关键词: 成纤维生长因子受体2, 瘦素, 胰岛素样生长因子1, 胰岛素样生长因子结合蛋白-3, 特发性矮小症, 生长激素缺乏症

Abstract:

Objective To investigate the correlations between serum fibroblast growth factor receptor 2（FGFR2），leptin，insulin-like growth factor-1（IGF-1） and insulin-like growth factor binding protein-3（IGFBP-3） in children with short stature. Methods A total of 130 children with short stature（short stature group） and 60 healthy children（healthy control group） were enrolled from Tangshan Maternal and Child Health Hospital from July 2022 to July 2024. The short stature group was further classified into growth hormone deficiency（GHD） group（56 cases） and idiopathic short stature（ISS） group（74 cases） based on the peak value of growth hormone（GH）. The clinical data were collected，and serum levels of FGFR2，leptin，IGF-1 and IGFBP-3 were determined. Multivariate Logistic regression analysis was used to evaluate the influencing factors of short stature onset. Pearson correlation analysis was used to assess the correlations between serum FGFR2，leptin and IGF-1，IGFBP-3. Receiver operating characteristic（ROC） curve was used to evaluate the diagnostic efficacy of FGFR2 and leptin for short stature onset. Interaction coefficient analysis was used to assess the interaction between serum FGFR2 and leptin on the onset of short stature. Results The height of GHD group and ISS group was lower than that of healthy control group（P<0.05），and the proportions of daily sleep deprivation and the frequency of weekly physical exercise among the 3 groups were statistically significant（P<0.05）. The serum levels of FGFR2，leptin，IGF-1 and IGFBP-3 in GHD group and ISS group were lower than those in healthy control group（P<0.05）. Serum FGFR2，leptin，IGF-1 and IGFBP-3 in short stature children were positively correlated（P<0.05）. After adjusting for confounding factors（daily sleep deprivation，the frequency of weekly physical exercise），the decrease in serum FGFR2，leptin，IGF-1 and IGFBP-3 levels was a risk factor for the onset of short stature（P<0.05）. The areas under curves（AUC） of FGFR2，leptin，IGF-1 and IGFBP-3 for diagnosing GHD were 0.739，0.729 and 0.856，respectively，and those for diagnosing ISS were 0.763，0.743 and 0.863，respectively. The interaction coefficient analysis showed that the low levels of serum FGFR2 and leptin were in a secondary multiplicative model and had a positive interaction in the occurrence of GHD and ISS（P<0.05）. Conclusions Decreased levels of FGFR2 and leptin are related to the occurrence of short stature. They have a positive interaction in the occurrence of GHD and ISS，and are positively correlated with the levels of IGF-1 and IGFBP-3 in children. Serum FGFR2 and leptin may be one of the indicators for screening and diagnosing short stature.

Key words: Fibroblast growth factor receptor 2, Leptin, Insulin-like growth factor 1, Insulin-like growth factor binding protein-3, Idiopathic short stature, Growth hormone deficiency