摘要
目的探讨超重或肥胖儿童血清胰岛素生长因子-1(IGF-1)水平与性早熟的相关性及性别差异。方法选取2023年9月至2024年6月在南方医科大学珠江医院就诊并确诊为中枢性性早熟(CPP)的超重或肥胖儿童作为性早熟组(n=200),同时选取同期体检健康的儿童作为对照组(n=200)。采用Logistic回归模型分析IGF-1水平与性早熟的独立相关性;采用Pearson相关性分析评估IGF-1、体质量指数(BMI)与性早熟的关系;Mann-Whitney U检验比较不同性别儿童性激素水平差异;Kruskal-Wallis H检验分析血清IGF-1不同水平下,不同BMI分组儿童性激素水平差异。结果经多元线性回归分析,在校正混杂因素后,IGF-1与性激素水平正相关(P<0.05)。Logistic回归显示,IGF-1与性早熟独立相关(OR=1.21,95%CI 1.03~1.31,P<0.001),高IGF-1水平者性早熟风险增加(OR=1.35,95%CI 1.13~2.41,P<0.001)。随着IGF-1水平上升,BMI与性早熟正相关性减弱,呈非线性剂量反应(P<0.05)。性早熟组内男童雌二醇(E_(2))水平低于女童,睾酮(TESTO)水平高于女童,黄体生成素(LH)、促卵泡激素(FSH)水平差异无统计学意义;对照组性别差异仅见于E_(2)水平。高水平IGF-1儿童中,不同BMI对性激素水平无显著影响;低水平IGF-1儿童中,男童性激素无显著差异,女童E_(2)随年龄增长显著升高,但其余指标无差异。结论超重或肥胖的CPP儿童相较于对照组,其血清IGF-1水平显著增高,且与性激素水平呈正相关,其中女童性早熟发病率高于男童。
Objective To explore the correlation between serum insulin-like growth factor 1(IGF-1)levels and precocious puberty,as well as gender-specific differences,in overweight or obese children.Methods Select overweight or obese children diagnosed with central precocious puberty(CPP)at Zhujiang Hospital of Southern Medical University from September 2023 to June 2024 as the precocious puberty group(n=200),and healthy children from routine physical examinations during the same period as the control group(n=200).The independent correlation between IGF-1 levels and precocious puberty was analyzed using the Logistic regression model.Pearson correlation analysis was employed to evaluate the relationship between IGF-1,body mass index(BMI),and precocious puberty.The Mann-Whitney U test was used to compare the differences in sex hormone levels between children of different genders.Additionally,the Kruskal-Wallis H test was utilized to analyze the differences in sex hormone levels among children in different BMI groups under varying serum IGF-1 levels.Results Multivariate linear regression analysis,after adjusting for confounders,revealed a positive correlation between IGF-1 and sex hormone levels(P<0.05).Logistic regression analysis demonstrated that IGF-1 was independently associated with precocious puberty,with an odds ratio(OR)of 1.21 and a 95% confidence interval(CI)of 1.03-1.31(P<0.001).Moreover,individuals with high IGF-1 levels had an increased risk of precocious puberty,as indicated by an OR of 1.35 and a 95%CI of 1.13-2.41(P<0.001).As the IGF-1 level increased,the positive correlation between BMI and precocious puberty weakened,showing a non-linear dose-response relationship(P<0.05).In the precocious puberty cohort,boys exhibited lower estradiol(E_(2))levels compared to girls,whereas testosterone(TESTO)levels were higher.No significant variations were observed in luteinizing hormone(LH)and follicle-stimulating hormone(FSH)concentrations.In the control group,gender differences were only observed in terms of the E_(2) level.Among children with high IGF-1 levels,different BMI did not have a significant impact on sex hormone levels.For children with low IGF-1 levels,there were no significant differences in sex hormones among boys.In girls,the E_(2) level increased significantly with age,whereas there were no differences in other indicators.Conclusion Compared to the control group,overweight or obese children with CPP exhibit significantly elevated serum IGF-1 levels.Additionally,a positive correlation exists between IGF-1 levels and sex hormone levels.Notably,the incidence of precocious puberty is higher in girls than in boys.
作者
贺艳
朱卉娟
袁雅琴
HE Yan;ZHU Huijuan;YUAN Yaqin(School of Nursing,Guangzhou Health Science College,Guangzhou,Guangdong 510000,China;Special Medical Service Center,Zhujiang Hospital,Southern Medical University,Guangzhou,Guangdong 510282,China;General Surgery Department,Zhujiang Hospital,Southern Medical University,Guangzhou,Guangdong 510280,China)
出处
《中国优生与遗传杂志》
2025年第5期1228-1235,共8页
Chinese Journal of Birth Health & Heredity
基金
2022年度广东省普通高校青年创新人才类项目(2022WQNCX198)。
作者简介
通讯作者:朱卉娟,HEyan01230@126net.com.cn。
