胰岛素抵抗与子宫体积在特发性中枢性性早熟女童中的关联研究

doi:10.7499/j.issn.1008-8830.2411003

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摘要目的探究特发性中枢性性早熟（idiopathic central precocious puberty, ICPP）女童胰岛素抵抗程度与子宫体积之间的关联。方法回顾性选取2022年1月—2024年9月于郑州大学第三附属医院儿科生长发育门诊就诊并诊断为ICPP的61例女童作为ICPP组，以及61例正常生长发育的女童作为对照组。比较两组稳态模型胰岛素抵抗指数（homeostasis model assessment of insulin resistance, HOMA-IR）、子宫体积以及其他指标的差异，并分析胰岛素抵抗与女童子宫体积之间的关系。结果 ICPP组子宫体积、HOMA-IR大于对照组（P<0.05）。相关性分析表明，ICPP组HOMA-IR水平与子宫体积呈正相关（r_s=0.643，P<0.001）。多元线性回归分析结果显示，随着HOMA-IR升高，女童子宫体积呈上升趋势（P<0.05）。结论 ICPP女童的胰岛素抵抗与子宫体积之间存在关联，且随着HOMA-IR升高，女童子宫体积随之增大。

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	张红如
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	孙俊
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	李锦波
	杨莹
	王伟

关键词 ：特发性中枢性性早熟, 胰岛素抵抗, 子宫体积, 下丘脑-垂体-性腺轴, 儿童

Abstract：Objective To investigate the association between insulin resistance and uterine volume in girls with idiopathic central precocious puberty (ICPP). Methods A retrospective study was conducted involving 61 girls diagnosed with ICPP who visited the pediatric growth and development clinic of the Third Affiliated Hospital of Zhengzhou University between January 2022 and September 2024, designated as the ICPP group, and 61 normally developing girls as the control group. The differences in insulin resistance index (homeostasis model assessment of insulin resistance, HOMA-IR), uterine volume, and other indicators between the two groups were compared, and the relationship between insulin resistance and uterine volume in these girls was analyzed. Results The uterine volume and HOMA-IR level in the ICPP group were significantly higher than those in the control group (P<0.05). Correlation analysis revealed that there was a positive correlation between HOMA-IR level and uterine volume in the ICPP group (r_s=0.643, P<0.001). Multiple linear regression analysis indicated that as HOMA-IR increased,uterine volume in the girls tended to increase (P<0.05). Conclusions There is an association between insulin resistance and uterine volume in girls with ICPP, and as HOMA-IR increases, uterine volume in the girls also increases.

Key words： Idiopathic central precocious puberty Insulin resistance Uterine volume Hypothalamic-pituitary- gonadal axis Child

收稿日期: 2024-11-01

通讯作者: 王伟，女，主任医师，教授。Email：weiwang169@126.com。 E-mail: weiwang169@126.com

作者简介: 张红如，女，硕士研究生；

引用本文:

张红如,肖雅,姜书琴等. 胰岛素抵抗与子宫体积在特发性中枢性性早熟女童中的关联研究[J]. 中国当代儿科杂志, 2025, 27(4): 404-409.

ZHANG Hong-Ru,XIAO Ya,JIANG Shu-Qin et al. Association between insulin resistance and uterine volume in girls with idiopathic central precocious puberty[J]. CJCP, 2025, 27(4): 404-409.

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	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专家共识（2022）[J]. 中华儿科杂志, 2023, 61(1): 16-22. PMID: 36594116. DOI: 10.3760/cma.j.cn112140-20220802-00693.
	Ge W, Wang HL, Shao HJ, et al. Evaluation of serum makorin ring finger protein 3 (MKRN3) levels in girls with idiopathic central precocious puberty and premature thelarche[J]. Physiol Res, 2020, 69(1): 127-133. PMID: 31852205. PMCID: PMC8565951. DOI: 10.33549/physiolres.934222.
	3 张晓洁, 杨培蓉, 黄晓东. 特发性中枢性性早熟病因的研究进展[J]. 国际内分泌代谢杂志, 2010, 30(6): 418-420. DOI: 10.3760/cma.j.issn.1673-4157.2010.06.018.
	Shi Y, Ma Z, Yang X, et al. Gonadotropin-releasing hormone analogue and recombinant human growth hormone treatment for idiopathic central precocious puberty in girls[J]. Front Endocrinol (Lausanne), 2022, 13: 1085385. PMID: 36589818. PMCID: PMC9794601. DOI: 10.3389/fendo.2022.1085385.
	5 马沉沉. 超声及性激素检查对诊断女童性早熟的价值评估[D]. 天津: 天津医科大学, 2018.
	6 董关萍, 梁黎, 王秀敏, 等. 中枢性性早熟女童血清性激素结合蛋白水平的变化[J]. 实用儿科临床杂志, 2011, 26(8): 577-578. DOI: 10.3969/j.issn.1003-515X.2011.08.009.
	Griffin IJ, Cole TJ, Duncan KA, et al. Pelvic ultrasound findings in different forms of sexual precocity[J]. Acta Paediatr, 1995, 84(5): 544-549. PMID: 7633151. DOI: 10.1111/j.1651-2227.1995.tb13691.x.
	Salardi S, Orsini LF, Cacciari E, et al. Pelvic ultrasonography in premenarcheal girls: relation to puberty and sex hormone concentrations[J]. Arch Dis Child, 1985, 60(2): 120-125. PMID: 3883910. PMCID: PMC1777113. DOI: 10.1136/adc.60.2.120.
	Bloch CA, Clemons P, Sperling MA. Puberty decreases insulin sensitivity[J]. J Pediatr, 1987, 110(3): 481-487. PMID: 2950219. DOI: 10.1016/s0022-3476(87)80522-x.
	Caprio S, Plewe G, Diamond MP, et al. Increased insulin secretion in puberty: a compensatory response to reductions in insulin sensitivity[J]. J Pediatr, 1989, 114(6): 963-967. PMID: 2524556. DOI: 10.1016/s0022-3476(89)80438-x.
	Moran A, Jacobs DR, Steinberger J, et al. Insulin resistance during puberty: results from clamp studies in 357 children[J]. Diabetes, 1999, 48(10): 2039-2044. PMID: 10512371. DOI: 10.2337/diabetes.48.10.2039.
	Moran A, Jacobs DR, Steinberger J, et al. Association between the insulin resistance of puberty and the insulin-like growth factor-I/growth hormone axis[J]. J Clin Endocrinol Metab, 2002, 87(10): 4817-4820. PMID: 12364479. DOI: 10.1210/jc.2002-020517.
	13 余月, 刘德云, 杨琍琦, 等. 特发性中枢性性早熟女童糖脂代谢指标、维生素D和性激素水平分析[J]. 实用医学杂志, 2020, 36(22): 3079-3083. DOI: 10.3969/j.issn.1006-5725.2020.22.010.
	Spicer LJ, Chamberlain CS, Maciel SM. Influence of gonadotropins on insulin- and insulin-like growth factor-I (IGF-I)-induced steroid production by bovine granulosa cells[J]. Domest Anim Endocrinol, 2002, 22(4): 237-254. PMID: 12044613. DOI: 10.1016/s0739-7240(02)00125-x.
	15 沈旭君, 田成功. 多囊卵巢综合征胰岛素抵抗的发生机制[J]. 中华内分泌代谢杂志, 2006, 22(2): 191-193. DOI: 10.3760/j.issn:1000-6699.2006.02.034.
	Yong Z, Mimi C, Yingjie L, et al. Mangiferin ameliorates polycystic ovary syndrome in rats by modulating insulin resistance, gut microbiota, and ovarian cell apoptosis[J]. Front Pharmacol, 2024, 15: 1457467. PMID: 39376609. PMCID: PMC11456450. DOI: 10.3389/fphar.2024.1457467.
	Dubey P, Reddy S, Sharma K, et al. Polycystic ovary syndrome, insulin resistance, and cardiovascular disease[J]. Curr Cardiol Rep, 2024, 26(6): 483-495. PMID: 38568339. DOI: 10.1007/s11886-024-02050-5.
	Correa-Burrows P, Matamoros M, de Toro V, et al. A single-point insulin sensitivity estimator (SPISE) of 5.4 is a good predictor of both metabolic syndrome and insulin resistance in adolescents with obesity[J]. Front Endocrinol (Lausanne), 2023, 14: 1078949. PMID: 36843603. PMCID: PMC9945119. DOI: 10.3389/fendo.2023.1078949.
	Tanner JM. Normal growth and techniques of growth assessment[J]. Clin Endocrinol Metab, 1986, 15(3): 411-451. PMID: 3533329. DOI: 10.1016/s0300-595x(86)80005-6.
	Nicholas JL, Douglas KE, Waters W, et al. US evaluation of bone age in rural ecuadorian children: association with anthropometry and nutrition[J]. Radiology, 2020, 296(1): 161-169. PMID: 32343211. DOI: 10.1148/radiol.2020190606.
	李辉, 季成叶, 宗心南, 等. 中国0~18岁儿童、青少年体块指数的生长曲线[J]. 中华儿科杂志, 2009, 47(7): 493-498. PMID: 19951508. DOI: 10.3760/cma.j.issn.0578-1310.2009.07.004.
	Nguyen NN, Huynh LBP, Do MD, et al. Diagnostic accuracy of female pelvic ultrasonography in differentiating precocious puberty from premature thelarche: a systematic review and meta-analysis[J]. Front Endocrinol (Lausanne), 2021, 12: 735875. PMID: 34539579. PMCID: PMC8442957. DOI: 10.3389/fendo.2021.735875.
	23 戴月娥. 双酚A引起胰岛素抵抗的机制[J]. 国际儿科学杂志, 2013, 40(2): 122-125. DOI: 10.3760/cma.j.issn.1673-4408.2013.02.005.
	Shi L, Jiang Z, Zhang L. Childhood obesity and central precocious puberty[J]. Front Endocrinol (Lausanne), 2022, 13: 1056871. PMID: 36465655. PMCID: PMC9716129. DOI: 10.3389/fendo.2022.1056871.
	Hur JH, Park S, Jung MK, et al. Insulin resistance and bone age advancement in girls with central precocious puberty[J]. Ann Pediatr Endocrinol Metab, 2017, 22(3): 176-182. PMID: 29025204. PMCID: PMC5642083. DOI: 10.6065/apem.2017.22.3.176.
	Brüning JC, Gautam D, Burks DJ, et al. Role of brain insulin receptor in control of body weight and reproduction[J]. Science, 2000, 289(5487): 2122-2125. PMID: 11000114. DOI: 10.1126/science.289.5487.2122.
	Burcelin R, Thorens B, Glauser M, et al. Gonadotropin-releasing hormone secretion from hypothalamic neurons: stimulation by insulin and potentiation by leptin[J]. Endocrinology, 2003, 144(10): 4484-4491. PMID: 12960084. DOI: 10.1210/en.2003-0457.
	Pralong FP. Insulin and NPY pathways and the control of GnRH function and puberty onset[J]. Mol Cell Endocrinol, 2010, 324(1-2): 82-86. PMID: 20138117. DOI: 10.1016/j.mce.2010.01.037.
	Amiel SA, Sherwin RS, Simonson DC, et al. Impaired insulin action in puberty. A contributing factor to poor glycemic control in adolescents with diabetes[J]. N Engl J Med, 1986, 315(4): 215-219. PMID: 3523245. DOI: 10.1056/NEJM198607243150402.
	Teixeira PDS, Tavares MR, Jose D. Temporal characterization of the insulin resistance during puberty in mice[J]. Endocr Regul, 2021, 55(1): 1-4. PMID: 33600667. DOI: 10.2478/enr-2021-0001.
	Giudice LC. Insulin-like growth factors and ovarian follicular development[J]. Endocr Rev, 1992, 13(4): 641-669. PMID: 1281087. DOI: 10.1210/edrv-13-4-641.
	32 单伟伟, 陈晓军, 顾超. 子宫内膜癌与胰岛素抵抗关系的研究进展[J]. 中华妇产科杂志, 2011, 46(2): 144-146. DOI: 10.3760/cma.j.issn.0529-567x.2011.02.016.
	33 高无怨, 王丽华. 胰岛素样生长因子家族在子宫内膜癌中的作用[J]. 国际肿瘤学杂志, 2017, 44(10): 794-797. DOI: 10.3760/cma.j.issn.1673-422X.2017.10.018.
	34 张丽娜, 闫华, 关宏, 等. IGF-2、IGF-1R、IGF-2R在子宫内膜腺癌的表达及临床意义[J]. 中国妇幼保健, 2010, 25(29): 4284-4287.