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抑制素 B 或抗苗勒管激素与女孩性早熟有关吗?系统评价和荟萃分析的结果。

Dose inhibin B or anti-Müllerian hormone relate to precocious puberty in girls? result of a systematic review and meta-analysis.

机构信息

Beijing Research Institute of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China.

Department of Acupuncture, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China.

出版信息

J Ovarian Res. 2023 Nov 23;16(1):227. doi: 10.1186/s13048-023-01302-2.

Abstract

BACKGROUNDS

Existing studies have investigated the relationship between the levels of serum inhibin B (INHB), anti-müllerian hormone (AMH) and precocious puberty in girls, but the results are inconsistent.

OBJECTIVE

The aim of this meta-analysis was to assess whether the INHB and AMH levels changed in girls with precocious puberty relative to healthy controls.

METHODS

PubMed, Embase, Cochrane Library and Web of Science were searched through June 2022. We included observational clinical studies reporting the serum levels INHB and AMH in girls with precocious puberty. Conference articles and observational study abstracts were included if they contained enough information regarding study design and outcome data. Case series and reports were excluded. An overall standard mean difference (SMD) between precocious puberty and healthy controls was estimated using a DerSimonian-Laird random-effects model.

RESULTS

A total of 11 studies featuring 552 girls with precocious puberty and 405 healthy girls were selected for analysis. The meta-analysis showed that the INHB level of precocious puberty [including central precocious puberty (CPP) and premature the larche (PT)] were significantly increased. While there was no significant association between precocious puberty [including CPP, PT, premature pubarche (PP) and premature adrenarche (PA)] and the level of serum AMH.

CONCLUSION

Scientific evidence suggested that the INHB level, but not the AMH level, altered in girls with precocious puberty compared with healthy controls. Through our results we think that INHB level might be a marker for the auxiliary diagnosis of precocious puberty (especially CPP and PT). Therefore, it is important to evaluate and thoroughly investigate the clinical indicators (e.g., INHB) in order to ensure early diagnosis and medical intervention, and the risk of physical, psychological and social disorders in immature girls with precocious puberty is minimized.

摘要

背景

已有研究探讨了血清抑制素 B(INHB)、抗苗勒管激素(AMH)水平与女童性早熟的关系,但结果不一致。

目的

本荟萃分析旨在评估性早熟女童与健康对照者相比,INHB 和 AMH 水平是否发生变化。

方法

检索 2022 年 6 月前的 PubMed、Embase、Cochrane 图书馆和 Web of Science 数据库。纳入 INHB 和 AMH 血清水平在性早熟女童中报道的观察性临床研究。若研究设计和结局数据足够,也纳入会议文章和观察性研究摘要。排除病例系列和报告。采用 DerSimonian-Laird 随机效应模型,估计性早熟与健康对照组间 INHB 和 AMH 总体标准化均数差(SMD)。

结果

共纳入 11 项研究,共 552 例性早熟女童和 405 例健康女童纳入分析。荟萃分析显示,性早熟女童 INHB 水平[包括中枢性性早熟(CPP)和特发性性早熟(PT)]显著升高,而性早熟女童[包括 CPP、PT、特发性阴毛早现(PP)和特发性肾上腺皮质功能早现(PA)]与血清 AMH 水平无显著相关性。

结论

有证据表明,与健康对照组相比,性早熟女童的 INHB 水平而非 AMH 水平发生改变。根据我们的结果,我们认为 INHB 水平可能是性早熟(尤其是 CPP 和 PT)辅助诊断的标志物。因此,评估和充分研究临床指标(如 INHB)以确保早期诊断和医疗干预非常重要,最大限度地降低性早熟女童不成熟时出现身体、心理和社会障碍的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6054/10668349/7ff3ff4bd218/13048_2023_1302_Fig1_HTML.jpg

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