摘要
目的 探究外周血维生素D与胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)交互作用在特发性矮小症(ISS)发病中的意义.方法 选取2021年5月至2023年3月昆明市儿童医院102例ISS患者作为观察组,另选取同期门诊健康体检正常的102例儿童作为对照组.比较两组临床资料及外周血25-(OH)D3、IGF-1、IGFBP-3,Logistic 回归分析外周血 25-(OH)D3、IGF-1、IGFBP-3 与 ISS 发病的关联性,分析外周血 25-(OH)D3、IGF-1、IGFBP-3对特发性矮小症发病的交互作用,评价外周血25-(OH)D3、IGF-1、IGFBP-3对ISS的诊断价值.结果 两组性别、年龄、父亲及母亲身高比较差异无统计学意义(P＞0.05);观察组身高、体质量及外周血25-(OH)D3、IGF-1、IGFBP-3水平均较对照组低(P＜0.05);Logistic回归分析显示,调整身高、体质量等其他混杂因素后,外周血25-(OH)D3、IGF-1、IGFBP-3仍与ISS发病显著相关(P＜0.05);外周血25-(OH)D3与IGF-1、IGFBP-3相加交互模型分析显示,25-(OH)D3与IGF-1水平、25-(OH)D3与IGFBP-3水平同时下降均对ISS发病具有协同作用(P＜0.05);外周血25-(OH)D3、IGF-1、IGFBP-3联合诊断ISS的曲线下面积(AUC)值为0.913,明显高于各指标单独诊断AUC值(P＜0.05).结论 外周血维生素D、IGF-1、IGFBP-3均为ISS发生影响因素,且外周血维生素D与IGF-1、IGFBP-3对ISS发生具有相加交互作用.
Abstract
Objective To investigate the significance of the interaction between peripheral blood vitamin D and insu-lin-like growth factor 1(IGF-1)and insulin-like growth factor binding protein 3(IGFBP-3)in the pathogenesis of idiopathic short stature(ISS).Methods A total of 102 ISS patients admitted to Kunming Children's Hospital from May 2021 to March 2023 were selected as the observation group,and 102 healthy children who underwent physical examinations in the same pe-riod were selected as the control group.Compare the clinical data and peripheral blood levels of 25-(OH)D3,IGF-1,and IGFBP-3 between the two groups,conduct Logistic regression analysis on the correlation between peripheral blood levels of 25-(OH)D3,IGF-1,and IGFBP-3 and the onset of ISS,analyze the interaction between peripheral blood levels of 25-(OH)D3,IGF-1,and IGFBP-3 and the onset of idiopathic dwarfism,and evaluate the diagnostic value of peripheral blood levels of 25-(OH)D3,IGF-1,and IGFBP-3 for ISS.Results There was no statistically significant difference in gender,age,father and mother height between the two groups(P＞0.05).The height,weight,and peripheral blood levels of 25-(OH)D3,IGF-1,and IGFBP-3 in the observation group were lower than those in the control group(P＜0.05).Logistic regression analysis showed that after adjusting for other confounding factors such as height and weight,peripheral blood 25-(OH)D3,IGF-1,and IGFBP-3 were still significantly correlated with the onset of ISS(P＜0.05).The analysis of the additive interaction model between pe-ripheral blood 25-(OH)D3 and IGF-1,IGFBP-3 showed that the simultaneous decrease of 25-(OH)D3 and IGF-1 levels,as well as the simultaneous decrease of 25-(OH)D3 and IGFBP-3 levels,all had a synergistic effect on the onset of ISS(P＜0.05).The area under the curve(AUC)value of the combined diagnosis of peripheral blood 25-(OH)D3,IGF-1,and IGFBP-3 for ISS was 0.913,which was significantly higher than the AUC value of each indicator alone(P＜0.05).Conclusion Peripheral blood vi-tamin D,IGF-1,and IGFBP-3 are all influencing factors for the occurrence of ISS,and there is an additive interaction between peripheral blood vitamin D,IGF-1,and IGFBP-3 on the occurrence of ISS.
基金项目
云南省科技厅科技项目(202001BA070023-0376)
NETL
NSTL
万方数据