迟组。青春期发育延迟组粪便SCFAs、乙酸、丙酸、丁酸水平均高于无青春期发育延迟组,差异均有统计学意义(P<0.05)。结论ISS的发生可能与粪便SCFAs、乙酸、丙酸以及丁酸表达异常升高有关,上述指标均在临床ISS患儿的诊断中具有良好的效能。Objective To analyze the diagnostic value of short-chain fatty acids(SCFAs)in children with idiopathic short stature(ISS).Methods A total of 150 patients with ISS who were treated in the hospital from January 2022 to June 2023 were selected as the ISS group.Another 70 children who underwent physical examination in the hospital during the same period were selected as the control group.The levels of fecal SCAFs,acetic acid,propionic acid and butyric acid were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of fecal SCFAs,acetic acid,propionic acid and butyric acid for ISS.Multivariate Logistic regression was used to analyze the risk factors of ISS.According to the presence or absence of delayed puberty,the ISS children were divided into delayed puberty group and non-delayed puberty group,and the levels of fecal SCFAs,acetic acid,propionic acid,and butyric acid were compared between the two groups.Results The levels of fecal SCFAs,acetic acid,propionic acid and butyric acid in the ISS group were higher than those in the control group,and the differences were statistically significant(P<0.05).ROC curve analysis showed that the best cut-off value of fecal SCFAs for the diagnosis of ISS was 90.78μmol/L,the area under the curve(AUC)was 0.843(95%CI:0.766-0.903),the sensitivity and specificity were 0.888 and 0.700 respectively.The best cut-off value of acetic acid in the diagnosis of ISS was 22.76μmol/g,the AUC was 0.889(95%CI:0.819-0.939),the sensitivity and specificity were 0.875 and 0.825 respectively.The best cut-off value of propionic acid in the diagnosis of ISS was 11.79μmol/g,the AUC was 0.872(95%CI:0.798-0.926),the sensitivity and specificity were 0.863 and 0.825 respectively.The best cut-off value of butyric acid in the diagnosis of ISS was 12.00μmol/g,the AUC was 0.850(95%CI:0.773-0.909),the sensitivity and specificity were 0.738 and 0.875 respectively.Multivariate Logistic regression analysis showed that increased levels of fecal SCF

关 键 词：特发性矮小症 胃肠道微生物群 脂肪酸类 挥发性 生态失调 

分 类 号：R729[医药卫生—儿科] R446.1[医药卫生—临床医学]