Department of Clinical Laboratory, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China.
Department of Endocrinology, The Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center For Child Health, Hangzhou, China.
J Clin Lab Anal. 2022 Feb;36(2):e24184. doi: 10.1002/jcla.24184. Epub 2021 Dec 24.
The present study aimed to assess the diagnostic significance of serum bone metabolic parameters in children with growing pains (GPs).
All patients diagnosed with GP and healthy controls matched with age and gender were recruited at the outpatient clinic of Children's Hospital at Zhejiang University School of Medicine from August 2016 to August 2021. In all subjects, serum levels of calcium (Ca), phosphorus (P), procollagen type-I N-terminal (PINP), parathormone (PTH), 25-hydroxyvitamin D (25-(OH)D), osteocalcin (OC), N-terminal cross-linked telopeptides of type-I collagen (CTX), and tartrate-resistant acid phosphatase type 5b (TRACP5b) were investigated. The univariate analysis, multivariate logistic regression analysis, and receiver operating characteristic (ROC) curve were used to identify the bone metabolic parameters factors for diagnosing GP.
We enrolled 386 children with GP and 399 healthy controls in present study. The mean age of GP group was 5.319 years, and, primarily, the subjects were preschool-age children. The gender ratio (male-to-female) was 1.27 in GP group. After adjusting for age and gender, we identified that the serum levels of Ca (p < 0.001, OR: 25.039), P (p = 0.018, OR: 2.681), PINP (p < 0.001, OR: 1.002), and PTH (p = 0.036, OR: 0.988) were independent diagnostic factors associated with GP. Area under curve (AUC) of the ROC curves was in the order: PINP (0.612) > Ca (0.599) > P (0.583) > PTH (0.541). A combination of independent diagnostic factors and multivariable logistic regression analysis provided a refined logistic regression model to improve the diagnostic potential, of which the AUC had reached 0.655.
Serum levels of Ca, P, PINP, and PTH could be independent diagnostic factors associated with GP. The logistic model was significantly superior to bone metabolic parameters for diagnosing GP.
本研究旨在评估血清骨代谢参数在儿童生长痛（GP）中的诊断意义。
本研究于 2016 年 8 月至 2021 年 8 月在浙江大学医学院附属儿童医院的门诊招募了所有被诊断为 GP 的患者和年龄与性别相匹配的健康对照组。所有受试者均检测血清钙（Ca）、磷（P）、I 型前胶原氨基端肽（PINP）、甲状旁腺素（PTH）、25-羟维生素 D（25-(OH)D）、骨钙素（OC）、I 型胶原 N 端交联肽（CTX）和抗酒石酸酸性磷酸酶 5b（TRACP5b）水平。采用单因素分析、多因素逻辑回归分析和受试者工作特征（ROC）曲线来识别用于诊断 GP 的骨代谢参数因素。
本研究共纳入 386 例 GP 患儿和 399 例健康对照组。GP 组的平均年龄为 5.319 岁，主要为学龄前儿童。GP 组的性别比（男/女）为 1.27。在校正年龄和性别后，我们发现血清 Ca（p<0.001，OR：25.039）、P（p=0.018，OR：2.681）、PINP（p<0.001，OR：1.002）和 PTH（p=0.036，OR：0.988）水平是与 GP 相关的独立诊断因素。ROC 曲线下面积（AUC）的顺序为：PINP（0.612）>Ca（0.599）>P（0.583）>PTH（0.541）。独立诊断因素和多变量逻辑回归分析的组合提供了一个改进的逻辑回归模型，以提高诊断潜能，其 AUC 已达到 0.655。
血清 Ca、P、PINP 和 PTH 水平可能是与 GP 相关的独立诊断因素。该逻辑模型在诊断 GP 方面明显优于骨代谢参数。
