目的 探讨胰岛素抵抗与特发性中枢性性早熟（idiopathic central precocious puberty, ICPP）女童的关系及其在早期诊断中的价值。 方法 回顾性分析2022年1月—2025年3月在河南省妇幼保健院儿童内分泌科就诊的245例4~7.5岁低黄体生成素（luteinizing hormone, LH）水平（0.2~0.83 IU/L）、体重正常（体重指数标准差积分在-2 SD~+2 SD之间）、乳房发育早期女童的临床资料，依据《中枢性性早熟诊断与治疗专家共识（2022）》的诊断标准，分为ICPP组（123例）和对照组（122例）。分析稳态模型评估-胰岛素抵抗指数（homeostasis model assessment of insulin resistance, HOMA-IR）与部分指标的相关性，应用多因素logistic回归分析HOMA-IR与ICPP的关联性，并评价不同指标对ICPP的诊断效能。 结果 ICPP组的HOMA-IR高于对照组（P<0.001），且HOMA-IR与LH峰值（r_s =0.467，P<0.05）及LH峰值/FSH峰值（r_s =0.444，P<0.05）呈正相关。多因素logistic回归模型分析同时纳入年龄、体重指数、LH基础值后，HOMA-IR与ICPP发生密切相关（OR=2.756，95%CI：1.940~3.913）。受试者操作特征曲线分析显示，LH基础值、HOMA-IR及两者联合诊断ICPP的曲线下面积分别为0.735、0.735、0.805（P<0.05），两者联合诊断的曲线下面积均高于LH基础值和HOMA-IR（P<0.05）。 结论 HOMA-IR与低LH且体重正常女童发生ICPP密切相关，将HOMA-IR与LH基础值联合检测，可提高该类ICPP女童的早期识别与诊断效能。

Objective To explore the relationship between insulin resistance and idiopathic central precocious puberty (ICPP) in girls and the diagnostic value of insulin resistance. Methods Clinical data of 245 girls aged 4 to 7.5 years with low luteinizing hormone (LH) levels (0.2-0.83 IU/L), normal body weight (body mass index standard deviation score between -2 and +2), and early breast development who visited the Department of Pediatric Endocrinology, Henan Provincial Maternal and Child Health Hospital from January 2022 to March 2025 were retrospectively analyzed. According to the Expert Consensus on the Diagnosis and Treatment of Central Precocious Puberty (2022), patients were assigned to an ICPP group (n=123) or a control group (n=122). Correlations between the homeostasis model assessment of insulin resistance (HOMA-IR) and selected indices were assessed. Multivariable logistic regression was used to evaluate the association between HOMA-IR and ICPP, and the diagnostic performance of various indices for ICPP was evaluated. Results HOMA-IR was higher in the ICPP group than in the control group (P<0.001) and was positively correlated with LH peak (r_s=0.467, P<0.05) and the LH peak/FSH peak ratio (r_s=0.444, P<0.05). The multivariable logistic regression model including age, BMI, and basal LH showed that HOMA-IR was closely associated with ICPP (OR=2.756, 95%CI: 1.940-3.913). Receiver operating characteristic curve analysis showed that the areas under the curve for basal LH, HOMA-IR, and their combination in diagnosing ICPP were 0.735, 0.735, and 0.805, respectively (P<0.05), and the combined model had a greater area under the curve than either basal LH or HOMA-IR alone (both P<0.05). Conclusions HOMA-IR is closely associated with ICPP in girls with low LH and normal body weight, and combining HOMA-IR with basal LH improves early identification and diagnostic efficiency in this population.