矮小儿童血清胰岛素样生长因子-1 和瘦素水平的表达及临床意义

目的了解不同病因的矮小儿童血清胰岛素样生长因子-1（IGF-1）和瘦素水平变化，探讨IGF-1和瘦素在生长激素缺乏症（GHD）诊断中的价值。方法选择深圳市妇幼保健院就诊的矮小儿童96例，年龄5-11岁，根据身高低于同性别同年龄均值-2～3SD，排除其他可致身材矮小疾病，根据生长激素激发试验，GH峰值〈10ng／mL为GHD者共67例（GHD组）、GH峰值≥10ng／mL为特发性矮小（ISS）者共29例（ISS组），另选择同期体检的生长发育正常儿童23名作为对照组。采集所有研究对象的外周静脉血3mL，分离血清后，使用双抗体一步夹心法酶联免疫吸附实验（ELISA）测定血清IGF-1、瘦素浓度。结果GHD组血清IGF-1及瘦素水平（45．7±19．02）μg／L、（4．25±0．63）mg／L]低于ISS组（114．07±24．45）μg／L、（4．69±0．69）mg／L]和对照组（164．61±46．22）μg／L、（6．27±0．89）mg／L]），组间比较，差异均有高度统计学意义（P〈0．01）；诊断GHD，IGF-1的敏感度为100％，特异度为98％；瘦素的敏感度为88％，特异度为71％。结论IGF-1和瘦素的检测可能可作为筛查和诊断GHD有价值的指标，并对GHD与ISS的鉴别诊断也有着一定的临床意义。

Expression and clinical significance of the level of serum insulin-like growth factor-1 and leptin in children with short stature

Objective To understand the levels of serum insulin-like growth factor-1 （IGF-1） and leptin and to discuss the value of IGF-1 and leptin in the diagnosis of growth hormone deficiency （GHD）. Methods A total of 96 patients were recruited in Shenzhen Maternity and Child Healthcare Hospital, whose height lower than -2-3SD of the same age and the same sex mean height, to rule out other diseases can cause short stature, according to growth hormone stim- ulation test, children with GHD whose GH peak 〈10 ng/mL were as GHD group （n=67）, children with idiopathic short stature （ISS） whose GH peak≥ 10 ng/mL were as ISS group （n=29）. The age of patients were at a range of 5-11 years, 23 children aged from 5 to 11 years old whose physical development were natural were chosen as control group. 3 mL peripheral blood of all subjects was chosen as the sample. The concentration of serum IGF-1 and leptin was measured by double antibody step clip art enzyme-linked immunosorbent assay （ELISA） method. Results The levels of serum IGF-1 and leptin in GHD group （45.7±19.02） μg/L, （4.25±0.63） mg/L] were significantly lower than those of ISS group （114.07±24.45）μg/L, （4.69±0.69） mg/L], and control group （164.61±46.22） μg/L, （6.27±0.89） mg/L], the differences were highly statistically significant （P 〈 0.01）. The diagnostic sensitivity of the IGF-1 was 100%, and the specificity was 98%; the diagnostic sensitivity of the leptin was 88%, and specificity was 71%. Conclusion The detection of IGF- 1 and leptin can be used as the screening and diagnosis of GHD valuable indicators, and it also has a certain clinical significance to the differential diagnosis of GHD and the ISS.