Combined diagnostic value of insulin-like growth factor-1, insulin-like growth factor binding protein-3, and baseline luteinizing hormone levels for central precocious puberty in girls

Lixue Ouyang, Fan Yang
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引用次数: 3

Abstract

Abstract Objectives The golden standard test for diagnosing central precocious puberty (CPP) is the gonadotropin releasing hormone stimulation test, which has many limitations. This study aimed to investigate the value of insulin-like growth factor-1 (IGF-1), IGF binding protein-3 (IGFBP-3), and basal luteinizing hormone (LH) levels in diagnosing CPP. Methods Cross-sectional study of the levels of IGF-1, IGFBP-3, and basal LH in girls with a chief complaint of premature breast development. Seventy-nine girls with CPP and 37 girls with premature thelarche (PT) diagnosed at West China Second University Hospital from January 2016 to October 2018 were recruited. All patients underwent physical examination, laboratory tests, uterine and ovarian ultrasound, and bone age tests, only CPP patients underwent pituitary magnetic resonance imaging (MRI). Statistical analysis was performed using the SPSS software 21.0. A receiver operating characteristic curve was used to determine diagnostic value. Results The anthropometric data and hormone indicators between CPP and PT were statistically different (p<0.001), except for peak follicle stimulating hormone (FSH) levels (p=0.181). IGF-1, IGFBP-3, and basal LH levels were significantly higher in the subjects with CPP than in those with PT; IGF-1 and basal LH were positively correlated with peak LH and LH/FSH (peak) (p<0.001). The area under the curve (AUC) of IGF-1, IGFBP-3, and basal LH were 0.880, 0.853, and 0.915, respectively. When combined, the AUC reached the highest value of 0.978. Conclusions IGF-1, IGFBP-3, and baseline LH levels were useful in diagnosing CPP. The combined analysis improved the diagnostic effectiveness.
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胰岛素样生长因子-1、胰岛素样生长因子结合蛋白-3及基线促黄体生成素水平对女孩中枢性性早熟的综合诊断价值
摘要目的诊断中枢性性早熟(CPP)的金标准试验是促性腺激素释放激素刺激试验,但该试验存在诸多局限性。本研究旨在探讨胰岛素样生长因子-1 (IGF-1)、IGF结合蛋白-3 (IGFBP-3)和基础黄体生成素(LH)水平在诊断CPP中的价值。方法对以乳房发育过早为主诉的女孩进行IGF-1、IGFBP-3和基础LH水平的横断面研究。招募2016年1月至2018年10月在华西第二大学医院诊断为CPP的79名女孩和早产(PT)的37名女孩。所有患者均行体格检查、实验室检查、子宫卵巢超声检查和骨龄检查,只有CPP患者行垂体磁共振成像(MRI)检查。采用SPSS 21.0软件进行统计分析。采用受试者工作特征曲线确定诊断价值。结果除促卵泡激素(FSH)峰值水平差异有统计学意义(p=0.181)外,CPP与PT的人体测量数据及激素指标差异均有统计学意义(p<0.001)。CPP患者的IGF-1、IGFBP-3和基础LH水平显著高于PT患者;IGF-1、基础LH与LH峰、LH/FSH(峰)呈正相关(p<0.001)。IGF-1、IGFBP-3和基础LH的曲线下面积(AUC)分别为0.880、0.853和0.915。综合使用时,AUC达到最大值0.978。结论IGF-1、IGFBP-3和基线LH水平对诊断CPP有价值。联合分析提高了诊断的有效性。
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