特发性中枢性性早熟女童FGF23、Klotho、IGF-1和性激素水平分析

目的 检测特发性中枢性性早熟女童的血清成纤维细胞生长因子23（FGF23）、Klotho、胰岛素样生长因子-1（IGF-1）和促性腺激素的水平，探讨其与特发性中枢性性早熟的关系。方法 选取2021年6月—2022年6月河北省人民医院儿科收治，年龄< 8岁，诊断为特发性中枢性性早熟的女童34例作为观察组。选取同期于本院行健康体检，年龄< 8岁，未启动青春期发育的26例健康女童作为对照组。检测所有入选者的血清FGF23、Klotho、IGF-1、性激素水平、骨龄及卵巢容积，并进行比较分析。结果 观察组和对照组的身高、身高标准差积分、体质量指数、体质量指数标准差积分、骨龄、骨龄指数和卵巢容积比较，差异均有统计学意义（P <0.05）。观察组和对照组的促黄体生成素（LH）、促卵泡激素（FSH）、FGF23比较，差异均有统计学意义（P <0.05）。观察组患儿的Klotho和FGF23呈正相关（r =0.781，P <0.05），Klotho与IGF-1、LH、体质量指数、骨龄和卵巢容积呈正相关（r =0.646、0.520、0.317、0.413和0.697，均P <0.05）；FGF23与IGF-1、LH、体质量指数、骨龄和卵巢容积呈正相关（r =0.781、0.591、0.392、0.353、0.410和0.669，均P <0.05）。结论 血清IGF-1、FGF23和 Klotho在女童青春期发育中发挥了一定的生理作用。

Analysis of FGF23, Klotho, IGF-1 and sex hormone levels in girls with central precocious puberty

Objective To detect the levels of serum fibroblast growth factor 23 (FGF23), Klotho, insulin-like growth factor-1 (IGF-1), and gonadotropins in girls with idiopathic central precocious puberty (ICPP) and explore their relationship with ICPP.Methods Thirty-four girls diagnosed with ICPP, aged < 8 years, treated at the Department of Pediatrics, Hebei Provincial People''s Hospital, from June 2021 to June 2022, were selected as the observation group. Twenty-six healthy girls aged < 8 years who underwent health examinations during the same period and had not initiated puberty were selected as the control group. Serum levels of FGF23, Klotho, IGF-1, sex hormones, bone age, and ovarian volume were measured in all participants, and the results were compared and analyzed.Results There were statistically significant differences in height, height standard deviation score, body mass index, body mass index standard deviation score, bone age, bone age index, and ovarian volume between the observation group and the control group (P < 0.05). The levels of luteinizing hormone (LH), follicle-stimulating hormone (FSH), and FGF23 were significantly different between the observation group and the control group (P < 0.05). In the observation group, Klotho and FGF23 were positively correlated (r = 0.781, P < 0.05), and Klotho was positively correlated with IGF-1, LH, body mass index, bone age, and ovarian volume (r = 0.646, 0.520, 0.317, 0.413, and 0.697, respectively; all P < 0.05). FGF23 was positively correlated with IGF-1, LH, body mass index, bone age, and ovarian volume (r = 0.781, 0.591, 0.392, 0.353, 0.410, and 0.669, respectively; all P < 0.05).Conclusion Serum IGF-1, FGF23, and Klotho play certain physiological roles in the pubertal development of girls.