DIAGNOSTIC VALUE OF SERUM INSULIN- LIKE GROWTH FACTOR BINDING PROTEIN- 3 IN CHILDREN WITH OR WITHOUT GROWTH HORMONE DEFICIENCY

OBJECTIVE: To study the value of serum insulin-like growth factor binding protein-3 (IGFBP-3) levels in differential diagnosis of growth hormone deficiency (GHD). METHODS: To measure serum IGFBP-3 levels by RIA in normal children and adolescents, GHD children and short-stature children without GHD. RESULTS: Serum level of IGFBP-3 in 129 children with untreated GHD and with no pubertal development was 1.6 +/- 0.9 mg/L, which was less than that in normal group of the same age, but overlapped with the normal children in Tanner stage I. After six-month treatment with recombinant human growth hormone (rhGH), serum level of IGFBP-3 in 59 GHD significantly increased from 1.3 +/- 0.7 mg/L to 2.7 +/- 0.9 mg/L, accompanied by an increase of body heights, growth velocities and serum level of IGF-1. Serum level of IGFBP-3 in 55 short-stature children without GHD was 3.3 +/- 2.2 mg/L, which was not significantly different from that in normal group. CONCLUSION: Serum IGFBP-3 level can reflect the status of GH secretion in children with GHD and is a useful marker for differential diagnosis of GHD.

Interplay between micro RNA-17-5p, insulin-like growth factor-Ⅱ through binding protein-3 in hepatocellular carcinoma

AIM: To investigate the effect of microR NA on insulinlike growth factor binding protein-3(IGFBP-3) and hence on insulin-like growth factor-Ⅱ(IGF-Ⅱ) bioavailability in hepatocellular carcinoma(HCC).METHODS: Bioinformatic analysis was performed using microrna.org, DIANA lab and Segal lab softwares. Total RNA was extracted from 23 HCC and 10 healthy liver tissues using mir Vana mi RNA Isolation Kit. microR NA-17-5p(miR-17-5p) expression was mimicked and antagonized in Hu H-7 cell lines using Hi Per Fect Transfection Reagent, then total RNA was extracted using Biozol reagent then reverse transcribed into cD NA followed by quantification of mi R-17-5p and IGFBP-3 expression using Taq Man real-time quantitative PCR. Luciferase reporter assay was performed to validate the binding of miR-17-5p to the 3'UTR of IGFBP-3. Free IGF-Ⅱ protein was measured in transfected Hu H-7 cells using IGF-Ⅱ ELISA kit. RESULTS: Bioinformatic analysis revealed IGFBP-3 as a potential target for miR-17-5p. Screening of miR-17-5p and IGFBP-3 revealed a moderate negative correlation in HCC patients, where mi R-17-5p was extensively underexpressed in HCC tissues(P = 0.0012), while IGFBP-3 showed significant upregulation in the same set of patients(P = 0.0041) compared to healthy donors. Forcing mi R-17-5p expression in Hu H-7 cell lines showed a significant downregulation of IGFBP-3 mR NA expression(P = 0.0267) and a significant increase in free IGF-Ⅱ protein(P = 0.0339) compared to mock untransfected cells using unpaired t-test. Luciferase assay validated IGFBP-3 as a direct target of mi R-17-5p; luciferase activity was inhibited by 27.5% in cells co-transfected with miR-17-5p mimics and the construct harboring the wild-type binding region 2 of IGFBP-3 compared to cells transfected with this construct alone(P = 0.0474).CONCLUSION: These data suggest that regulating IGF-Ⅱ bioavailability and hence HCC progression can be achieved through targeting IGFBP-3 via manipulating the expression of miR NAs.

Circulating insulin-like growth factor-binding protein 3 as prognostic biomarker in liver cirrhosis

AIM: To investigate the prognostic significance of insulin-like growth factor-binding protein 3(IGFBP-3) in patients with cirrhosis.METHODS: Prospective study that included two cohorts: outpatients with stable cirrhosis(n = 138) and patients hospitalized for acute decompensation(n = 189). Development of complications, mortality or liver transplantation was assessed by periodical phone calls and during outpatient visits. The cohort of stable cirrhosis also underwent clinical and laboratory evaluation yearly(2013 and 2014) in predefined study visits. In patients with stable cirrhosis, IGFBP-3 levels were measured at baseline(2012) and at second re-evaluation(2014). In hospitalized subjects, IGFBP-3 levels were measured in serum samples collected in the first and in the third day after admission and stored at-80 ℃. IGFBP-3 levels were measured by immunochemiluminescence.RESULTS: IGFBP-3 levels were lower in hospitalized patients as compared to outpatients(0.94 mcg/mL vs 1.69 mcg/m L, P < 0.001) and increased after liver transplantation(3.81 mcg/m L vs 1.33 mcg/mL, P = 0.008). During the follow-up of the stable cohort, 17 patients died and 11 received liver transplantation. Bivariate analysis showed that death or transplant was associated with lower IGFBP-3 levels(1.44 mcg/mL vs 1.74 mcg/m L, P = 0.027). The Kaplan-Meier transplant-free survival probability was 88.6% in patients with IGFBP-3 ≥ 1.67 mcg/mL and 72.1% for those with IGFBP3 < 1.67 mcg/mL(P = 0.015). In the hospitalized cohort, 30-d mortality was 24.3% and was independently associated with creatinine, INR, SpO_2/FiO_2 ratio and IGFBP-3 levels in the logistic regression. The 90-d transplant-free survival probability was 80.4% in patients with IGFBP-3 ≥ 0.86 mcg/mL and 56.1% for those with IGFBP3 < 0.86 mcg/mL(P < 0.001). CONCLUSION: Lower IGFBP-3 levels were associated with worse outcomes in patients with cirrhosis, and might represent a promising prognostic tool that can be incorporated in clinical practice.

Increased expression of insulin-like growth factor-binding protein-3 is implicated in erectile dysfunction in two-kidney one-clip hypertensive rats after propranolol treatment

This study aimed to investigate the role of insulin-like growth factor-binding protein-3 （IGFBP-3） in erectUe dysfunction （ED） in two-kidney one-clip （2K-1C） hypertensive rats treated with the β-blocking agent propranolol. Adult male Wistar rats were randomly divided into three groups： a normal control group, a hypertensive control group and a propranolol treatment group （n=9）. After 4 weeks of propranolol treatment, intracavemous pressure （ICP） responses to electrical stimulation of the cavernous nerves were evaluated. The expression of IGFBP-3 and insulin-like growth factor-1 （IGF-1） mRNA and protein in the rat cavernous tissue were detected by quantitative real-time PCR and Western blot, respectively. The concentration of cyclic guanosine monophosphate （cGMP） in the cavernous tissue was determined by enzyme-linked immunosorbent assay （ELISA）. Cavernosal pressure in response to cavernous nerve stimulation was decreased 4 weeks after propranolol treatment （P〈0.01, compared to the hypertensive control group）. IGFBP-3 mRNA and protein expression was increased in the propranolol treatment group compared to the hypertensive control group （P〈O.01）, whereas IGF-1 expression was decreased in the propranolol treatment group compared to the hypertensive control group （P〈0.01）. In addition, cavernous cGMP concentration was decreased in the prepranolol treatment group compared to the hypertensive control group （P〈0.01）. Taken together, these results suggest that the upregulation of IGFBP-3 may play a role in the development of ED in hypertensive rats.

Changes of insulin-like growth factor-Ⅱ and insulin-like growth factor binding protein-3 in cerebrospinal fluid of children with tuberculous meningitis

BACKGROUND： Recent studies have found that insulin-like growth factors （IGFs） and insulin-like growth factor binding protein-3 （IGFBP-3） have stronger neurotrophic and neuroprotective effects. But whether their levels in cerebrospinal fluid could be used as an auxiliary indicator in differentially diagnosing tuberculous meningitis and viral encephalitis is not yet clear. OBJECTIVE： To explore the changes of insulin-like growth factor-Ⅱ （IGF-Ⅱ ） and IGFBP-3 in cerebrospinal fluid （CSF） of children with tuberculous meningitis and the significance of the changes. DESIGN： A non-randomized concurrent controlled study. SETTING： Department of Pediatric Internal Medicine, the First Affiliated Hospital of Xinxiang Medical College. PARTICIPANTS： Thirty children with tuberculous meningitis （14 males and 16 females） were selected from the Department of Pediatric Internal Medicine, the First Affiliated Hospital of Xinxiang Medical College from January 2005 to December 2006. Tuberculous meningitis was diagnosed according to their clinical manifestations, the history of close contact with tuberculosis, typical cerebrospinal fluid changes of tuberculous meningitis, positive tuberculosis antibody and effective antituberculosis treatment. There were 30 children （13 males and 17 females） with viral encephalitis, and viral encephalitis was diagnosed according to epidemiological history, clinical manifestations, conventional and biochemical changes of cerebrospinal fluid, and negative bacteriology judgment. Meanwhile, 30 children （13 males and 17 females） without infectious and central nervous system disease were selected as the control group. Informed consent was obtained from the parents of all the enrolled children. METHODS： ①The lumbar puncture operation was implemented immediately to obtain cerebrospinal fluid （3 mL）. The contents of IGF-Ⅱ and IGFBP-3 were detected with immunoradiometric assay. The concentrations of glucose and protein in cerebrospinal fluid were determined with a dry-chemical method. The number of white blood cells was counted by Fushi Method. ②The Pearson correlation analysis was used to analyze the correlation of the contents of IGF-Ⅱ and IGFBP-3 in cerebrospinal fluid with the leucocyte counting and the concentrations of glucose and protein in cerebrospinal fluid. MAIN OUTCOME MEASURES： The contents of IGF- Ⅱ and IGFBP-3 in cerebrospinal fluid, and their correlation with the leucocyte counting and the concentrations of glucose and protein in cerebrospinal fluid. RESULTS： ①Contents of IGF-Ⅱ and IGFBP-3 in cerebrospinal fluid： The contents of IGF-Ⅱ and IGFBP-3 in cerebrospinal fluid in the tuberculous meningitis group were significantly higher than those in the encephalitis virus group and control group （P 〈 0.05）. There was no significant difference in the contents of IGF- Ⅱ and IGFBP-3 in cerebrospinal fluid between the viral encephalitis group and control group （P 〉 0.05）. ②Correlation： The IGF- Ⅱ and IGFBP-3 contents in cerebrospinal fluid were positively correlated with the protein concentration in cerebrospinal fluid （r =0.821, 0.855, P 〈 0.01）, but negatively with the glucose （r =0.742, - 0.605, P 〈 0.01）. CONCLUSION- ①IGFs and IGVBPs are involved in the pathophysiological process of tuberculous meningitis, as well as the glucose and protein metabolism in cerebrospinal fluid. ②The IGF-Ⅱ and IGFBP-3 contents in cerebrospinal fluid can be used as the auxiliary indicators to differentially diagnose tuberculous meningitis and viral enceohalitis.

Insulin-like growth factor-binding protein-3 inhibits IGF-1-induced proliferation of human hepatocellular carcinoma cells

OBJECTIVE Basic fibroblast growth factor(b FGF)and platelet-derived growth factor(PDGF)produced by hepatocellular carcinoma(HCC)cells are responsible for the cell growth.Accumulating evidence shows that insulin-like growth factor-binding protein-3(IGFBP-3)suppresses HCC cell proliferation in both IGF-dependent and independent manners.The present study is to investigate whether treatment with exogenous IGFBP-3 inhibits bF GF and PDGF production and the cell proliferation of HCC cells.METHODS Cell Counting Kit 8 assay were designed to detect HCC cell proliferation,transcription factor early growth response-1(EGR1)involving in IGFBP-3 regulation of b FGF and PDGF were detected by RT-PCR and Western blot assays.Western blot assay was adopted to detect the IGFBP-3 regulating insulin-like growth factor 1 receptor(IGF-1R)signaling pathway.RESULTS The present study demonstrates that IGFBP-3 suppressed IGF-1-induced b FGF and PDGF expression while it does not affect their expression in the absence of IGF-1.To delineate the underlying mechanism,Western-blot and RT-PCR assays confirmed that the transcription factor early growth response protein 1(EGR1)is involved in IGFBP-3 regulation of b FGF and PDGF.IGFBP-3 inhibition of type 1 insulin-like growth factor receptor(IGF1R),ERK and AKT activation is IGF-1-dependent.Furthermore,transient transfection with constitutively activated AKT or MEK partially blocks the IGFBP-3 inhibition of EGR1,b FGF and PDGF expression.CONCLUSION In conclusion,these findings suggest that IGFBP-3suppresses transcription of EGR1 and its target genes b FGF and PDGF through inhibiting IGF-1-dependent ERK and AKT activation.It demonstrates the importance of IGFBP-3 in the regulation of HCC cell proliferation,suggesting that IGFBP-3 could be a target for the treatment of HCC.

Insulin-like growth factor 2 mRNA-binding protein 1 promotes cell proliferation via activation of AKT and is directly targeted by microRNA-494 in pancreatic cancer

BACKGROUND Studies have shown that insulin-like growth factor 2 mRNA-binding protein 1(IGF2BP1)plays critical roles in the genesis and development of human cancers.AIM To investigate the clinical significance and role of IGF2BP1 in pancreatic cancer.METHODS Expression levels of IGF2BP1 and microRNA-494(miR-494)were mined based on Gene Expression Omnibus datasets and validated in both clinical samples and cell lines by quantitative real-time polymerase chain reaction and Western blot.The relationship between IGF2BP1 expression and clinicopathological factors of pancreatic cancer patients was analyzed.The effect and mechanism of IGF2BP1 on pancreatic cancer cell proliferation were investigated in vitro and in vivo.Analyses were performed to explore underlying mechanisms of IGF2BP1 upregulation in pancreatic cancer and assays were carried out to verify the posttranscriptional regulation of IGF2BP1 by miR-494.RESULTS We found that IGF2BP1 was upregulated and associated with a poor prognosis in pancreatic cancer patients.We showed that downregulation of IGF2BP1 inhibited pancreatic cancer cell growth in vitro and in vivo via the AKT signaling pathway.Mechanistically,we showed that the frequent upregulation of IGF2BP1 was attributed to the downregulation of miR-494 expression in pancreatic cancer.Furthermore,we discovered that reexpression of miR-494 could partially abrogate the oncogenic role of IGF2BP1.CONCLUSION Our results revealed that upregulated IGF2BP1 promotes the proliferation of pancreatic cancer cells via the AKT signaling pathway and confirmed that the activation of IGF2BP1 is partly due to the silencing of miR-494.

Insulin-like growth factor binding protein related protein 1 knockdown attenuates hepatic ?brosis via the regulation of MMPs/TIMPs in mice

Background: Previous research suggested that insulin-like growth factor binding protein related protein 1(IGFBPrP1), as a novel mediator, contributes to hepatic fibrogenesis. Matrix metalloproteinases(MMP) and tissue inhibitors of metalloproteinases(TIMP) play an essential role in hepatic fibrogenesis by regulating homeostasis and remodeling of the extracellular matrix(ECM). However, the interaction between IGFBPrP1 and MMP/TIMP is not clear. The present study was to knockdown IGFBPrP1 to investigate the correlation between IGFBPrP1 and MMP/TIMP in hepatic fibrosis. Methods: Hepatic fibrosis was induced by thioacetamide(TAA) in mice. Knockdown of IGFBPrP1 expression by ultrasound-targeted microbubble destruction-mediated CMB-shRNA-IGFBPrP1 delivery, or inhibition of the Hedgehog(Hh) pathway by cyclopamine treatment, was performed in TAA-induced liver fibrosis mice. Hepatic fibrosis was determined by hematoxylin and eosin and Sirius red staining. Hepatic expression of IGFBPrP1, α-smooth muscle actin( α-SMA), transforming growth factor β 1(TGF β1), collagen I, MMPs/TIMPs, Sonic Hedgehog(Shh), and glioblastoma family transcription factors(Gli1) were investigated by immunohistochemical staining and Western blotting analysis. Results: We found that hepatic expression of IGFBPrP1, TGF β1, α-SMA, and collagen I were increased longitudinally in mice with TAA-induced hepatic fibrosis, concomitant with MMP2/TIMP2 and MMP9/TIMP1 imbalance and Hh pathway activation. Knockdown of IGFBPrP1 expression, or inhibition of the Hh pathway, reduced the hepatic expression of IGFBPrP1, TGF β1, α-SMA, and collagen I and re-established MMP2/TIMP2 and MMP9/TIMP1 balance. Conclusions: Our findings suggest that IGFBPrP1 knockdown attenuates liver fibrosis by re-establishing MMP2/TIMP2 and MMP9/TIMP1 balance, concomitant with the inhibition of hepatic stellate cell activation, down-regulation of TGF β1 expression, and degradation of the ECM. Furthermore, the Hh pathway mediates IGFBPrP1 knockdown-induced attenuation of hepatic fibrosis through the regulation of MMPs/TIMPs balance.

Interaction between insulin-like growth factor binding protein-related protein 1 and transforming growth factor beta 1 in primary hepatic stellate cells

BACKGROUND: We previously showed that insulin-like growth factor binding protein-related protein 1 (IGFBPrP1) is a novel mediator in liver fibrosis. Transforming growth factor beta 1 (TGF beta 1) is known as the strongest effector of liver fibrosis. Therefore, we aimed to investigate the detailed interaction between IGFBPrP1 and TGF beta 1 in primary hepatic stellate cells (HSCs). METHODS: We overexpressed TGF beta 1 or IGFBPrP1 and inhibited TGF beta 1 expression in primary HSCs for 6, 12, 24, 48, 72, and 96 hours to investigate their interaction and observe the accompanying expressions of a-smooth muscle actin (alpha-SMA), collagen I, fibronectin, and phosphorylated-mothers against decapentaplegic homolog 2/3 (p-Smad2/3). RESULTS: We found that the adenovirus vector encoding the TGF beta 1 gene (AdTGF beta 1) induced IGFBPrP1 expression while that of alpha-SMA, collagen I, fibronectin, and TGF beta 1 increased gradually. Concomitantly, AdIGFBPrP1 upregulated TGF beta 1, alpha-SMA, collagen I, fibronectin, and p-Smad2/3 in a time-dependent manner while IGFBPrP1 expression was decreased at 96 hours. Inhibition of TGF beta 1 expression reduced the IGFBPrP1-stimulated expression of alpha-SMA, collagen I, fibronectin, and p-Smad2/3. CONCLUSIONS: These findings for the first time suggest the existence of a possible mutually regulation between IGFBPrP1 and TGF beta 1, which likely accelerates liver fibrosis progression. Furthermore, IGFBPrP1 likely participates in liver fibrosis in a TGF beta 1-depedent manner, and may act as an upstream regulatory factor of TGF beta 1 in the Smad pathway.

Modified insulin-like growth factor 1 containing collagen-binding domain for nerve regeneration

Insulin-like growth factor 1 （IGF-I） is a potential nutrient for nerve repair. However, it is impractical as a therapy because of its limited half- life, rapid clearance, and limited target specificity. To achieve targeted and long-lasting treatment, we investigated the addition of a binding structure by fusing a collagen-binding domain to IGF- 1. After confirming its affinity for collagen, the biological activity of this construct was examined by measuring cell proliferation after transfection into PC12 and Schwann cells using a 3-（4,5-dimethyl-2-thiazolyl）-2,5-di- phenyl-2-H-tetrazolium bromide assay. Immunofluorescence staining was conducted to detect neurofilament and microtubule-associated protein 2 expression, while real time-polymerase chain reaction was utilized to determine IGF-1 receptor and nerve growth/actor mRNA expression. Our results demonstrate a significant increase in collagen-binding activity of the recombinant protein compared with IGF-1. Moreover, the recombinant protein promoted proliferation of PC12 and Schwann cells, and increased the expression of neurofilament and microtubule-associated protein 2. Importantly, the recombinant protein also stimulated sustained expression of IGF-1 receptor and nerve growth factor mRNA for days. These results show that the recombinant protein achieved the goal of targeting and long-lasting treatment, and thus could become a clinically used factor for promoting nerve regeneration with a prolonged therapeutic effect.

Mendelian randomization provides evidence for a causal effect of serum insulin-like growth factor family concentration on risk of atrial fibrillation

BACKGROUND Atrial fibrillation(AF)is one of the most common persistent arrhythmias among adult cardiovascular diseases.It is important to identify potential risk factors for AF.Members of the insulin-like growth factor(IGF)family exert a variety of effects on various cell types in the context of the pathogenesis of cardiovascular diseases,and previous population-based studies indicate associations between IGF family members and AF.However,the causal effects of IGF family members in AF have not been evaluated.assess genetic relationships between IGF family members and AF.METHODS MR was performed based on genome-wide association study(GWAS)datasets,and concentration levels of 14 IGF family members were retrieved.An initial MR analysis was conducted to identify single nucleotide polymorphisms potentially associated with IGF serum concentrations.A GWAS meta-analysis including 60620 AF cases and 970216 control participants of European ancestry was then conducted to identify AF causal effects.Two-sample MR packages were used to perform MR analysis in R.MR-Egger,weighted median(WM),and inverse va-riance weighted(IVW)methods were used.RESULTS Core Tip:Due to the high prevalence of atrial fibrillation(AF),and adverse outcomes related to it,it is important to identify risk factors associated with development of the condition.Insulin-like growth factor(IGF)family members exert a variety of effects on various cell types in the context of the pathogenesis of cardiovascular diseases,and previous population-based studies indicate associations between IGF family members and AF.However,the causal effects of IGF family members in AF have not been evaluated.The results of the current study provide novel insights on the pathogenesis of AF,and implic-ations of serum IGF family member concentrations when assessing the risk of AF.The study generated evidence on the potential roles of developmental pathological effects in the pathogenesis of AF.Further observational and experimental studies are critically needed.

Tribulus terrestris extracts alleviate muscle damage and promote anaerobic performance of trained male boxers and its mechanisms： Roles of androgen, IGF-1, and IGF binding protein-3

Purpose: To investigate the effects of Tribulus terrestris(TT) extracts on muscle mass, muscle damage, and anaerobic performances of trained male boxers and its mechanisms: roles of plasma androgen, insulin growth factor 1(IGF-1), and IGF-1 binding protein-3(IGFBP-3).Methods: Fifteen male boxers were divided into exercise group(E, n = 7) and exercise plus TT group(E + TT, n = 8). The 2 groups both undertook3-week high-intensity and 3-week high-volume trainings separated by a 4-week rest. TT extracts(1250 mg/day) were orally administered by boxers in E + TT group. TT extract compositions were detected by UHPLC–Q-TOF/MS. Before and at the end of the 2 trainings, muscle mass, anaerobic performance, and blood indicators were explored.Results: Compared with E group, decreases of plasma CK(1591.5 ± 909.6 U/L vs. 2719.9 ± 832.5 U/L) and IGFBP-3(3075.5 ± 1072.5 ng/m L vs. 3950.8 ± 479.3 ng/m L) as well as increases of mean power(MP, 459.4 ± 122.3 W vs. 434.6 ± 69.5 W) and MP/body weight(MP/BW, 7.5 ± 0.9 W/kg vs. 7.1 ± 1.1 W/kg) were detected in E + TT group after a high-intensity training. For high-volume training, reduction of IGFBP-3(2946.4 ± 974.1 ng/m L vs. 3632.7 ± 470.1 ng/m L) and increases of MP(508.7 ± 103.2 W vs. 477.8 ± 49.9 W) and MP/BW(8.2 ± 0.3 W/kg vs.7.5 ± 0.9 W/kg) were detected in E + TT group, compared with E group. Muscle mass, blood levels of testosterone, dihydrotestosterone(DHT),and IGF-1 were not signifiantly changed between the 2 groups.Conclusion: Taking 1250 mg capsules containing TT extracts did not change muscle mass and plasma levels of testosterone, DHT, and IGF-1 but significantly alleviated muscle damage and promoted anaerobic performance of trained male boxers, which may be related to the decrease of plasma IGFBP-3 rather than androgen in plasma.

2型糖尿病合并甲状腺功能亢进患者血清Sema 5A、IGFBP-3水平与糖代谢指标的相关性分析

目的分析2型糖尿病合并甲状腺功能亢进(以下简称甲亢)患者血清信号素5A(Sema 5A)、胰岛素样生长因子结合蛋白-3(IGFBP-3)水平与糖代谢指标的相关性。方法选取2021年6月至2022年6月邯郸市中心医院收治的73例2型糖尿病合并甲亢患者作为合并组,56例单纯2型糖尿病患者作为糖尿病组,另选取同期在邯郸市中心医院体检的68例健康者作为对照组。比较对照组、糖尿病组、合并组血清Sema 5A、IGFBP-3水平,比较糖尿病组、合并组临床资料[体质量指数、糖尿病病程、空腹血糖(FBG)、餐后2 h血糖(2 h PG)、胰岛素(FIN)、甘油三酯、总胆固醇、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、糖化血红蛋白(HbA1c)、三碘甲腺原氨酸(T_(3))、甲状腺素(T_(4))、游离三碘甲腺原氨酸(FT_(3))、游离甲状腺素(FT_(4))、促甲状腺素(TSH)、促甲状腺激素受体抗体(TRAB)及甲状腺过氧化物酶抗体(TPOAB)、胰岛素抵抗指数(HOMA-IR)]。采用多因素Logisitic回归分析2型糖尿病并发甲亢的危险因素,采用Pearson相关分析2型糖尿病合并甲亢患者血清Sema 5A、IGFBP-3水平与糖代谢指标的相关性,绘制受试者工作特征(ROC)曲线分析血清Sema 5A、IGFBP-3对2型糖尿病合并甲亢的诊断价值。结果合并组血清Sema 5A、IGFBP-3水平高于对照组和糖尿病组,且糖尿病组高于对照组,差异均有统计学意义(P<0.05)。合并组糖尿病病程长于糖尿病组,血清HOMA-IR、FIN、HbA1c、T_(3)、T_(4)、FT_(3)、FT_(4)、TRAB、TPOAB水平高于糖尿病组,TSH水平低于糖尿病组,差异均有统计学意义(P<0.05)。多因素Logisitic回归分析结果显示,HOMA-IR、TPOAB、Sema 5A、IGFBP-3水平升高,TSH水平降低为2型糖尿病并发甲亢的危险因素(P<0.05)。Pearson相关分析结果显示,2型糖尿病并发甲亢患者血清Sema 5A、IGFBP-3水平与HOMA-IR、FBG、2 h PG、FIN、HbA1c、HDL-C水平均呈正相关(P<0.05)。2型糖尿病并发甲亢患者血清Sema 5A、IGFBP-3水平与LDL-C水平呈负相关(P<0.05)。ROC曲线分析结果显示,血清Sema 5A、IGFBP-3诊断2型糖尿病合并甲亢的曲线下面积(AUC)分别为0.854、0.804,2项指标联合诊断的AUC为0.900,且2项指标联合诊断的AUC高于Sema 5A、IGFBP-3单独诊断的AUC(Z联合-Sema 5A=2.156,P=0.043;Z联合-IGFBP-3=2.873,P=0.004)。结论2型糖尿病合并甲亢患者血清Sema 5A、IGFBP-3水平升高,且二者与糖代谢指标密切相关。

高危儿体格发育情况影响因素分析及胰岛素样生长因子1和胰岛素样生长因子结合蛋白3对高危儿体格发育的预测价值

目的 分析高危儿体格发育情况的影响因素及胰岛素样生长因子1(IGF-1)、胰岛素样生长因子结合蛋白3(IGFBP-3)对高危儿体格发育的预测价值。方法 选取2021年10月—2022年8月北京大学第一医院宁夏妇女儿童医院产科出生的105例高危儿为研究对象,统计高危儿体格发育情况,检测高危儿IGF-1、IGFBP-3水平。结果 105例高危儿中,74例体格发育正常,占70.48%。单因素分析显示:与体格发育正常高危儿相比,体格发育不良高危儿出生体质量<1.5 kg(35.14%vs.74.19%)、出生身长<47 cm(39.19%vs.77.42%)、未添加营养补充剂(28.38%vs.58.06%)、母乳喂养(24.32%vs.41.94%)、人工喂养(18.92%vs.38.71%)、母亲文化程度高中及以下(33.78%vs.61.29%)、无多个看护人(36.49%vs.64.52%)、IGF-1<200 ng/ml(29.73%vs.74.19%)、IGFBP-3<5.0μg/ml(33.78%vs.70.97%)比例较高(均P<0.05)。多因素logistic回归分析结果显示:出生体质量、出生身长、是否添加营养补充剂、喂养方式、母亲文化程度、多个看护人、IGF-1、IGFBP-3为影响高危儿体格发育情况的主要因素(均P<0.05)。与IGF-1、IGFBP-3单项诊断相比,两项联合预测高危儿体格发育不良的灵敏度(58.06%vs.77.42%vs.93.55%)、准确度(72.38%vs.64.76%vs.90.48%)较高(均P<0.05)。结论 出生体质量、出生身长、是否添加营养补充剂、喂养方式、母亲文化程度、多个看护人、IGF-1、IGFBP-3为高危儿体格发育情况的影响因素,IGF-1、IGFBP-3联合检测对高危儿体格发育不良的预测价值较高。

血清IGFBP-3、Gd-IgA1在儿童紫癜性肾炎早期诊断中的应用价值

目的 探索血清胰岛素样生长因子结合蛋白-3(IGFBP-3)及半乳糖缺乏免疫球蛋白A1(Gd-IgA1)联合检测在儿童紫癜性肾炎(HSPN)早期诊断中的应用价值。方法 选取2021年6月至2023年4月在该院确诊的105例首发过敏性紫癜(HSP)患儿作为研究对象,在入院后按照HSP是否累及肾脏将患儿分为HSPN组及无肾炎组(HSP组),同期选择在该院体检的52例健康儿童作为对照组(NC组)。收集3组临床资料,采用酶联免疫吸附试验(ELISA)对血清及尿液中IGFBP-3、Gd-IgA1表达水平进行检测,受试者工作特征(ROC)曲线分析血清IGFBP-3、Gd-IgA1对HSPN的早期诊断价值,多因素Logistic回归分析HSPN早期发生的影响因素。结果 与NC组相比,HSPN组及HSP组的IgA、IgG、补体C3、IgA/C3、白细胞计数(WBC)、红细胞计数(RBC)、血小板计数(PLT)及血清光抑素C(CysC)、血肌酐(sCr)水平显著升高(P<0.05),但HSPN组与HSP组的临床资料差异无统计学意义(P>0.05);HSPN组及HSP组血清IGFBP-3、Gd-IgA1及尿液IGFBP-3/尿肌酐(uCr)、Gd-IgA1/uCr表达水平较NC组显著升高(P<0.05),并且,与HSP组相比,HSPN组血清IGFBP-3、Gd-IgA1及尿液Gd-IgA1/uCr表达水平进一步升高(P<0.05);ROC曲线分析显示,联合IGFBP-3、Gd-IgA1诊断HSPN的曲线下面积(AUC)显著大于IGFBP-3单独诊断的AUC(Z=3.629,P<0.001)和Gd-IgA1单独诊断的AUC(Z=2.274,P=0.023);多因素Logistic回归分析显示,血清CysC、IGFBP-3、Gd-IgA1、尿液Gd-IgA1/uCr是HSPN早期发生的影响因素(P<0.05)。结论 HSPN患儿血清IGFBP-3、Gd-IgA1的表达水平均显著上升,二者是HSPN早期发生的影响因素,血清IGFBP-3、Gd-IgA1水平联合检测对HSPN的早期诊断具有较高的应用价值。

IGF-1、IGFBP-3在非小细胞肺癌患者血清中的表达及其临床意义

目的探讨胰岛素样生长因子-1(IGF-1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)在非小细胞肺癌(NSCLC)患者血清中的表达及其临床意义。方法选择84例NSCLC患者作为肺癌组,84例肺部良性疾病患者作为对照组。采集所有患者入院第2 d时空腹静脉血4 ml,应用全自动化学发光免疫分析仪检测血清IGF-1、IGFBP-3含量。对比两组受检者血清IGF-1、IGFBP-3差异,分析血清IGF-1、IGFBP-3表达与NSCLC患者临床病理特征的关系。结果肺癌组血清IGF-1水平高于对照组,IGFBP-3水平低于对照组,有统计学差异(P<0.05);不同年龄、性别、肿瘤部位、肿瘤最大直径、病理类型、分化程度NSCLC患者血清IGF-1、IGFBP-3水平比较,无统计学差异(P<0.05);局部侵犯T_(1)~T_(2)、Ⅰ~Ⅱ期NSCLC患者血清IGF-1水平低于T_(3)~T_(4)、Ⅲ期者,IGFBP-3水平高于T_(3)~T_(4)、Ⅲ期者,有淋巴结转移者血清IGF-1水平高于T_(3)~T_(4)者,IGFBP-3水平低于T_(3)~T_(4)者,有统计学差异(P<0.05)。Pearson分析显示,血清IGF-1水平与NSCLC患者局部侵犯程度、TNM分期、淋巴结转移呈正相关(P<0.05),血清IGFBP-3-水平与NSCLC患者局部侵犯程度、TNM分期、淋巴结转移呈负相关(P<0.05)。结论NSCLC患者血清IGF-1、IGFBP-3水平表达异常,其水平高低与患者局部侵犯程度、TNM分期、淋巴结转移有关。

危重患者血浆IGF-1和IGFBP-3水平对预测ARDS和预后判断的临床价值

目的探讨危重患者血浆胰岛素样生长因子(insulin-like growth factor,IGF)-1和胰岛素样生长因子结合蛋白(insulin-like growth factor binding protein,IGFBP)-3水平对预测急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)和预后判断的临床价值。方法回顾性分析131例在温州医科大学附属第一医院重症监护室住院的危重患者,检测入组患者血浆IGF-1、IGFBP-3水平和血生化、降钙素原(procalcitonin,PCT)、乳酸(lactic acid,LAC)、血白蛋白等。计算入组患者60d病死率。比较ARDS患者和对照组患者及60d死亡患者和生存患者的差异。结果ARDS组患者血浆IGF-1、IGFBP-3明显低于对照组,而PCT高于对照组。死亡组患者血浆IGF-1、IGFBP-3水平明显低于存活组。多因素Logistic回归分析和受试者操作特征曲线结果显示IGF-1曲线下面积(area under the curve,AUC)为0.770、序贯器官衰竭评分(sequential organ failure assessment,SOFA)评分(AUC=0.692)和PCT(AUC=0.710)是危重患者发生ARDS的独立危险因素,IGF-1(AUC=0.807)、IGFBP-3(AUC=0.759)和SOFA评分(AUC=0.859)是危重患者死亡发生的独立危险因素。结论危重患者血浆IGF-1、IGFBP-3水平明显降低,血浆IGF-1和IGFBP-3水平降低是危重患者可能发生ARDS和死亡的重要因素。

安图A2000全自动化学发光分析仪检测IGFBP3的性能验证及与IGF-1相关性研究

目的:对安图A2000全自动化学发光仪检测血清胰岛素样生长因子结合蛋白3(IGFBP3)的性能进行评价,并探讨其在矮小症、性早熟及垂体性病变中与IGF-1的相关性。方法:对安图A2000系统检测IGFBP3的精密度(CV)、线性范围、可报告范围、参考区间进行验证。选取2023年1月-2023年9月在本院诊断或治疗的矮小症21例、性早熟10例、垂体性病变19例,回顾性分析其胰岛素生长因子-Ⅰ(IGF-1)和IGHBP3水平,并进行Spearman相关性分析。结果:IGFBP3高低水平质控品批内CV为2.019%、2.931%,批间CV为3.818%、4.137%;测定结果在0.3~16.0μg/mL范围内呈线性,线性回归方程为Y=0.9995X~0.0213,R2=0.9974;临床可报告范围为0.3~32.0μg/mL;18~70岁和>70岁健康体检者检测结果均在厂家提供的参考区间内;IGFBP3和IGF-1在矮小症、性早熟和垂体性病变患者中具有较好的相关性(r=0.81,P<0.0001)。结论:安图A2000检测血清IGFBP3的性能能够满足实验室质量要求,且与IGF-1具有较好的相关性。

磁共振SWI序列联合血清Id1、IGFBP-3对脑胶质瘤术前分级的评估价值

目的分析磁共振磁敏感加权成像(SWI)序列联合血清分化抑制因子1(Id1)、胰岛素样生长因子结合蛋白-3(IGFBP-3)对脑胶质瘤术前分级的评估价值。方法选取2019年12月至2022年6月我院收治的脑胶质瘤患者98例作为此次研究对象,根据恶化情况分为低级别组(世界卫生组织Ⅰ级和Ⅱ级)46例,高级别组(世界卫生组织Ⅲ级和Ⅳ级)52例;入选患者均进行磁共振SWI序列检查;采用酶联免疫吸附(ELISA)法检测血清Id1、IGFBP-3水平;采用Pearson法分析血清Id1、IGFBP-3水平的相关性;受试者工作特征(ROC)曲线分析Id1、IGFBP-3水平对脑胶质瘤术前分级的临界诊断点;采用四格表分析磁共振SWI序列联合血清Id1、IGFBP-3对脑胶质瘤术前高低级别的诊断价值。结果高级别组ITSS分级显著高于低级别组(P>0.05)。高级别组Id1、IGFBP-3水平均显著高于低级别组(P>0.05)。根据pearson相关性分析得知,脑胶质瘤患者血清Id1、IGFBP-3水平呈正相关(r=0.486,P<0.05)。根据ROC曲线得知,Id1、IGFBP-3诊断脑胶质瘤术前分级的曲线下面积(AUC)分别为0.837、0.861,二者联合诊断脑胶质瘤术前分级的AUC为0.908。磁共振SWI序列在脑胶质瘤术前分级诊断中准确度为83.67%,灵敏度为84.62%,特异度为82.61%;Id1在脑胶质瘤术前分级诊断中准确度为79.59%,灵敏度为80.77%,特异度为78.26%;IGFBP-3在脑胶质瘤术前分级诊断中准确度为81.63%,灵敏度为82.69%,特异度为80.43%;三者联合检测在脑胶质瘤术前分级诊断中准确度为91.84%,灵敏度为92.31%,特异度为91.30%。结论Id1、IGFBP-3在脑胶质瘤患者血清中显著升高,磁共振SWI序列联合血清Id1、IGFBP-3可以提高对脑胶质瘤术前分级的评估价值。

血清LH、IGF-ⅠSDS、IGF-bp3诊断女童快速进展型中枢性性早熟的价值研究

目的分析血清黄体生成素(LH)、胰岛素样生长因子Ⅰ标准差积分(IGF-ⅠSDS)及胰岛素样生长因子结合蛋白3(IGF-bp3)在早期识别快速进展型中枢性性早熟(RP-CPP)和缓慢进展型中枢性性早熟(SP-CPP)患儿中的有效性,为临床进一步提高对女童RP-CPP的诊疗水平提供参考资料。方法回顾性分析2021年4月至2023年6月西安交通大学附属儿童医院收治的120例中枢性性早熟(CPP)女童患儿的临床资料,将其纳入研究组,按照线性生长或骨龄成熟加速等条件,将其分为RP-CPP组(71例),SP-CPP组(49例);纳入同期在院体检的青春期发育正常女童64例为对照组。比较不同人群LH、IGF-ⅠSDS及IGF-bp3水平的变化情况,采用多元Logistic回归分析影响儿童RP-CPP的相关危险因素,采用受试者工作特征(ROC)曲线评估LH、IGF-ⅠSDS及IGF-bp3预测RP-CPP的效能。结果研究组的LH、IGF-ⅠSDS、IGF-bp3及骨龄均明显高于对照组,经比较差异均有统计学意义(t值分别为26.256、47.930、20.390、14.008,P<0.05)。LH、IGF-ⅠSDS、IGF-bp3与骨龄均呈正相关(r值分别为0.435、0.502、0.397,P<0.05)。RP-CPP组的LH、IGF-ⅠSDS水平均明显高于SP-CPP组,经比较差异均有统计学意义(t值分别为7.867、33.943,P<0.05),但RP-CPP组与SP-CPP组的IGF-bp3水平比较,差异无统计学意义(P>0.05)。经多元Logistic回归分析显示,LH[OR(95%CI):1.962(1.172~3.285)]、IGF-ⅠSDS[OR(95%CI):1.707(1.142~2.552)]及IGF-bp3[OR(95%CI):2.314(1.221~4.384)]均是影响RP-CPP发生的危险因素(P<0.01)。经ROC曲线分析显示,LH、IGF-ⅠSDS及IGF-bp3单独预测RP-CPP的曲线下面积(AUC)从高到低依次为0.799、0.762、0.714,三者联合预测RP-CPP的AUC为0.864,其明显高于各指标单独预测的结果(P<0.001)。结论CPP女童的血清LH、IGF-ⅠSDS及IGF-bp3水平均存在异常,通过检测患儿的上述指标变化,可有效地预测病情的进展,LH、IGF-ⅠSDS及IGF-bp3水平较高者发生RP-CPP的风险相对较大。