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/cm2 低于 A 组(0.79± 0.23)g/cm2,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/cm2 均低于健康组(0.86±0.33)g/cm2,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327 μg/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.
Correlation and diagnostic efficacy of insulin-like growth factor-1 with bone mineral density levels in children with growth hormone deficient short stature
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 96 children who underwent examination at the First Affiliated Hospital of Nanyang Medical College from January 10,2021 to December 10,2022 were selected as the research subjects for a retrospective study.They were divided into a case group(50 cases)and a health group(46 cases)based on the presence or absence of short stature.Partial growth hormone deficiency dwarfism in the case group was classified as Group A(32 cases),and complete growth hormone defi-ciency dwarfism was classified as Group B(18 cases).The IGF-1 and 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 pre-dictive efficacy of IGF-1 for short stature.Results The IGF-1 level 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/cm2 was lower than that of Group A(0.79±0.23)g/cm2,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-1 level and BMD level.The IGF-1 level 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/cm2 was lower than that of the healthy group(0.86±0.33)g/cm2,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-1 for predicting dwarfism were 79.35％,80.25％,respectively,and the cutoff value was 327 μg/L,AUC=0.857.Conclusion IGF-1 is positively correlated with growth hormone levels and BMD levels,and monitoring IGF-1 levels can achieve effective diagnosis and prediction of dwarfism.
insulin like growth factor 1idiopathic short stature in childrenbone densitycorrelation analysispredictive performance
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