促性腺激素释放激素类似物对不同血清中网膜素-1水平的特发性矮小症患儿的治疗效果

The therapeutic effects of gonadotropin-releasing hormone analogues on idiopathic short stature children with different serum omentin-1 levels

目的分析促性腺激素释放激素类似物对不同血清中网膜素-1水平的特发性矮小症患儿治疗效果。方法选取2022年8月至2023年3月收治的95例特发性矮小症患儿为研究对象,以网膜素-1水平58.91 ng/mL为临界值,将网膜素-1<58.91 ng/mL的47例患儿作为低表达组,网膜素-1≥58.91 ng/mL的48例患儿作为高表达组,两组均给予促性腺激素释放激素类似物。检测对比两组体格发育指标、相关生长因子、骨代谢指标、维生素D、微量元素、甲状腺功能指标水平。结果治疗后两组患儿生长速度、身高、骨龄、预测成年身高、胰岛素样生长因子1(IGF-1)、骨密度、骨碱性磷酸酶(BALP)、Ⅰ型前胶原N端前肽(PINP)、维生素D、锌、镁、钙水平上升,且高表达组较高;人生长激素释放多肽(ghrelin)、摄食抑制因子1(nesfatin-1)、β-胶原降解产物(β-CTX)水平下降,且高表达组较低(P<0.05)。治疗后两组患儿促甲状腺激素(TSH)、游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))水平与治疗前相比差异无统计学意义(P>0.05),两组间比较亦差异无统计学意义(P>0.05)。结论特发性矮小症患儿采用促性腺激素释放激素类似物治疗后均取得较好效果,但网膜素-1高表达水平患儿治疗后体格发育、相关生长因子水平、骨代谢改善较为明显,维生素D、微量元素提升较为明显,且甲状腺功能无明显变化。

Objective To analyze the therapeutic effects of gonadotropin-releasing hormone analogues on idiopathic short stature(ISS)children with different serum omentin-1 levels.Methods The study selected 95 ISS children treated at our hospital from August 2022 to March 2023.Based on an omentin-1 threshold of 58.91 ng/mL,47 children with omentin-1 levels<58.91 ng/mL were categorized as the low-expression group,while 48 children with omentin-1 levels≥58.91 ng/mL were categorized as the high-expression group.Both groups were treated with gonadotropin-releasing hormone analogues.The study compared physical development indicators,related growth factors,bone metabolism markers,vitamin D,trace elements,and thyroid function indicators between the two groups.Results Post-treatment,both groups exhibited increased growth velocity,height,bone age,predicted adult height,insulin-like growth factor 1(IGF-1),bone density,bone alkaline phosphatase(BALP),typeⅠprocollagen N-terminal propeptide(PINP),vitamin D,zinc,magnesium,and calcium levels,with the high-expression group showing more significant improvements.The levels of growth hormone-releasing peptide(Ghrelin),appetite suppressor 1(nesfatin-1),andβ-C-terminal telopeptide of typeⅠcollagen(β-CTX)decreased,with a more pronounced reduction in the high-expression group(P<0.05).There were no statistically significant differences in thyroid-stimulating hormone(TSH),free triiodothyronine(FT_(3)),and free thyroxine(FT_(4))levels before and after treatment,nor between the two groups(P>0.05).Conclusion Treatment with gonadotropin-releasing hormone analogues is effective in ISS children,with more significant improvements in physical development,related growth factors,and bone metabolism in children with high omentin-1 expression.Vitamin D and trace element levels also improved significantly,while thyroid function remained stable.