背景:研究不同发育状态女童血清irisin水平,探讨irisin对诊断女童中枢性性早熟(CPP)的意义。
方法:在这项横断面研究中,有111名女孩参加,包括43例CPP,44例外周性早熟(PPP)和24例性发育正常的女童作为对照。关于年龄的数据,体重和身高,测量黄体生成素(LH)的血液水平,卵泡刺激素(FSH),雌二醇,irisin被收集了.进行盆腔多普勒超声检查以评估子宫长度,横向直径,前后直径。根据促性腺激素释放激素(GnRH)刺激试验将女童分为非CPP组和CPP组。
结果:CPP组血清irisin水平明显高于PPP组和正常对照组。血清irisin水平与基础LH水平呈正相关,基础FSH水平,LH峰值水平,LH/FSH峰值比值,子宫体积,骨龄,和骨龄指数。曲线下的面积,截止值,血清irisin的敏感性和特异性分别为0.958,219.255pg/ml,100%和80.6%。通过血清irisin和血清基础LH联合子宫体积对女童CPP的联合诊断有AUC,灵敏度,特异性为0.994,97.6%,100%,优于单一指数。
结论:CPP女孩血清irisin水平显著升高。irisin联合指数可以帮助诊断女孩的CPP。
BACKGROUND: To investigate serum irisin levels in girls at different developmental status and explore the significance of irisin for the diagnosis of central precocious puberty (CPP) in girls.
METHODS: In this cross-sectional study 111 girls were enrolled, including 43 cases of CPP, 44 cases of peripheral precocious puberty (PPP) and 24 cases of girls with normal sexual development as controls. The data on age, weight and height, measured blood levels of luteinizing hormone (LH), follicle stimulating hormone (FSH), estradiol, and irisin were collected. Pelvic Doppler ultrasound was performed to evaluate uterine length, transverse diameter, anteroposterior diameter. The girls were divided into non-CPP group and CPP group according to gonadotropin-releasing hormone (GnRH) stimulation test.
RESULTS: Serum irisin levels were significantly higher in CPP group than in PPP group and normal control group. Serum irisin level was positively correlated with basal LH level, basal FSH level, peak LH level, peak LH /FSH ratio, uterine volume, bone age, and bone age index. The area under the curve, cut-off value, sensitivity and specificity of serum irisin were 0.958, 219.255 pg/ml, 100% and 80.6%. The combined diagnosis of CPP in girls by serum irisin and serum basal LH combined with uterine volume had an AUC, sensitivity, and specificity of 0.994, 97.6%, and 100%, superior to that of the single index.
CONCLUSIONS: Serum irisin level in girls with CPP is significantly increased. An irisin combined index could help the diagnosis of CPP in girls.