Hertel N T, Stoltenberg M, Juul A, Main K M, Müller J, Nielsen C T, Lorenzen I, Skakkebaek N E
Department of Growth and Reproduction, Rigshospitalet, University of Copenhagen, Denmark.
J Clin Endocrinol Metab. 1993 Apr;76(4):924-7. doi: 10.1210/jcem.76.4.8473407.
Serum levels of type I and III procollagen propeptides (s-PICP and s-PIIINP) were measured in 466 healthy school children and in 23 girls with central precocious puberty (CPP) during GnRH analog and cyproterone acetate therapy, using two commercially available RIAs. In normal children, s-PICP and s-PIIINP changed significantly with age and pubertal development stages. For s-PIIINP, a peak was seen at 12 yr for girls and 13 yr for boys; no peak could be discerned for s-PICP. The prepubertal (Tanner stage 1) s-PICP value (mean +/- SD) for girls was 374 +/- 132 micrograms/L, the midpubertal value (stage 3) was 442 +/- 135 micrograms/L, and the postpubertal value (stage 5) was 203 +/- 103 micrograms/L. The mean s-PIIINP levels for girls were 9.1 +/- 2.4, 15.0 +/- 4.3, and 6.8 +/- 3.1 micrograms/L, respectively. For boys, levels were 362 +/- 119, 544 +/- 138, and 359 +/- 256 micrograms/L for s-PICP and 8.5 +/- 2.2, 14.5 +/- 5.0, and 8.6 +/- 3.8 micrograms/L for s-PIIINP (P < 0.001 for both propeptides in both boys and girls). There was, however, a large variation in normal values for both propeptides within the age groups and pubertal stages. There was a significant correlation of s-PICP and s-PIIINP levels to height velocity in girls (r = 0.35; P < 0.001 and r = 0.33; P < 0.001, respectively), while in boys, only s-PIIINP showed significant correlation to height velocity (r = 0.40; P < 0.001). In untreated girls with CPP, serum levels of s-PIIINP were elevated [PIIINP SD score (SDS), 2.13]. Levels of s-PICP were normal (PICP SDS, 0.39). Levels of both propeptides decreased within 2 months after initiation of therapy and remained below initial values (P < 0.01). The decrease in s-PIIINP after 2 months of therapy showed a significant correlation with the fall in height velocity SDS for chronological age after 6 months of therapy (r = 0.64; P < 0.01). We conclude that s-PIIINP and, to a lesser degree, s-PICP reflect growth in normal children, but due to the large variation, both propeptides seem unsuitable as markers for screening of growth disorders in children.
采用两种市售放射免疫分析法（RIA），对466名健康学童以及23名接受促性腺激素释放激素（GnRH）类似物和醋酸环丙孕酮治疗的中枢性性早熟（CPP）女孩的血清I型和III型前胶原肽（s-PICP和s-PIIINP）水平进行了测定。在正常儿童中，s-PICP和s-PIIINP随年龄和青春期发育阶段有显著变化。对于s-PIIINP，女孩在12岁、男孩在13岁时出现峰值；s-PICP未观察到峰值。女孩青春期前（坦纳1期）s-PICP值（均值±标准差）为374±132μg/L，青春期中期（3期）值为442±135μg/L，青春期后期（5期）值为203±103μg/L。女孩的平均s-PIIINP水平分别为9.1±2.4、15.0±4.3和6.8±3.1μg/L。对于男孩，s-PICP水平分别为362±119、544±138和359±256μg/L，s-PIIINP水平分别为8.5±2.2、14.5±5.0和8.6±3.8μg/L（男孩和女孩的两种前胶原肽P均<0.001）。然而，在各年龄组和青春期阶段，两种前胶原肽的正常值存在很大差异。女孩中s-PICP和s-PIIINP水平与身高增长速度显著相关（r分别为0.35；P<0.001和r为0.33；P<0.001），而在男孩中，只有s-PIIINP与身高增长速度显著相关（r=0.40；P<0.001）。在未经治疗的CPP女孩中，s-PIIINP血清水平升高[PIIINP标准差评分（SDS），2.13]。s-PICP水平正常（PICP SDS，0.39）。治疗开始后2个月内，两种前胶原肽水平均下降，并维持在初始值以下（P<0.01）。治疗2个月后s-PIIINP的下降与治疗6个月后按实际年龄计算的身高增长速度SDS的下降显著相关（r=0.64；P<0.01）。我们得出结论，s-PIIINP以及在较小程度上s-PICP反映正常儿童的生长情况，但由于差异较大，两种前胶原肽似乎都不适合作为筛查儿童生长障碍的标志物。
