La correlación entre el ratio vitamina D/insulina y la pubertad precoz central en niñas y su potencial para el cribado

IF 2.1 4区 医学 Q2 PEDIATRICS
Jun Sun, Ya Xiao, Shu-Qin Jiang, Hong-Ru Zhang, Jin-Bo Li, Wen-Hui Shi, Wei Wang
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Abstract

Introduction

There are still no effective biomarkers for the diagnosis of central precocious puberty (CPP), and single metabolic indicators (such as vitamin D or insulin) are susceptible to interference from metabolic interactions. We conducted a study to assess the correlation between the vitamin D/insulin ratio (VDIR) and CPP and the screening potential of the VDIR.

Methods

Case-control study in a sample of 170 girls aged 6 to 10 years, including 85 girls with CPP and 85 girls with normal growth and development. We collected data on growth and developmental indicators and laboratory test results for both groups. The association between the VDIR and CPP/gonadal development was assessed by means of multivariate logistic and linear regression analyses. The diagnostic value of VDIR was evaluated by means of receiver operating characteristic (ROC) curve analysis.

Results

The VDIR in the CPP group was lower than in the control group (3.45 vs 6.18). The area under the ROC curve (AUC) of the VDIR for diagnosis of CPP was 0.731, with a sensitivity of 70.59% and a specificity of 67.06%, higher compared to vitamin D alone (AUC = 0.682) or insulin alone (AUC = 0.690). The multivariate logistic/linear regression analysis revealed that for every 1-unit increase in VDIR, there was a 0.814-fold decrease in the risk of CPP and a 233.54 mm3 decrease in uterine volume.

Conclusion

By integrating the metabolic interactions between vitamin D and insulin, VDIR shows promising value in assessing the risk of CPP. As a potential biomarker, it may offer dual clinical value by enabling early screening of high-risk individuals prior to the definitive diagnosis, as well as providing guidance for personalized interventions.

Abstract Image

维生素D/胰岛素比与女孩核心青春期早期的相关性及其筛查潜力
目前仍没有诊断中枢性性早熟(CPP)的有效生物标志物,单一代谢指标(如维生素D或胰岛素)容易受到代谢相互作用的干扰。我们进行了一项研究,以评估维生素D/胰岛素比率(VDIR)和CPP之间的相关性以及VDIR的筛选潜力。方法对170例6 ~ 10岁女童进行病例对照研究,其中85例为CPP女童,85例为正常生长发育女童。我们收集了两组的生长发育指标和实验室测试结果。通过多元逻辑分析和线性回归分析评估VDIR与CPP/性腺发育之间的关系。通过受试者工作特征(ROC)曲线分析评价VDIR的诊断价值。结果CPP组VDIR低于对照组(3.45 vs 6.18)。VDIR诊断CPP的ROC曲线下面积(AUC)为0.731,敏感性为70.59%,特异性为67.06%,高于单独使用维生素D (AUC = 0.682)或单独使用胰岛素(AUC = 0.690)。多因素logistic/线性回归分析显示,VDIR每增加1个单位,发生CPP的风险降低0.814倍,子宫体积减少233.54 mm3。结论VDIR通过整合维生素D和胰岛素之间的代谢相互作用,在评估CPP风险方面具有重要价值。作为一种潜在的生物标志物,它可以提供双重临床价值,既可以在明确诊断之前对高危个体进行早期筛查,也可以为个性化干预提供指导。
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来源期刊
Anales de pediatria
Anales de pediatria 医学-小儿科
CiteScore
2.10
自引率
4.80%
发文量
155
审稿时长
44 days
期刊介绍: La Asociación Española de Pediatría tiene como uno de sus objetivos principales la difusión de información científica rigurosa y actualizada sobre las distintas áreas de la pediatría. Anales de Pediatría es el Órgano de Expresión Científica de la Asociación y constituye el vehículo a través del cual se comunican los asociados. Publica trabajos originales sobre investigación clínica en pediatría procedentes de España y países latinoamericanos, así como artículos de revisión elaborados por los mejores profesionales de cada especialidad, las comunicaciones del congreso anual y los libros de actas de la Asociación, y guías de actuación elaboradas por las diferentes Sociedades/Secciones Especializadas integradas en la Asociación Española de Pediatría.
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