Abstract：
Background: The relevance of growth determination in orthodontics is driving the search for the most precise and least invasive way of tracking the pubertal growth spurt. Objectives: The aim was to explore whether minimally invasive salivary estimation of biomarkers Insulin-like growth factor (IGF-1) and Insulin-like growth factor binding protein-3 (IGFBP-3) could be used to estimate skeletal maturity with diagnostic accuracy, especially in children and adolescent age groups. Subjects and methods: The cross-sectional study was conducted on 105 participants aged 6−25 years from the out-patient Department of Preventive Dental Science at Majmaah University between the period 2 January 2021 and 12 July 2021. Each subject’s lateral cephalogram radiograph was categorized based on skeletal maturity, and saliva samples were estimated for IGF-1 and IGFBP-3 using the respective ELISA kits. Two-way ANOVA with interaction was applied to examine the main effects due to cervical vertebral maturation staging (CVS), Sex and interaction effect due to CVS, and Sex on study parameters. Karl Pearson’s Product Moment Correlation Coefficient was calculated for finding a significant association between IGF, IGFBP3, and the IGF-1/IGFBP3 molar ratio. Results: Highest mean salivary IGF-1 was observed in the pubertal peak stage, which coincides with cervical vertebral maturity stages 3 and 4 (CVS3 and CVS4) for both males (2.57 ng/mL) and females (1.57 ng/mL) and the lowest mean level of IGF-1 for females (0.85 ng/mL) and males (1.22 ng/mL) was observed during the prepubertal stage. There exists a significant variation in IGF-1 between males and females in the pubertal stage (p < 0.01), but the difference is very narrow in the prepubertal and post-pubertal groups (p > 0.05). There was no significant interaction effect of different skeletal stages and gender on the IGFBP3 and the IGF-1/IGFBP3 molar ratio (p > 0.05), but there exists a significant interaction effect on IGF-1 (p < 0.05). Conclusion: Estimation of the IGF-1 and the IGF-1/IGFBP3 molar ratio in saliva, being a non-invasive biological marker, could serve as an adjunctive tool along with radiographic assessment in estimating growth maturity in the adolescence age group. By initiating orthodontic treatment during the mandibular growth peak in adolescence, a positive outcome is ensured in managing skeletal deformities within the craniofacial complex.
摘要：
背景：正畸学中生长测定的相关性正在推动寻找最精确，侵入性最小的追踪青春期生长突增的方法。目的：探讨微创唾液生物标志物胰岛素样生长因子-1（IGF-1）和胰岛素样生长因子结合蛋白-3（IGFBP-3）是否可用于评估骨骼成熟度的诊断准确性。特别是在儿童和青少年年龄组。受试者和方法：横断面研究是在2021年1月2日至2021年7月12日期间，来自Majmaah大学预防性牙科科学门诊的105名6-25岁参与者进行的。每个受试者的侧位头影X光片都是根据骨骼成熟度进行分类的，使用各自的ELISA试剂盒估计和唾液样品的IGF-1和IGFBP-3。应用具有相互作用的双向方差分析来检查由于颈椎成熟分期（CVS）引起的主要影响，由于CVS的性别和相互作用效应，和性别对研究参数的影响。KarlPearson的乘积矩相关系数被计算用于发现IGF，IGFBP3,且IGF-1/IGFBP3摩尔比。结果：在青春期高峰期观察到最高平均唾液IGF-1，男性（2.57ng/mL）和女性（1.57ng/mL）与颈椎成熟度3和4期（CVS3和CVS4）一致，女性（0.85ng/mL）和男性（1.22ng/mL）的IGF-1平均水平最低。IGF-1在青春期男性和女性之间存在显着差异（p<0.01）。但在青春期前和青春期后组的差异非常小(p>0.05)。不同骨骼阶段和性别对IGFBP3和IGF-1/IGFBP3摩尔比没有显著的交互作用(p>0.05),但对IGF-1有显著的交互作用(p<0.05)。结论：唾液中IGF-1和IGF-1/IGFBP3摩尔比的估算，作为一种非侵入性的生物标记，可以作为评估青春期年龄组生长成熟度的辅助工具。通过在青春期的下颌生长高峰期开始正畸治疗，在处理颅面复合体内的骨骼畸形时，确保了积极的结果。
