目的 研究特发中枢性性早熟(ICPP)女童血清神经激肽B(NKB)、神经肽吻素(kisspeptin)水平变化及其与骨龄指数(BAI)的相关性,以期寻找评估此类儿童发育情况及治疗效果的标志物。方法 选择2017年6月-2019年5月在洛阳市妇幼保健院治疗的ICPP女童89例,另选取同期健康体检女童90例作为对照组,检测血清NKB、Kisspeptin、激素水平及骨龄、骨龄指数(BAI)等,比较治疗前、治疗后患者各指标变化,采用Pearson分析ICPP女童治疗前血清NKB、Kisspeptin水平与BAI相关性,Logistic回归分析影响骨龄指数(骨发育)的因素。结果 与对照组比较,ICPP组女童骨龄、BAI、子宫体积、血清雌激素、黄体生成素、卵泡刺激素、催乳素及NKB、Kisspeptin水平均显著升高,差异均有统计学意义(t=14.245、22.089、8.321、18.619、27.727、14.241、28.152,17.655,9.668,P<0.05);相关性分析显示,治疗前ICPP女童血清NKB、Kisspeptin水平与BAI呈正相关(r=0.591、0.634,P<0.05);Logistic回归分析显示NKB(OR=2.009,95%CI:1.105~3.654,P=0.038)、Kisspeptin(OR=1.859,95%CI:1.341~2.578,P=0.017)是骨龄指数(骨发育)的影响因素;治疗后ICPP女童血清雌激素、黄体生成素、卵泡刺激素、催乳素、NKB、Kisspeptin水平及BAI均显著降低,与治疗前比较差异均有统计学意义(t=14.367、22.482、9.465、23.807、13.664、8.642、7.100,P<0.05)。结论 ICPP女童血清NKB、Kisspeptin水平升高,与患者骨龄指数有关,可作为评估ICPP女童性发育情况及治疗效果的标志物。
Abstract
Objective To study the changes in serum levels of neurokinin B (NKB) and neuropeptide (Kisspeptin) in girls with idiopathic central precocious puberty (ICPP), and to analyze the correlation with the bone age index, so as to provide reference for assessing the development of these children and the efficacy of treatment. Methods A total of 89 cases of ICPP girls treated in Luoyang Maternal and Child Health Hospital from June 2017 to May 2019 were enrolled in this study, and meanwhile 90 healthy girls were selected as the control group.The levels of serum NKB, Kisspeptin, hormone, bone age and bone age index (BAI) of the participants were detected.The changes of the indicators were compared before and after treatment.Pearson analysis was used to analyze the correlation among serum NKB, Kisspeptin levels and BAI in girls with ICPP before treatment.Logistic regression analysis was used to analyze the influencing factors of bone age index (bone development). Results Compared with those in the control group, the bone age, BAI, uterine volume, serum estrogen, luteinizing hormone, follicle stimulating hormone, prolactin, NKB and Kisspeptin levels were significantly increased in ICPP group (t=14.245, 22.089, 8.321, 18.619, 27.727, 14.241, 28.152,17.655,9.668, P<0.05).Pearson correlation analysis showed that serum NKB and Kisspeptin levels were positively correlated with BAI (r=0.591, 0.634, P<0.05).Logistic regression analysis showed that NKB(OR=2.009, 95%CI:1.105 - 3.654, P=0.038) and Kisspeptin(OR=1.859, 95%CI:1.341 - 2.578, P=0.017) are factors that affect bone age index (bone development).Compared with those before treatment, the levels of serum estrogen, luteinizing hormone, follicle stimulating hormone, prolactin, NKB, Kisspeptin and BAI in ICPP girls were significantly decreased after treatment (t=14.367, 22.482, 9.465, 23.807, 13.664, 8.642, 7.100, P<0.05). Conclusions The serum levels of NKB and Kisspeptin in ICPP girls are increasing, which is related to the patient's bone age index and can be used as markers to assess the sexual development of ICPP girls and the effect of treatment.
关键词
神经激肽B /
神经肽吻素 /
特发中枢性性早熟 /
骨龄指数 /
女童 /
相关性 /
血清
Key words
neurokinin B /
kisspeptin /
idiopathic central precocious puberty /
bone age index /
girls /
correlation /
serum
{{custom_sec.title}}
{{custom_sec.title}}
{{custom_sec.content}}
参考文献
[1] Latronico AC, Brito VN, Carel JC.Causes, diagnosis, and treatment of central precocious puberty[J].Lancet Diabetes Endocrinol, 2016,4(3):265-274.
[2] 白敏, 韩宜姚, 李珍, 等.醋酸曲普瑞林治疗特发性中枢性性早熟女童疗效及对下丘脑-垂体-性腺轴激素水平的影响[J].重庆医学, 2020,49(7):1128-1131.
[3] Harter CJL, Kavanagh GS, Smith JT.The role of kisspeptin neurons in reproduction and metabolism[J].J Endocrinol, 2018,238(3):R173-R183.
[4] 杨玉, 张仁龙, 熊翔宇, 等.Kisspeptin水平与婴幼儿女童乳房早发育的相关性研究[J].国际内分泌代谢杂志, 2018,38(5):302-304,308.
[5] Fergani C, Leon S, Padilla SL, et al.NKB signaling in the posterodorsal medial amygdala stimulates gonadotropin release in a kisspeptin-independent manner in female mice[J].Elife, 2018,7:e40476.
[6] Abacı A,Çatlı G, Anık A, et al.Significance of serum neurokinin B and kisspeptin levels in the differential diagnosis of premature thelarche and idiopathic central precocious puberty[J].Peptides, 2015,64(1):29-33.
[7] 中华医学会儿科学分会内分泌遗传代谢学组,《中华儿科杂志》编辑委员会.中枢性性早熟诊断与治疗共识(2015)[J].中华儿科杂志, 2015,53(6):412-418.
[8] 张建, 周红娟,高锦萍, 等.中枢性性早熟女童体重指数与性激素及瘦素、脂联素水平的相关性研究[J].中国儿童保健杂志, 2020,28(2):187-190.
[9] 唐家彦, 黄娟, 黄连红,等.中枢性性早熟女童血清miR-125b与维生素D联合检测的临床意义研究[J].中国全科医学, 2019,22(9):1047-1051.
[10] Beltramo M, Dardente H, Cayla X, et al.Cellular mechanisms and integrative timing of neuroendocrine control of GnRH secretion by kisspeptin[J].Mol Cell Endocrinol, 2014,382(1):387-399.
[11] Terasawa E, Garcia JP, Seminara SB, et al.Role of Kisspeptin and Neurokinin B in Puberty in Female Non-Human Primates[J].Front Endocrinol (Lausanne), 2018,9(1):148.
[12] 葛伟, 王海莲, 邵鸿家, 等.特发性中枢性性早熟女童血浆kisspeptin、神经激肽B及强啡肽浓度的变化研究[J].中国儿童保健杂志, 2019,27(3):258-261.
[13] 郭威, 姚桂东, 辛志敏.Kisspeptin对多囊卵巢综合征来源颗粒细胞雌孕激素分泌调节的研究[J].现代妇产科进展, 2019,28(3):190-193.
[14] Lippincott MF, León S, Chan YM, et al.Hypothalamic reproductive endocrine pulse generator activity independent of Neurokinin B and dynorphin signaling[J].J Clin Endocrinol Metab, 2019,104(10):4304-4318.
[15] 司文宇, 宋爽, 康铁柱, 等.外源性神经激肽B对大鼠初情期的影响[J].西北农林科技大学学报(自然科学版), 2020, 48(4):10-17,26.
[16] Parlak M, Türkkahraman D, Ellidaĝ HY, et al.Basal serum neurokinin B levels in differentiating idiopathic central precocious puberty from premature thelarche[J].J Clin Res Pediatr Endocrinol, 2017,9(2):101-105.
[17] 陈晓康, 陈泽坤, 郑伟坤, 等.三维超声VOCAL技术及骨龄指数对诊断男童性早熟的价值[J].中国超声医学杂志, 2020,36(6):551-553.
[18] 张莹,王龙胜.中枢性性早熟女童腺垂体前叶高度与体内性激素水平的相关性研究[J].安徽医学, 2020,41(4):417-420.
基金
河南省医学科技攻关计划联合共建项目(LHGJ20191376)
PDF(509 KB)
