使用IGF-1和IGFBP-3标准偏差得分的中部早熟青春期的预测建模
Rihwa Choi1,2, Gayoung Chun3, Sung-Eun Cho4
1Laboratory Medicine Center, Division of Laboratory Medicine, GC Labs, Yongin-si 16924, Republic of Korea.
Diagnostics (Basel, Switzerland)
|October 16, 2025
概括
基线胰岛素样生长因子1 (IGF-1) 和IGF结合蛋白3 (IGFBP-3) 标准偏差分数 (SDS) 在韩国儿童的预测模型中改善了中部早期青春期 (CPP) 诊断. 性别特定的解释对于准确的临床应用至关重要.
科学领域:
- 儿科内分泌学 儿科内分泌学
- 生殖医学 生殖医学
- 临床诊断 临床诊断 临床诊断
背景情况:
- 中央早熟性青春期 (CPP) 诊断依赖于性腺激素释放激素 (GnRH) 刺激测试,这对于儿科患者来说往往是繁重的.
- 评估基线荷尔蒙标志物可以提供一种不那么侵入性的诊断方法.
研究的目的:
- 评估基线激素标记物的有用性,特别是胰岛素样生长因子1 (IGF-1) 和IGF结合蛋白3 (IGFBP-3),作为在韩国儿童中诊断CPP的辅助工具.
- 确定这些标记物的诊断准确性,单独和预测模型中,使用标准偏差得分 (SDS).
主要方法:
- 对2464名接受GnRH刺激测试的韩国儿童进行了回顾性分析.
- 评估基线白质化激素 (LH),卵泡刺激激素 (FSH),IGF-1和IGFBP-3水平,并使用两个参考间隔进行SDS计算.
- 多变量逻辑回归和接收器操作特征 (ROC) 分析,按性别分层,以评估诊断性能 (曲线下的面积 - AUC).
主要成果:
- 卵泡刺激激素 (FSH) 在个体基线标志物中显示出最高的AUC (0.767在女孩中,0.895在男孩中).
- 结合IGF-1 SDS和IGFBP-3 SDS的预测模型显著改善了诊断性能 (AUC=0.800在女孩中,0.920在男孩中) 与单独使用这些标志物相比.
- 中部早期青春期的发病率是54.2%的女孩和65.6%的男孩.
结论:
- 当将IGF-1和IGFBP-3的标准偏差分数 (SDS) 集成到预测模型中时,可以提高中部早期青春期 (CPP) 的诊断准确性.
- 这些发现强调了在临床实践中对这些标志物的性别特异性解释和标准化参考间隔的重要性.
- 这种方法可以减少对繁的GnRH刺激测试的依赖.
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