目的 探讨胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)和白细胞介素-17A(interleukin-17A,IL-17A)在儿童孤独症谱系障碍(autism spectrum disorder,ASD)中的诊断价值.方法 选取2023年1～12月武汉儿童医院儿童保健科招募的1～6岁86例高度疑似ASD的患儿,采用美国《精神障碍诊断与统计手册》第5版(diagnostic and statistical manu-al of mental disorders-5,DSM-5)筛选出ASD组和对照组,检测两组患儿的血清IGF-1及IL-17A水平.结果 确诊ASD组56例,占比65％(56/86);ASD组血清IGF-1和IL-17A水平高于对照组,差异均有统计学意义(P＜0.05);分别对不同临床特征的血清IGF-1和IL-17A水平进行比较发现,ASD组血清IGF-1和IL-17A水平与年龄、性别比较差异均无统计学意义(P＞0.05);重度ASD组的血清IL-17A水平高于轻中度组(P＜0.05),而重度与轻中度ASD两组间血清IGF-1水平差异无统计学意义(P＞0.05);Logistic回归分析结果显示,血清IGF-1和IL-17A高表达是ASD发生的影响因素(OR＞1,P＜0.05);受试者工作特征(receiver operating characteristic,ROC)曲线分析结果表明,血清IGF-1和IL-17A水平单独及联合检测诊断ASD的曲线下面积(area under the curve,AUC)分别为0.644、0.630、0.720,联合检测诊断价值较高.结论 血清IGF-1和IL-17A具有早期诊断ASD的潜能,两者联合检测有利于提高对ASD的诊断价值.
Diagnostic Value of IGF-1 and IL-17A in Children with Autism Spectrum Disorder
Objective To explore the diagnostic value of insulin-like growth factor-1(IGF-1)and interleukin-17 A(IL-17A)in children with autism spectrum disorder(ASD).Methods Eighty-six children aged 1 to 6 years with highly suspected ASD were recruited from the Department of Children Health Care,Wuhan Children's Hospital from January 2023 to December 2023.Diagnostic and Statistical Manual of Mental Disorders-5(DSM-5)was used to screen out ASD group and control group.,and the serum IGF-1 and IL-17A levels in the two groups were detected.Results Fifty-six ASD children were confirmed,accounting for 65％(56/86).Serum IGF-1 and IL-17A levels in ASD group were higher than those in control group,and the differences were statistically significant(P＜0.05).The serum IGF-1 and IL-17A levels with different clinical characteristics were compared,and there was no statistically significant difference in serum IGF-1 and IL-17A levels with age and gender in ASD group(P＞0.05).The children with severe ASD had significant higher serum IL-17A level than those with mild-to-moderate ASD(P＜0.05),while the difference in serum IGF-1 level between the two groups of severe and mild-to-moderate ASD was not statistically significant(P＞0.05).The Logistic regression analysis showed that overexpression of serum IGF-1 and IL-17 A was the influencing factor in the occurrence of ASD(OR＞1,P＜0.05).The receiver operating characteristic(ROC)curve analysis showed that the area under the curve(AUC)of serum IGF-1 and IL-17 A levels for diagnosing ASD alone and combination were 0.644,0.630 and 0.720.The combined detection had higher diag-nostic value.Conclusion Serum IGF-1 and IL-17A have the potential for early diagnosis of ASD,and the combined detection of the two levels is conducive to improving the diagnostic value of ASD.
Autism spectrum disorderInsulin-like growth factor-1Interleukin-17ADiagnostic value
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