Abstract: Objective To explore the expression and significance of serum cortisol, insulin growth factor binding protein-3(IGFBP-3), and 25-hydroxyvitamin D [25-(OH)D] in children with idiopathic short stature(ISS). Methods A total of 86 patients with ISS diagnosed and treated in Longquanyi District Maternal and Child Health Hospital of Chengdu from April 2020 to June 2022 were selected as the study subjects. Meabwhile, 43 children who took physical examination were enrolled into control group. Baseline data, serum cortisol, IGFBP-3, 25-(OH)D levels were compared. Pearson analysis was used to test the associations of cortisol, IGFBP-3, and 25-(OH)D with height, weight and body mass index(BMI). Logistic regression model was used to construct a combination model of cortisol, IGFBP-3 and 25-(OH)D for diagnosing ISS. The AUC value, sensitivity, and specificity of cortisol, IGFBP-3, 25-(OH)D and three combined indicators for diagnozing ISS were analyzed using the ROC curve model. Results Height, weight and BMI of the observation group were significantly lower than those of the control group(t=6.472, 15.193, 5.208, P<0.05). Serum level of cortisol in the observation group was significantly higher than that in the control group, while IGFBP-3 and 25-(OH)D levles were significantly lower than those in the control group(t=4.505, 5.341, 4.857, P<0.05). Pearson correlation analysis showed that serumcortisol level was negatively correlated with height, body weight and BMI(r＝-0.231,-0.716,-0.720, P<0.05), while serum IGFBP-3 and 25-(OH)D levels were positively correlated with height, body weight and BMI(r=0.200, 0.612, 0.636, 0.365, 0.716, 0.715, P<0.05). ROC curve analysis showed that the AUC values of cortisol, IGFBP-3, 25-(OH)D and three combined diagnosis of ISS were 0.750, 0.736, 0.728, 0.941(P<0.05), and the sensitivities were 54.70%, 93.00%, 90.70% and 93.00%, respectively, while the specificity was 88.40%, 53.50%, 51.20% and 79.10%, respectively. Conclusions Serum cortisol, IGFBP-3, 25-(OH) D levels show an abnormal expression trend in children with ISS. Monitoring the changes in their levels is beneficial to provide guidance for the early detection of ISS.

Key words: cortisol, insulin growth factor binding protein-3, 25-hydroxyvitamin D, idiopathic short stature

摘要： 目的 探讨血清皮质醇、胰岛素生长因子结合蛋白-3(IGFBP-3)、25-羟维生素D[25-(OH)D]在特发性矮小症(ISS)患儿中的表达及意义。方法 选取2020年4月—2022年6月于成都市龙泉驿区妇幼保健院诊治的86例ISS患儿作为观察组,同期选取43例健康体检儿童为对照组,对比基线资料、血清皮质醇、IGFBP-3、25-(OH)D水平;采用Pearson法分析皮质醇、IGFBP-3、25-(OH)D与身高、体重、体质量指数(BMI)的相关性;采用Logistic回归模型构建皮质醇、IGFBP-3、25-(OH)D联合诊断ISS模型;采用ROC曲线模型分析皮质醇、IGFBP-3、25-(OH)D及三项联合诊断ISS的AUC值、敏感度、特异度。结果 观察组身高、体重、BMI均低于对照组(t=6.472、15.193、5.208,P＜0.05)。观察组皮质醇水平高于对照组,而IGFBP-3、25-(OH)D水平低于对照组(t=4.505、5.341、4.857,P＜0.05)。Pearson相关性分析显示,血清皮质醇水平与身高、体重、BMI呈负相关(r＝-0.231、-0.716、-0.720,P＜0.05);血清IGFBP-3、25-(OH)D水平分别与身高、体重、BMI呈正相关(r=0.200、0.612、0.636、0.365、0.716、0.715,P＜0.05)。ROC曲线分析显示,皮质醇、IGFBP-3、25-(OH)D及三项联合诊断ISS的AUC值分别为0.750、0.736、0.728、0.941(P＜0.05),敏感度分别为54.70%、93.00%、90.70%、93.00%;特异度分别为88.40%、53.50%、51.20%、79.10%。结论 血清皮质醇、IGFBP-3、25-(OH)D在ISS患儿中呈异常表达,监测其水平变化有利于及早发现ISS提供指导。

关键词: 皮质醇, 胰岛素生长因子结合蛋白-3, 25-羟维生素D, 特发性矮小症