胰岛素样生长因子-1在儿童生长激素缺乏症诊断中的应用价值

Application value of insulin-like growth factor-1 in the diagnosis of growth hormone deficiency in children

目的本研究评估胰岛素样生长因子-1(IGF-1)在儿童生长激素缺乏症(GHD)中的诊断价值。方法将234名儿童按生长激素激发试验结果分为GHD组(59例)和非GHD(175例),采用化学发光法测定所有样品血清的IGF-1,儿童年龄和性别采用ROC分析评价最佳IGF-1的SDS切断值和诊断准确性。结果GHD组儿童IGF-1浓度明显低于非GHD组。IGF-1诊断GHD的ROC曲线图,曲线下面积(AUC)为0.716,最佳IGF-1截断值为-0.66 SDS(敏感性67.80%,特异性69.14%)。结论IGF-1可以用于区分GHD和非GHD,但由于引起儿童矮小的原因众多,须结合其他临床和生化指标结果才能诊断生长激素缺乏症。

Objective To study evaluates the diagnostic value of insulin-like growth factor 1(IGF1)in children with growth hormone deficiency(GHD).Methods A total of 234 children were divided into GHD group(59 cases)and non-GHD(175 cases)according to the results of growth hormone provocation test,and IGF1 was determined by chemiluminescence method in all samples of sera,and the age and sex of children were evaluated by ROC analysis for optimal IGF-1 SDS cut-off values and diagnostic accuracy.Results The concentration of IGF-1 in children in the GHD group was significantly lower than that in the non-GHD group(P<0.05).The ROC curve plot of IGF-1 in the diagnosis of GHD with an area under the curve(AUC)is 0.716,and the best IGF-1 cut-off value is-0.66 SDS(sensitivity 67.80%,specificity 69.14%).Conclusion IGF 1 can be used to distinguish between GHD and non-GHD,but due to the numerous causes of short stature in children,other clinical and biochemical indicators must be combined with the results to diagnose growth hormone deficiency.