Clinical Significance Of Serum IGF-1 And IGFBP-3 Levels In The Diagnosis Of Precocious Puberty Girls

Objective:To explore the changes in serum levels of insulin-like growth factor-1(IGF-1)and insulin-like growth factor binding protein(IGFBP-3)in girls with precocious puberty,and to study the clinical application value of IGF-1 and IGFBP-3 in girls with precocious puberty to guide clinical diagnosis and treatment.Methods:A total of 239 girls aged 5～8 who attended the endocrinology clinic of our hospital from January 2022～January 2023 were selected as the experimental group,and gonadotropin-releasing hormone(Gn RH)stimulation experiments were performed.According to the consensus on the diagnosis and treatment of central precocious puberty(CPP)released by domestic scholars in 2015,the experimental subjects were divided into idiopathic central precocious puberty(ICPP)group and simple breast development(SPT)group.Among them,there were 113 cases in the ICPP group and 126 cases in the SPT group.A total of 71 healthy prepubertal girls collected by the outpatient clinic of Jiangxi Provincial Children’s Hospital during the same period were selected as the control group.All subjects undergo laboratory tests to measure serum IGF-1 and IGFBP-3.Graphpad Prism statistical software was used for data processing and analysis,and P<0.05 was statistically significant.Results:1.Comparison of IGF-1 and IGFBP-3 levels in the three groupsIGF-1: IGF-1 levels were compared between the three groups,and differences between groups were found(P<0.05).Pairwise comparisons: IGF-1 levels in the ICPP group were higher than those in the SPT group and the control group(both P <0.05),and IGF-1 levels in the SPT group were higher than those in the control group(P<0.05).IGFBP-3: IGFBP-3 levels were compared between the three groups,and differences between groups were found(P<0.05).The level of IGFBP-3 in the ICPP group was significantly higher than that in the SPT group and the control group(both P < 0.05),and the level of IGFBP-3 in the SPT group was significantly higher than that in the normal control group(P<0.05).2.Correlation between serum IGF-1 and IGFBP-3 levels and LH peak in ICPP groupIGF-1 was moderately positively correlated with LH peak(r=0.522,P<0.001).IGFBP-3 was weakly correlated with LH peak(r=0.023,P<0.001).3.ICPP influencing factors multivariate logistic regression analysisIGF-1 and basal LH are independent risk factors for ICPP,and IGFBP-3 is not an independent risk factor for ICPP.4.ROC curve analysis to evaluate diagnostic value4.1 Analysis of IGF-1 and IGFBP-3 ROC curves: the area under the ROC curve of serum IGF-1 was 0.871,the optimal cut-off value(cut-off value)was 186.80ng/mL,the sensitivity was 79%,the specificity was 85%,and the Yoden index was 0.64.IGFBP-3 had an area under the ROC curve of 0.740,a cut-off value of 3.90 ug/mL,a sensitivity of only 66%,a specificity of 73%,and a Jordon index of only 0.39.4.2 Combined ROC curve analysis of multiple indicators: When IGF-1 and basic LH are combined,the area under the ROC curve and the Jordon index reach the maximum values,which are 0.907 and 0.68,respectively.Conclusion:1.Serum IGF-1 and IGFBP-3 have important clinical significance for the diagnosis of ICPP.2.IGF-1 is closely linked to the activation of the gonadal axis in children.3.The combined IGF-1 and basic LH detection indexes greatly improve the diagnostic efficiency of ICPP compared with the single detection index.