胰岛素样生长因子-1与小儿生长激素缺乏型身材矮小症骨密度水平的相关性及诊断效能  

Correlation and diagnostic efficacy of insulin-like growth factor-1with bone mineral density levels in children with growth hormone deficient short stature

作　　者：马阳 关浩 MA Yang;GUAN Hao(The Second Ward of Pediatrics,The First Affiliated Hospital of Nanyang Medical College,Nanyang,Henan 473000,China)

机构地区：[1]南阳医学高等专科学校第一附属医院儿科二病区,河南南阳473000

出　　处：《社区医学杂志》2024年第7期248-252,共5页Journal Of Community Medicine

基　　金：河南省医学科技攻关项目(LHGJ202001273)。

摘　　要：目的分析胰岛素样生长因子-1(IGF-1)与骨密度(BMD)水平的关联,及对生长激素缺乏型身材矮小症(矮小症)的诊断效能。方法选择2021-01-10-2022-12-10南阳医学高等专科学校第一附属医院接受检查的96名儿童作为研究对象,开展回顾性研究,根据是否发生矮小症将其分为病例组(n=50)和健康组(n=46),将病例组内生长激素部分缺乏型矮小症列为A组(32例),生长激素完全缺乏型矮小症列为B组(18例),比较A和B组患儿IGF-1及BMD水平,当P<0.05时表示差异有统计学意义;通过Spearman相关性系数验证二者相关性,并通过绘制受试者工作特征(receiver operating characteristic,ROC)曲线验证IGF-1对矮小症的预测效能。结果B组的IGF-1(102.45±20.36)μg/L低于A组(117.33±20.15)μg/L,差异有统计学意义,t=2.497,P=0.016;BMD(0.62±0.11)g/cm^(2)低于A组(0.79±0.23)g/cm^(2),差异有统计学意义,t=2.943,P=0.005。经Spearman相关性系数检验,IGF-1水平与BMD水平呈显著正相关。病例组的IGF-1(110.35±30.61)μg/L低于健康组(161.45±50.33)μg/L,差异有统计学意义,t=6.064;P<0.001;BMD(0.71±0.16)g/cm^(2)均低于健康组(0.86±0.33)g/cm^(2),差异有统计学意义,t=2.869,P=0.005。ROC曲线显示,小儿BMD水平会随IGF-1下降而逐步下降,IGF-1对矮小症预测的灵敏度为79.35%、特异度为80.25%,截断值为327μg/L,曲线下面积(area under curve,AUC)为0.857。结论IGF-1与生长激素水平、BMD水平正相关,监测IGF-1水平能实现对矮小症的有效诊断及预测。Objective To analyze the association between insulin-like growth factor-1(IGF-1)and bone mineral density(BMD)levels,as well as its diagnostic efficacy for growth hormone deficient short stature(short stature).Methods A total of 96children who underwent examination at the First Affiliated Hospital of Nanyang Medical College from January 10,2021to December 10,2022were selected as the research subjects for a retrospective study.They were divided into a case group(50cases)and a health group(46cases)based on the presence or absence of short stature.Partial growth hormone deficiency dwarfism in the case group was classified as Group A(32cases),and complete growth hormone deficiency dwarfism was classified as Group B(18cases).The IGF-1and BMD levels were compared between Groups A and B.A difference was considered statistically significant when P<0.05.The Spearman correlation coefficient was used to verify the correlation between the two,and the receiver operating characteristic(ROC)curve was used to verify the predictive efficacy of IGF-1for short stature.Results The IGF-1level of Group B(102.45±20.36)μg/L was lower than that of Group A(117.33±20.15)μg/L,and the difference was statistically significant t=2.497,P=0.016;The BMD(0.62±0.11)g/cm^(2) was lower than that of Group A(0.79±0.23)g/cm^(2),with a statistically significant difference,t=2.943,P=0.005.According to Spearman correlation coefficient test,there was a significant positive correlation between IGF-1level and BMD level.The IGF-1level of the case group(110.35±30.61)μg/L was lower than that of the healthy group(161.45±50.33)μg/L,and the difference was statistically significant,t=6.064,P<0.001;BMD(0.71±0.16)g/cm^(2) was lower than that of the healthy group(0.86±0.33)g/cm^(2),with statistically significant differences,t=2.869,P=0.005.The ROC curve showed that the BMD level in children gradually decreased with the decline of IGF-1.The sensitivity and specificity of IGF-1for predicting dwarfism were 79.35%,80.25%,respectively,and the cutoff value was 327

关 键 词：胰岛素样生长因子-1 小儿身材矮小症 骨密度 相关性分析 预测效能 

分 类 号：R58[医药卫生—内分泌]