中枢性性早熟女童血清Kisspeptin、LH的水平及意义

doi:10.11958/20250395

摘要/Abstract

摘要：

目的探讨血清神经肽吻素（Kisspeptin）、促黄体生成素（LH）在中枢性性早熟（CPP）女童血清中的表达及意义。方法纳入98例CPP女童并作为研究组，另将同期纳入的91例健康女童设为对照组。无干预状态下对CPP女童随访6个月，依据随访期间发育情况分为快进展型CPP（RP-CPP）组（n=46）和慢进展型CPP（SP-CPP）组（n=52）。采用酶联免疫吸附试验（ELISA）检测血清Kisspeptin水平，化学发光法检测血清LH和卵泡刺激素（FSH）水平。分析血清Kisspeptin和LH基础值（B-LH）与生长发育和影像学指标的相关性；受试者工作特征（ROC）曲线分析血清Kisspeptin、LH预测RP-CPP的价值。结果与对照组比较，研究组体质量指数（BMI）、血清Kisspeptin、B-LH和FSH基础值（B-FSH）水平均明显较高（P<0.05）。与SP-CPP组比较，RP-CPP组BMI、骨龄指数（BAI）、血清Kisspepti和B-LH水平较高，卵巢容积较大（P<0.05）。相关性分析显示，CPP女童血清Kisspeptin水平与BMI、BAI、卵巢和子宫容积呈正相关（P<0.05），血清B-LH水平与CPP女童卵巢和子宫容积呈正相关（P<0.05）。ROC曲线显示，血清Kisspeptin联合B-LH预测RP-CPP的敏感度和特异度分别为95.65%和82.69%。结论 CPP女童血清Kisspeptin和B-LH水平较高，且二者联合对RP-CPP具有较高的预测价值，可为临床诊断和治疗提供一定参考。

关键词: 青春期，早熟, 亲吻素, 促黄体激素, 性腺, 卵巢

Abstract:

Objective To explore the expression significance of serum Kisspeptin and luteinizing hormone (LH) in girls with central precocious puberty (CPP). Methods A total of 98 CPP girls were included as the study group, and 91 healthy girls during the same period were used as the control group. Under the condition of no intervention, CPP girls were followed up for 6 months and assigned into the fast progressive CPP (RP-CPP) group (n=46) and the slowly progressive CPP (SP-CPP) group (n=52) based on their developmental status during the follow-up period. ELISA was applied to detect serum Kisspeptin level. Chemiluminescence method was applied to detect serum LH and follicle stimulating hormone (FSH) levels. The correlation of serum Kisspeptin, LH baseline (B-LH) and growth development and imaging indicators was analyzed. Receiver operating characteristic curve (ROC) was applied to analyze the value of serum Kisspeptin and LH in predicting RP-CPP. Results Compared with the control group, body mass index (BMI), serum levels of Kisspeptin, B-LH, and FSH baseline (B-FSH) were significantly higher in the study group (P<0.05). Compared with the SP-CPP group, BMI, bone age index (BAI), serum Kisspepti and B-LH levels were higher in the RP-CPP group, and ovarian volume was larger (P<0.05). Correlation analysis showed that serum Kisspeptin level was positively correlated with BMI, BAI, ovarian and uterine volume of CPP girls (P<0.05), and serum B-LH level was positively correlated with ovarian and uterine volume of CPP girls (r=0.218, 0.381, 0.300, P<0.05). ROC curve showed that the sensitivity and specificity of Kisspeptin combined with B-LH in predicting RP-CPP were 95.65% and 82.69%, respectively. Conclusion Serum Kisspeptin and B-LH levels are higher in CPP girls, and the combined of the two has a high predictive value for RP-CPP, which can provide a certain reference for clinical diagnosis and treatment.

Key words: puberty, precocious, Kisspeptins, luteinizing hormone, gonads, ovary

中图分类号:

R725.8

图/表 6

参考文献 22

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组别		n	年龄/岁		BMI/（kg/m²）
对照组		91	7（6，8）		15.49±2.49
研究组		98	7（6，8）		18.23±2.54
Z或t			0.095		7.481^＊＊
组别	Kisspeptin/（μg/L）			B-LH/（IU/L）		B-FSH/（IU/L）
对照组	1.25±0.31			0.17±0.05		1.76±0.49
研究组	1.86±0.46			0.56±0.15		3.94±1.20
Z或t	10.610^＊＊			23.610^＊＊		16.120^＊＊

组别		n	年龄/岁		BMI/（kg/m²）
对照组		91	7（6，8）		15.49±2.49
研究组		98	7（6，8）		18.23±2.54
Z或t			0.095		7.481^＊＊
组别	Kisspeptin/（μg/L）			B-LH/（IU/L）		B-FSH/（IU/L）
对照组	1.25±0.31			0.17±0.05		1.76±0.49
研究组	1.86±0.46			0.56±0.15		3.94±1.20
Z或t	10.610^＊＊			23.610^＊＊		16.120^＊＊

组别	n	年龄/ 岁	BMI/ （kg/m²）	BAI	卵巢容积/ mL	子宫容积/ mL
SP-CPP组	52	7（6，8）	17.78±1.51	1.15±0.06	2.41±0.48	2.28±0.46
RP-CPP组	46	7（6，8）	18.46±1.56	1.19±0.07	2.66±0.61	2.45±0.52
Z或t		0.083	2.191^＊	3.046^＊	2.267^＊	1.717

组别	n	年龄/ 岁	BMI/ （kg/m²）	BAI	卵巢容积/ mL	子宫容积/ mL
SP-CPP组	52	7（6，8）	17.78±1.51	1.15±0.06	2.41±0.48	2.28±0.46
RP-CPP组	46	7（6，8）	18.46±1.56	1.19±0.07	2.66±0.61	2.45±0.52
Z或t		0.083	2.191^＊	3.046^＊	2.267^＊	1.717

组别		n	Kisspeptin/（μg/L）		B-LH/（IU/L）		P-LH/（IU/L）
SP-CPP组		52	1.40±0.36		0.43±0.12		15.67±4.55
RP-CPP组		46	2.39±0.58		0.71±0.18		17.53±4.96
t			10.280^＊＊		9.154^＊＊		1.936
组别	B-FSH/（IU/L）			P-FSH/（IU/L）		P-LH/P-FSH
SP-CPP组	3.74±1.13			14.85±3.32		1.04±0.31
RP-CPP组	4.17±1.28			15.92±4.81		1.16±0.35
t	1.766			1.294		1.800