目的 比较单纯性乳房早发育（isolated premature thelarche, IPT）女童与中枢性性早熟（central precocious puberty, CPP）女童的血清胰岛素样生长因子1（insulin-like growth factor-1, IGF-1）、生长激素（growth hormone, GH）峰值水平差异，构建IPT进展为CPP的预测模型，并分析模型诊断价值。 方法 回顾性选择2022年1月—2023年8月于中日友好医院及新疆生产建设兵团医院诊断为IPT的111例女童为研究对象。根据随访结果将其分为CPP组（35例）和IPT组（36例）。多因素logistic回归分析构建进展为CPP的临床预测模型，并验证IGF-1、GH峰值对模型的贡献。采用限制性立方样条分析IGF-1、GH峰值与CPP的剂量-反应关系。决策曲线分析评估预测模型的临床价值。 结果 CPP组IGF-1、GH峰值高于IPT组（P<0.05）。与模型1（未加入IGF-1、GH峰值）相比，模型2（加入IGF-1、GH峰值）的曲线下面积（area under the curve, AUC）、通过综合判别改善指数和重分类改善指标均显著提高（P<0.05）。且模型2（{\chi }^{\mathrm{2}}=6.054，P=0.889）较模型1（{\chi }^{\mathrm{2}}=7.717，P=0.634）拟合优度更理想。GH峰值、IGF-1与CPP存在非线性剂量-反应关系（P_总趋势<0.05，P_{非线性检验}<0.05）。决策曲线分析显示，IGF-1、GH峰值联合预测对CPP的总体净收益高于单独预测的净收益。 结论 GH峰值、IGF-1与IPT女童进展为CPP密切相关。基于GH峰值与IGF-1构建的临床预测模型能提高对IPT女童进展为CPP的预测价值，并获得较高净收益。

Objective To compare serum insulin-like growth factor 1 (IGF-1) and peak growth hormone (GH) levels between girls with isolated premature thelarche (IPT) and central precocious puberty (CPP), to construct a prediction model for progression from IPT to CPP, and to assess its diagnostic value. Methods Girls diagnosed with IPT (n=111) between January 2022 and August 2023 at the China-Japan Friendship Hospital and the Xinjiang Production and Construction Corps Hospital were retrospectively included. According to follow-up outcomes, participants were categorized into a CPP group (35 cases) and an IPT group (36 cases). A clinical prediction model for progression to CPP was constructed by multivariable logistic regression, and the contributions of IGF-1 and peak GH were evaluated. Restricted cubic spline analysis was used to assess the dose-response relationships of IGF-1 and peak GH with CPP. Decision curve analysis was applied to evaluate clinical utility. Results IGF-1 and peak GH were higher in the CPP group than in the IPT group (P<0.05). Compared with model 1 (without IGF-1 and peak GH), model 2 (with IGF-1 and peak GH) showed significantly higher area under the curve, integrated discrimination improvement, and net reclassification improvement (all P<0.05). Model 2 ({\chi }^{\mathrm{2}}=6.054, P=0.889) also demonstrated better goodness-of-fit than model 1 ({\chi }^{\mathrm{2}}=7.717, P=0.634). Nonlinear dose-response relationships were observed for peak GH and IGF-1 with CPP (P for overall trend <0.05; P for nonlinearity <0.05). Decision curve analysis indicated that combined prediction using IGF-1 and peak GH provided greater net benefit than either biomarker alone. Conclusions Peak GH and IGF-1 are closely associated with progression from IPT to CPP in girls. A clinical prediction model incorporating peak GH and IGF-1 can improve prediction of progression to CPP and yield higher net benefit.