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【目的】探讨特发性中枢性性早熟(idiopathic central precocious puberty,ICPP)女童、单纯性乳房早发育(simple premature thelarche,SPT)患儿血清胰岛素样生长因子-1(IGF-1)、瘦素(leptin)、体质指数(body mass index,BMI)的变化及临床意义。【方法】测定28例ICPP及32例SPT女童BMI、血清IGF-1和leptin的水平,并以26名正常青春发育期女童及30名未发育女童作为对照,观察BMI及血清IGF-1l、eptin水平的相互关系;以IGF-1及leptin为诊断指标,对ICPP进行诊断试验评价。【结果】ICPP组女童血清IGF-1及leptin水平均明显高于SPT及未发育女童,差异有统计学意义(P<0.01),而与正常青春发育女童差异无统计学意义(P>0.05)。ICPP组女童IGF-1及leptin水平均与BMI呈正相关(r=0.67,0.71,P<0.01);正常青春发育组女童IGF-1及leptin水平均与BMI亦呈正相关(r=0.63、0.68,P<0.01);SPT组、未发育组女童IGF-1及leptin水平均与BMI无相关关系(P>0.05)。IGF-1>319.47 ng/mL对诊断ICPP的灵敏度、特异度、阳性预测值分别为95.4%、96.3%、95.6%;leptin>6.32 ng/mL对诊断ICPP的灵敏度、特异度、阳性预测值分别为96.5%,95.7%,94.8%。【结论】IGF-1和leptin水平的测定可作为ICPP诊断的参考指标,对鉴别ICPP与SPT具有重要临床意义;同时,IGF-1和Leptin可能是激活GnRH脉冲分泌的相关代谢因子。
【Objective】 To investigate the effects of idiopathic central precocious puberty (ICPP) on serum insulin-like growth factor-1 (IGF-1) and leptin levels in children with simple premature the lamella (SPT) (leptin), body mass index (body mass index, BMI) changes and clinical significance. 【Methods】 The levels of BMI, serum IGF-1 and leptin in 28 ICPP and 32 female SPT girls were measured. Twenty-six normal girls and 30 un-girls were used as control. BMI, serum IGF-1, eptin Level of the relationship between; IGF-1 and leptin as diagnostic indicators, ICPP diagnostic test evaluation. 【Results】 The levels of serum IGF-1 and leptin in girls with ICPP were significantly higher than those in girls with SPT and those without girls (P <0.01), but there was no significant difference between them (P> 0.05) . The levels of IGF-1 and leptin in girls with ICPP were positively correlated with BMI (r = 0.67,0.71, P <0.01). The levels of IGF-1 and leptin in girls with normal puberty were also positively correlated with BMI (r = 0.63,0.68, P <0.01). There was no correlation between IGF-1 and leptin levels in BMI and SPT group (P> 0.05). The sensitivity, specificity and positive predictive value of IGF-1> 319.47 ng / mL for the diagnosis of ICPP were 95.4%, 96.3% and 95.6%, respectively. The sensitivity, specificity and positive predictive value of ICP- 96.5%, 95.7%, 94.8%. 【Conclusion】 The determination of IGF-1 and leptin levels can be used as a reference for ICPP diagnosis, and has important clinical significance for the identification of ICPP and SPT. Meanwhile, IGF-1 and Leptin may be related metabolic factors that activate GnRH pulse secretion.