摘要
目的探讨血清抗苗勒管激素(AMH)、脂联素(ADPN)、胰岛素样生长因子-1(IGF-1)联合检测对女童中枢性性早熟的预测价值。方法选择2022年6月至2023年9月焦作市人民医院收治的110例性早熟女童为研究对象,根据性早熟性质分为对照组(外周性性早熟患儿,n=68)和观察组(中枢性性早熟患儿,n=42)。比较2组患儿基本资料、超声测量指标(子宫容积、卵巢容积、>4 mm卵泡数)、血清AMH、ADPN、IGF-1、促卵泡激素(FSH)、黄体生成素(LH)、胰岛素样生长因子结合蛋白-3(IGFBP-3)、25羟维生素D[25-(OH)D]水平。采用多因素logistic回归分析影响女童中枢性性早熟的相关因素,将logistic回归模型分析结果作为依据建立预测女童中枢性性早熟发生的模型,应用受试者操作特征(ROC)曲线评估模型预测效能。结果观察组患儿血清AMH、IGF-1水平显著高于对照组,ADPN水平显著低于对照组(P<0.05)。多因素logistic回归模型分析显示,血清AMH、IGF-1及ADPN水平是女童中枢性性早熟发生的影响因素(P<0.05)。基于AMH、ADPN、IGF-1构建了女童中枢性性早熟发生的风险预测模型,该模型预测女童中枢性性早熟发生的曲线下面积为0.920(95%置信区间:0.853~0.963),灵敏度为80.95%(95%置信区间:68.500~96.200),特异度为88.24%(95%置信区间:76.200~91.500)。结论中枢性性早熟女童中血清AMH、IGF-1水平升高,ADPN水平降低,且血清AMH、IGF-1、ADPN水平是女童中枢性性早熟发生的影响因素,据此构建的风险预测模型对女童中枢性性早熟的预测价值较高。
Objective To explore the predictive value of the combined use of serum anti-Müllerian hormone(AMH),adiponectin(ADPN)and insulin-like growth factor-1(IGF-1)in the detection of central precocious puberty in girls.Methods A total of 110 girls with precocious puberty admitted to Jiaozuo People′s Hospital from June 2022 to September 2023 were included and divided into a control group(peripheral precocious puberty,n=68)and an observation group(central precocious puberty,n=42)based on the type of precocious puberty.The basic data,ultrasound measurement indicators(including uterine volume,ovarian volume,and number of follicles>4 mm),and serum levels of AMH,ADPN,IGF-1,follicle-stimulating hormone(FSH),luteinizing hormone(LH),insulin-like growth factor binding protein-3(IGFBP-3),and 25-hydroxyvitamin D[25-(OH)D]were compared between the two groups.The multivariate logistic regression analysis was used to analyze the related factors affecting central precocious puberty in girls.Based on the logistic regression results,a model to predict central precocious puberty in girls was constructed.The receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model.Results The observation group had significantly higher serum AMH and IGF-1 levels but significantly lower ADPN levels than the control group(P<0.05).The multivariate logistic regression model analysis showed that serum AMH,IGF-1 and ADPN levels were factors influencing the occurrence of central precocious puberty in girls(P<0.05).A risk prediction model for the occurrence of central precocious puberty in girls was constructed based on AMH,ADPN,and IGF-1.Its area under the ROC curve was 0.920[95%confidence interval(CI):0.853-0.963],with a sensitivity of 80.95%(95%CI:68.500-96.200)and a specificity of 88.24%(95%CI:76.200-91.500).Conclusion In girls with central precocious puberty,serum AMH and IGF-1 levels are elevated,while ADPN levels are decreased.Serum AMH,IGF-1,and ADPN levels are factors influencing the occurrence of central precocious puberty in girls.The risk prediction model constructed based on these 3 factors has a high predictive value for central precocious puberty in girls.
作者
李卫
岳晓静
郑丽丽
李军民
杨文涛
LI Wei;YUE Xiaojing;ZHENG Lili;LI Junmin;YANG Wentao(Department of Nuclear Medicine,Jiaozuo People′s Hospital,Jiaozuo 454000,Henan Province,China;Department of Clinical Laboratory,Jiaozuo Maternal and Child Health Hospital,Jiaozuo 454000,Henan Province,China;Department of Pediatrics,Jiaozuo People′s Hospital,Jiaozuo 454000,Henan Province,China;Department of Clinical Laboratory,Jiaozuo People′s Hospital,Jiaozuo 454000,Henan Province,China;Department of Ultrasound,Jiaozuo People′s Hospital,Jiaozuo 454000,Henan Province,China)
出处
《新乡医学院学报》
2025年第6期461-465,共5页
Journal of Xinxiang Medical University
关键词
中枢性性早熟
女童
抗苗勒管激素
脂联素
胰岛素样生长因子
预测价值
central precocious puberty
girls
anti-Müllerian hormone
adiponectin
insulin-like growth factor
predictive value
作者简介
李卫(1983-),男,河南焦作人,学士,副主任技师,研究方向:内分泌疾病相关检验检测。
