雌二醇胰岛素样生长因子结合蛋白-3瘦素在中枢性性早熟女童中的表达及与环境内分泌干扰物的相关性

Expressions of estradiol,insulin-like growth factor binding protein-3,and leptin in girls with central precocious puberty and the correlations with environmental endocrine disruptors

目的分析雌二醇(E_(2))、胰岛素样生长因子结合蛋白-3(IGFBP3)及瘦素在中枢性性早熟(CPP)女童中的表达及与环境内分泌干扰物的相关性。方法选取2019年3月—2021年3月台州市立医院收治的88例CPP患儿为观察组,50例健康儿童为对照组。采用化学发光法检测血清E_(2)水平,采用放射免疫法检测血清IGFBP3、瘦素水平,采用高效液相色谱分析法检测环境内分泌干扰物[邻苯二甲酸二乙酯(DEHP)、辛基酚(OP)及双酚A(BPA)]水平。结果观察组血清E_(2)、IGFBP3及瘦素水平分别为(36.21±3.21)pg/ml、(6.47±0.32)mg/L及(6.43±0.52)ng/ml;对照组血清E_(2)、IGFBP3及瘦素水平分别为(6.23±0.53)pg/ml、(4.25±0.47)mg/L及(2.65±0.22)ng/ml。观察组血清E_(2)、IGFBP3及瘦素水平均显著高于对照组(t=65.440,P<0.05;t=32.910,P<0.05;t=48.910,P<0.05)。观察组DEHP、OP及BPA水平分别为(2.35±0.22)ng/ml、(1.23±0.12)ng/ml及(2.68±0.27)ng/ml;对照组DEHP、OP及BPA水平分别为(7.69±0.71)ng/ml、(5.23±0.52)ng/ml及(11.56±1.11)ng/ml。与对照组相比,观察组患儿DEHP、OP及BPA水平均较低(t=65.400,P<0.05;t=69.170,P<0.05;t=71.590,P<0.05)。CPP患儿E_(2)表达与DEHP、OP及BPA水平均呈负相关,IGFBP3表达与DEHP、OP及BPA水平均呈负相关,瘦素表达与DEHP、OP及BPA水平均呈负相关(均P<0.05)。结论E_(2)、IGFBP3及瘦素在CPP患儿中均呈高表达,三者之间具有一定相关性,且与环境内分泌干扰物各指标相关,可能共同参与CPP的发生、发展。

Objective To analyze the expressions of estradiol(E_(2)),insulin-like growth factor binding protein-3(IGFBP3),and leptin in girls with central precocious puberty(CPP)and the correlations with environmental endocrine disruptors.Methods From March 2019 to March 2021,88 children with CPP treated in Taizhou Municipal Hospital were selected as observation group,50 healthy children were selected as control group.Chemiluminescent immunoassay was used to detect serum E_(2) levels,radioimmunoassay was used to detect the levels of serum IGFBP3 and leptin.High performance liquid chromatographic method was used to detect the levels of environmental endocrine disruptors[diethyl phthalate(DEHP),octyl phenol(OP),and bisphenol A(BPA)].Results The levels of serum E_(2),IGFBP3,and leptin in observation group were(36.21±3.21)pg/ml,(6.47±0.32)mg/L,and(6.43±0.52)ng/ml,respectively;the levels of serum E_(2),IGFBP3,and leptin in control group were(6.23±0.53)pg/ml,(4.25±0.47)mg/L,and(2.65±0.22)ng/ml,respectively.The levels of serum E_(2),IGFBP3,and leptin in observation group were statistically significantly higher than those in control group(t=65.440,P<0.05;t=32.910,P<0.05;t=48.910,P<0.05).The levels of DEHP,OP,and BPA in observation group were(2.35±0.22)ng/ml,(1.23±0.12)ng/ml,and(2.68±0.27)ng/ml,respectively;the levels of DEHP,OP,and BPA in control group were(7.69±0.71)ng/ml,(5.23±0.52)ng/ml,and(11.56±1.11)ng/ml,respectively.Compared with control group,the levels of DEHP,OP,and BPA in observation group were lower,there were statistically significant differences(t=65.400,P<0.05;t=69.170,P<0.05;t=71.590,P<0.05).In CPP children,E_(2) expression was negatively correlated with DEHP,OP,and BPA levels,IGFBP3 expression was negatively correlated with DEHP,OP,and BPA levels,leptin expression was negatively correlated with DEHP,OP,and BPA levels(P<0.05).Conclusion E_(2),IGFBP3,and leptin are highly expressed in CPP children,there are certain correlations among the three indexes,which are correlated with environmental endocrine disruptors,E_(2),IGFBP3,and leptin may participate in occurrence and development of CPP.