体液中的生物标志物作为骨骼成熟度的指标:系统综述和荟萃分析。

IF 1.4 Q2 MEDICINE, GENERAL & INTERNAL Rambam Maimonides Medical Journal Pub Date : 2023-08-30 DOI:10.5041/RMMJ.10506
Priyanka Kapoor, Rajiv Balachandran, Aman Chowdhry, Giuseppe Perinetti, Om Prakash Kharbanda
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引用次数: 0

摘要

目的:本综述旨在批判性地评估血清、龈沟液(GCF)、唾液和尿液中生物标志物的证据,并与骨骼成熟评估的标准放射学指标进行比较。材料和方法:在多个数据库中进行了全面的文献检索,以寻找体液中用于骨骼成熟的生物标志物,这些生物标志物在侧位头影或腕关节X线片中用颈椎进行评估。使用了包括自由文本、MeSH术语和布尔运算符在内的不同组合。两名研究人员使用严格的纳入和排除标准筛选标题、摘要和全文,并使用诊断准确性研究质量评估(QUADAS)-2工具对个别研究的偏倚风险进行评估。使用RevMan 5软件对符合条件的研究进行荟萃分析。结果:共筛选出344篇文章,其中33篇符合纳入标准和质量评价。骨骼成熟度指标包括胰岛素样生长因子(IGF-1)、碱性磷酸酶(ALP)、骨特异性碱性磷酸酶(BALP)、脱氢表雄酮硫酸酯(DHEAS)、维生素D结合蛋白(DBP)、甲状旁腺相关蛋白(PTHrP)、骨钙素、金属蛋白和血清转铁蛋白(TF)以及不同的代谢产物。在青春期,IGF-1、DBP、ALP、骨钙素、TF和BALP显著升高。然而,从青春期前到青春期后,血清DHEAS和PTHrP增加。由于数据的异质性,可以对血清和血液中IGF-1的总共7项研究进行荟萃分析。其中,5项为男性数据,6项为女性数据,4项为血清和血液中IGF-1的研究。与生长起始期(CS2)相比,青春期生长高峰期(CS3和CS4)和青春期生长减速期(CS5)的IGF-1水平存在显著差异。在男性和女性的联合样本中,GCF中的ALP峰值水平与青春期爆发有关。强烈建议未来的研究采用标准的生物流体收集方案以及采样和方法的同质性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Biomarkers in Body Fluids as Indicators of Skeletal Maturity: A Systematic Review and Meta-analysis.

Objectives: This review aimed to critically appraise the evidence for biomarkers in blood serum, gingival crevicular fluid (GCF), saliva, and urine in comparison with standard radiographic indices for skeletal maturation assessment.

Materials and methods: A thorough literature search in multiple databases was conducted for biomarkers in body fluids for skeletal maturation assessed with cervical vertebrae in lateral cephalograms or on hand-wrist radiographs. Different combinations including free text, MeSH terms, and Boolean operators were used. Two researchers used strict inclusion and exclusion criteria to screen title, abstract, and full text, and used the Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 instrument for risk of bias assessment of individual studies. Meta-analysis was performed on eligible studies using RevMan 5 software.

Results: A total of 344 articles were screened, of which 33 met the inclusion criteria and quality assessment. The skeletal maturity indicators included insulin-like growth factors (IGF-1), alkaline phosphatase (ALP), bone-specific alkaline phosphatase (BALP), dehydroepiandrosterone sulfate (DHEAS), vitamin D binding protein (DBP), parathormone-related protein (PTHrP), osteocalcin, metalloproteins, and serotransferrin (TF) along with different metabolites. At puberty, a significant rise was seen in IGF-1, DBP, ALP, osteocalcin, TF, and BALP. However, the serum DHEAS and PTHrP increased from pre-pubertal to post-pubertal stages. Due to the data heterogeneity, a meta-analysis could be performed on seven studies in total on IGF-1 in serum and blood. Of these, five were included for data in males and six in females, and four studies on IGF-1 in serum and blood. A significant difference in IGF-1 levels was seen between stages of peak pubertal growth spurt (CS3 and CS4) and decelerating pubertal growth (CS5) compared with growth initiation stage (CS2).

Conclusions: Pubertal growth spurts were correlated with peak serum IGF-1 and BALP in both sexes individually. Peak ALP levels in GCF were correlated with the pubertal spurt in a combined sample of males and females. Standard biofluid collection protocols and homogeneity in sampling and methodology are strongly recommended for future research.

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来源期刊
Rambam Maimonides Medical Journal
Rambam Maimonides Medical Journal MEDICINE, GENERAL & INTERNAL-
CiteScore
3.20
自引率
6.70%
发文量
55
审稿时长
8 weeks
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