人胰岛素生长因子BP3、makorin环指蛋白3在特发性中枢性性早熟女童诊断中的应用价值

Values of human insulin growth factor BP3 and makorin ring finger protein 3 in the diagnosis of girls with idiopathic central precocious puberty

目的检测特发性中枢性性早熟(ICPP)女童血清中人胰岛素生长因子BP3(IGF-BP3)、makorin环指蛋白3(MKRN3)水平,并探讨IGF-BP3、MKRN3在ICPP女童诊断中的应用价值。方法选取2017年3月-2019年3月于本院就诊的95例ICPP女童(ICPP组)为研究对象,同期选取83例健康体检女童(CG组)作为对照组。采用化学发光法检测2组激素水平;全自动免疫分析仪检测血清中IGF-BP3水平、qRT-PCR法检测血清中MKRN3水平;分析IGF-BP3、MKRN3水平与一般资料、激素水平的相关性;分析IGF-BP3、MKRN3对ICPP女童的诊断价值。结果 ICPP组IGF-BP3水平、骨龄、泌乳素(PRL)、雌二醇(E2)显著高于CG组(P <0.05),MKRN3、乳房发育年龄水平显著低于CG组(P <0.05);骨龄、PRL、E2与IGF-BP3水平均呈正相关,与MKRN3水平均呈负相关(P <0.05);乳房发育年龄与IGF-BP3水平呈负相关,与MKRN3水平呈正相关(P <0.05);IGF-BP3、E2是ICPP疾病发生的危险因素,MKRN3是ICPP疾病发生的保护因素;IGF-BP3、MKRN3联合诊断ICPP疾病的AUC为0.918(95%CI:0.875~0.961),特异度为87.4%,敏感度为86.7%。结论 IGF-BP3、MKRN3在ICPP发生中发挥重要作用,可能参与ICPP发病机制,IGF-BP3联合MKRN3可作为诊断ICPP女童的参考指标。

Objective To detect the levels of serum human insulin growth factor BP3( IGF-BP3) and makorin ring finger protein 3( MKRN3) in girls with idiopathic central precocious puberty( ICPP),and to explore the values of IGF-BP3 and MKRN3 in the diagnosis of ICPP girls. Methods Ninety-five ICPP girls( ICPP group) who were treated in our hospital from March 2017 to March 2019 were selected as the study subjects. Meanwhile,83 healthy girls( CG group) were selected as control group. Chemiluminescence method was used to detect the levels of hormones in the two groups;the levels of serum IGF-BP3 and MKRN3 were detected by automatic immunoassay and qRT-PCR. The correlations between the levels of IGF-BP3,MKRN3 and general data,hormone levels were analyzed,and the diagnostic values of IGF-BP3 and MKRN3 in ICPP girls were analyzed. Results The IGF-BP3 level,bone age,prolactin( PRL),estradiol( E2) levels in ICPP group were significantly higher than those in CG group( P < 0. 05),and the levels of MKRN3 and breast development age were significantly lower than those in CG group( P < 0. 05). Bone age,levels of PRL and E2 were positively correlated with the level of IGF-BP3 and negatively correlated with the level of MKRN3( P < 0. 05). The age of breast development was negatively correlated with the level of IGF-BP3 and positively correlated with the level of MKRN3( P < 0. 05). IGF-BP3 and E2 were risk factors for ICPP disease,while MKRN3 was protective factor for ICPP disease. The AUC of combined diagnosis of IGF-BP3 and MKRN3 for ICPP was 0. 918( 95% CI: 0. 875-0. 961),the specificity was 87. 4%,and the sensitivity was 86. 7%. Conclusion IGF-BP3 and MKRN3 play important roles in the occurrence of ICPP and may be involved in the pathogenesis of ICPP. The combination of IGF-BP3 and MKRN3 can be used as a reference index for the diagnosis of ICPP girls.