目的 探究血清摄食抑制因子(Nesfatin-1)、类胰岛素生长因子结合蛋白3(IGFBP-3)、成纤维细胞生长因子21(FGF-21)联合检测对特发性矮小症(ISS)的诊断价值.方法 本研究选取2022年6月至2023年6月期间在本院诊治的85例ISS患儿记为ISS组,另选74例在本院体检的儿童记为对照组,记录两组儿童一般资料并进行比较分析.酶联免疫吸附实验(ELISA)检测受试者血清Nesfatin-1、IGFBP-3、FGF-21;使用原子吸收光谱仪测定受试者血清营养元素钙(Ca)、镁(Mg)、铜(Cu)、铁(Fe)、锌(Zn)的水平.X线骨密度仪检查受试者骨龄(BA).Pearson相关性分析ISS患儿血清Nesfatin-1、IGFBP-3、FGF-21水平的相关性;多因素Logistic回归分析影响儿童发生ISS的影响因素;受试者工作特征(ROC)曲线分析Nesfatin-1、IGFBP-3、FGF-21水平对ISS的诊断价值;通过Z检验比较曲线下面积(AUC)的差异.结果 与对照组相比,ISS组BA、身高、体重、BMI以及IGFBP-3、FGF-21水平较低,Nesfatin-1水平、性发育状态I级人数较高(P<0.05);ISS组患儿Nesfatin-1与IGFBP-3、FGF-21水平呈负相关(rNesfatin-1 vs IGFBP-3=-0.469,rNesfatin-1 vs FGF-21=-0.483),IGFBP-3与FGF-21水平呈正相关(rIGFBP-3 vs FGF-21=0.456)(P<0.05);BA、性发育状态、IGFBP-3、FGF-21是儿童发生ISS的独立保护因素,而Nesfatin-1是儿童发生ISS的独立危险因素(P<0.05);Nesfatin-1、IGFBP-3、FGF-21单独诊断ISS的AUC分别为0.831、0.836、0.823,3者联合诊断ISS的AUC为0.928,优于单独及两两联合诊断(P<0.05).结论 ISS患儿血清中Nesfatin-1水平较高,IGFBP-3、FGF-21水平较低,3者是儿童发生ISS的影响因素,联合诊断ISS具有较高价值.
The Diagnostic Value of Combined Detection of Serum Nesfatin-1,IGFBP-3 and FGF-21 in Idiopathic Short Stature
Objective To explore the diagnostic value of combined detection of serum Nesfatin-1,insulin-like growth factor binding protein-3 (IGFBP-3),and fibroblast growth factor-21(FGF-21)for idiopathic short stature (ISS).Methods In the current study,we selected 85 children with ISS who were treated in our hospital between June,2022 and June,2023 as the ISS group,while another 74 children who underwent physical examination in our hospital were enrolled as the reference group.General information of the two groups was recorded and compared.Enzyme linked immunosorbent assay(ELISA)was applied to detect serum Nesfatin-1,IGFBP-3 and FGF-21 in all subjects;Atomic absorption spectroscopy was applied to determine levels of serum nutrients calcium(Ca),magnesium (Mg),copper(Cu),iron(Fe),and zinc(Zn).X-ray bone density meter was applied to examine the bone age (BA)of subjects.Pearson correlation method was applied to e valuate the correlation between serum Nesfatin-1,IGFBP-3 and FGF-21 expression levels in children with ISS;Multivariate logistic regression was applied to identify influencing factors of ISS in children;Receiver operating characteristic (ROC)curve was drawn to evaluate the diagnostic value of Nesfatin-1,IGFBP-3 and FGF-21 expression levels for ISS;Z-test was applied to identify differences in areas under the curve (AUCs).Results Compared with the reference group,the ISS group had lower BA,height,weight,BMI,IGFBP-3,FGF-21 levels,higher Nesfatin-1 level,and more individuals with grade I sexual development status (P<0.05);The level of Nesfatin-1 was negatively correlated with IGFBP-3 and FGF-21 in the ISS group (rNesfatin-1 vs IGFBP-3=-0.469,rNesfatin-1 vs FGF-21=-0.483),while expression levels of IGFBP-3 and FGF-21 were positively correlated (rIGFBP-3 vs FGF-21=0.456)(P<0.05);BA,sexual development status,IGFBP-3 and FGF-21 were independent protective factors for the development of ISS in children,while Nesfatin-1 was an independent risk factor for the development of ISS in children (P<0.05);AUCs of Nesfatin-1,IGFBP-3 and FGF-21 for diagnosing ISS individually were 0.831,0.836,and 0.823,respectively,while AUC of the three-marker combination for diagnosing ISS was 0.928,which was better than single-marker diagnosis and pairwise combined diagnosis (P<0.05).Conclusion The serum level of Nesfatin-1 is higher in children with ISS,while levels of IGFBP-3 and FGF-21 are lower.The three factors are the influencing factors for children to develop ISS,and the combined diagnosis of ISS has a high value.
Idiopathic short statureNesfatin-1Insulin-like growth factor binding protein-3Fibroblast growth factor-21Diagnostic value
万方数据
维普
