Levels of IGF-1 and IGFBP-3 in Childhood Obesity and Their Diagnostic Value
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摘要:
目的 探讨IGF-1和IGFBP-3在儿童肥胖症中的表达变化及诊断价值。 方法 血液样本和对应的临床信息来源于2023年12月至2024年3月期间就诊于昆明市儿童医院的人群，设置对照组（健康儿童；n = 115）和研究组（肥胖症儿童；n = 86）。采用ELISA法检测两组血清中IGF-1和IGFBP-3的水平。收集两组的临床资料，分析IGF-1和IGFBP-3与临床资料的相关性及在儿童肥胖症中的诊断价值。 结果 相较于对照组，研究组中体重和BMI显著增加（P < 0.001），IGF-1和IGFBP-3显著降低（P < 0.05）。IGF-1水平与总胆固醇、甘油三酯、载脂蛋白B和胰岛素抵抗指数呈现显著的负相关（P < 0.05），与载脂蛋白A和空腹胰岛素呈现显著的正相关（P < 0.05）；IGFBP-3表现出相反的模式（P < 0.05）。ROC诊断曲线显示，IGF-1和IGFBP-3的曲线下面积为0.598和0.665。 结论 IGF-1和IGFBP-3在儿童肥胖症中低表达，并且与肥胖指标相关，具有较弱的诊断价值。 Abstract:Objective To explore the expression changes of IGF-1 and IGFBP-3 in childhood obesity and their diagnostic value. Methods Blood samples and corresponding clinical information were collected from patients attending Kunming Children's Hospital from December 2023 and March 2024, and were divided into a control group （healthy children; n = 115） and a study group （obese children; n = 86）. Serum levels of IGF-1 and IGFBP-3 in both groups were measured by using ELISA. Clinical data from both groups were analyzed to assess the correlation between IGF-1 and IGFBP-3 and clinical information, as well as their diagnostic value in childhood obesity. Results Compared to the control group, the study group exhibited a significant increase in weight and BMI（P < 0.001） while IGF-1 and IGFBP-3 levels were significantly lower （P < 0.05） . IGF-1 levels exhibited a significant negative correlation with total cholesterol, triglycerides, apolipoprotein B, and insulin resistance index （P < 0.05）, and a significant positive correlation with apolipoprotein A and fasting insulin （P < 0.05）; IGFBP-3 displayed the opposite pattern （P < 0.05）. ROC diagnostic curves indicated that the area under the curve for IGF-1 and IGFBP-3 was 0.598 and 0.665, respectively. Conclusion IGF-1 and IGFBP-3 are expressed at low levels in childhood obesity and are associated with obesity indicators, demonstrating weak diagnostic value. -
Key words:
- Childhood obesity /
- Diagnosis /
- IGF-1 /
- IGFBP-3
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图 1 肥胖儿童的IGF-1和IGFBP-3水平与肥胖指标的相关性
Figure 1. Correlation of IGF-1 and IGFBP-3 levels with obesity indicators in obese children
图 2 IGF-1和IGFBP-3在儿童肥胖症中的诊断价值
Figure 2. Diagnostic value of IGF-1 and IGFBP-3 in childhood obesity
表 1 正常及肥胖儿童的一般临床资料和肥胖指标的比较[IQR/n （%）]
Table 1. Comparison of general clinical data and obesity indicators in normal and obese children [IQR/n （%）]
项目 对照组（n = 86） 研究组（n = 115） Z/U P 性别 男 43（50） 73（63） 1.914 0.056 女 43（50） 42（37） 年龄（岁） 9.8（7.8～11.9） 10.3（8.6～11.6） 4770 0.670 发育情况 未发育 51（59） 66（57） 0.272 0.786 发育 35（41） 49（43） 体重（kg） 30.4（24.9～42.2） 55.0（43.0～64.5） 1103 < 0.001*** BMI（kg/m2） 16.1（15.1～17.7） 24.5（22.6～28.4） 31 < 0.001*** ***P < 0.001。 
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表 2 正常及肥胖儿童的生化指标的比较[IQR]
Table 2. Comparison of biochemical indicators in normal and obese children [IQR]
指标 对照组（n = 86） 研究组（n = 115） U P 丙氨酸氨基转氨酶（U/L） 11.0（8.0～13.25） 18.0（13.75～28.0） 1849 < 0.001*** 天门冬氨酸氨基转氨酶（U/L） 26.5（23.8～30.0） 27.5（23.0～32.0） 4426 0.240 肌酐（µmol/L） 44.5（37.0～50.0） 42.0（38.0～48.0） 4599 0.397 尿酸（µmol/L） 314.0（273.8～359.3） 392.0（329.0～456.0） 2232 < 0.001*** 尿素（mmol/L） 5.0（4.4～6.1） 4.7（4.1～5.5） 4042 0.027* *P < 0.05；***P < 0.001。
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表 3 正常及肥胖儿童的IGF-1和IGFBP-3水平的比较 [IQR/（$ \bar x\pm s $）]
Table 3. Comparison of IGF-1 and IGFBP-3 levels in normal and obese children [IQR/（$ \bar{x}\pm s $）]
指标 对照组（n = 86） 研究组（n = 115） U/t P IGF-1（ng/mL） 48.5（24.84～92.3） 39.2（20.4～58.9） 3973 0.017* IGFBP-3（ng/mL） 46.42 ± 14.43 37.65 ± 17.23 3.820 < 0.001*** *P < 0.05；***P < 0.001。
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表 4 IGF-1和IGFBP-3相关ROC曲线的信息表
Table 4. The ROC curve information table for IGF-1 and IGFBP-3
项目 IGF-1 IGFBP-3 截断值 63.4 46.505 灵敏度 0.8087 0.73913 特异度 0.43023 0.59302 准确率 0.64677 0.67662 真阳个数 93 85 真阴个数 37 51 假阳个数 49 35 假阴个数 22 30 阳性预测值 0.65493 0.70833
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