肥胖儿童IGF-1与中枢性性早熟的相关性研究

Correlation between IGF-1 and Central Precocious Puberty in Obese Children

目的探讨肥胖儿童体内胰岛素样生长因子-1(insulin-like growth factor-1,IGF-1)、血脂的代谢特征及骨发育情况,并分析其与中枢性性早熟的相关性。方法选取2020年10月~2021年7月在兰州市区肥胖调查问卷中符合肥胖和非肥胖标准的6~10岁儿童157例,其中肥胖儿童81例纳入肥胖组,非肥胖儿童76例纳入非肥胖组。然后再根据肥胖与否、性早熟有无分为4组,即肥胖性早熟组(n=21)、肥胖无性早熟组(n=60)、非肥胖性早熟组(n=10)、非肥胖无性早熟组(n=66)。完善IGF-1、胰岛素生长因子结合蛋3(insulin growth factor binding protein 3,IGFBP3)、总胆固醇(total cholesterol,TC)、甘油三酯(triglyceride,TG)、高密度脂蛋白胆固醇(high density lipoprotein-cholesterol,HDL-C)、低密度脂蛋白胆固醇(low density lipoprotein-cholesterol,LDL-C),拍摄左手腕关节骨龄片。比较不同组间儿童性发育、IGF-1、血脂及骨龄发育情况。结果肥胖组儿童性早熟发生率高于非肥胖组,女孩多于男孩(P<0.05);肥胖组儿童的骨龄发育偏早、IGF-1、IGFBP3、TC、TG、LDL-C均高于非肥胖组,HDL-C降低(P<0.05)。与肥胖无性早熟组比较,肥胖性早熟组儿童的骨龄发育偏早,TC、TG、LDL-C较低(P<0.05),IGF-1、IGFBP3略低(P>0.05);与非肥胖无性早熟组比较,非肥胖性早熟儿童的IGF-1水平偏高,LDL-C较低(P<0.05);肥胖性早熟组与非肥胖性早熟组儿童的IGF-1、血脂比较,差异无统计学意义(P>0.05)。结论肥胖是诱发性早熟的关键因素之一。肥胖儿童IGF-1升高、骨龄发育偏早;性早熟儿童骨龄发育偏早,但血脂、IGF-1在不同分组中水平不一样,提示性发育过早时IGF-1、脂质代谢可能是紊乱的。

Objective To investigate the metabolic characteristics of insulin growth factor-1(IGF-1),blood lipid and bone development in obese children,and to analyze the correlation between IGF-1 and central precocity.Methods From October 2020 to July 2021,children aged 6-10 years who met the obesity and non-obesity standards in Lanzhou urban obesity questionnaire were selected,among them,81 obese children were included in the obese group,and 76 non-obese children were included in the non-obese group.According to obesity and precocious puberty,the participants were divided into four groups:obese with precocious puberty group(n=21),obese without precocious puberty group(n=60),non-obese with precocious puberty group(n=10)and non-obese without precocious puberty group(n=66).IGF-1,insulin growth factor binding protein 3(IGFBP3),total cholesterol(TC),triglyceride(TG),high density lipoprotein-cholesterol(HDL-C)and low density lipoprotein-cholesterol(LDL-C)were improved and bone age films of left wrist joint were taken.The sexual development,IGF-1,blood lipid and bone age of children in different groups were compared.Results The incidence of precocious puberty in obese group was higher than that in non-obese group,and that in girls were more than that in boys(P<0.05).The development of bone age,IGF-1,IGFBP3,TC,TG and LDL-C in obese group were higher than those in non-obese group,while HDL-C was decreased(P<0.05).Compared with the obese without precocious puberty group,the bone age development was earlier,TC,TG and LDL-C were lower in the obese with precocious puberty group(P<0.05),IGF-1 and IGFBP3 was slightly lower(P>0.05).Compared with non-obese without precocious puberty group,the level of IGF-1 was higher,and LDL-C was lower in non-obese with precocious puberty group(P<0.05).Non-obese children in the precocious puberty group were compared,There were no significant differences in IGF-1 and blood lipid between obese with precocious puberty group and non-obese without precocious puberty group(P>0.05).Conclusion Obesity is one of the key factors to induce precocious puberty.IGF-1 was elevated and bone age development was earlier in obese children.The bone age development of children with precocious puberty was earlier,but the levels of blood lipid and IGF-1 are different in different groups.It is suggested that IGF-1 and lipid metabolism may be disturbed during precocious puberty.