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摘要: 胰岛素样生长因子-1(insulin-like growth factor-1, IGF-1)介导生长激素(growth hormone, GH)在外周靶器官组织的促生长效应, 主要由肝脏合成, 循环中大部分IGF-1与特异的结合蛋白结合, 较GH更为稳定, 故临床测定IGF-1用于生长激素缺乏症、肢端肥大症的诊断及治疗监测等。目前IGF-1的测定方法主要有放射免疫法/免疫放射法、ELISA法、化学发光法、质谱分析法等, 不同方法各有利弊, 需要结合检测目的择优选择。IGF-1正常参考值范围的建立需基于背景人群随机抽样, 德国、意大利等欧洲国家及日本、韩国等亚洲国家已建立基于本国人群的血清IGF-1参考值范围。北京协和医院对北京及贵州地区汉族成人进行血清IGF-1水平测定, 初步建立了基于化学发光法的中国汉族成人血清IGF-1水平参考值范围, 为肢端肥大症、生长激素缺乏症等疾病的诊治奠定了基础。
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关键词:
- 胰岛素样生长因子-1 /
- 放射免疫法 /
- 化学发光法 /
- 参考值
Abstract: Insulin-like growth factor-1(IGF-1) mediates the growth-promoting effect of growth hormone on peripheral tissues, which is mainly synthesized in the liver. In the circulation, most IGF-1 binds to specific binding proteins, which is more stable than growth hormone. Therefore, IGF-1 is commonly used as a diagnostic marker and treatment monitor of growth hormone deficiency and acromegaly. There are many kinds of assays that measure serum IGF-1 concentrations, including radioimmunoassay, ELISA, chemiluminescence, and mass spectrometry. Different methods have their advantages and disadvantages, so it is necessary to select the best method according to the purpose of detection. The normal reference range of IGF-1 should be established based on a random sampling of the background population. Some European and Asian countries such as Germany, Italy, Japan, and South Korea have established reference ranges of serum IGF-1 based on their own population. ZHU Hui-juan et al. from Peking Union Medical College Hospital preliminarily established the reference range of serum IGF-1 of Han Chinese adults, laying a foundation for the diagnosis and treatment of acromegaly, growth hormone deficiency, and other diseases.利益冲突 无 -
表 1 IGF-1各类测定方法比较
方法 原理 优点 缺点 放射免疫法/免疫放射法 抗原抗体反应 试剂成本低，灵敏度高 操作复杂，存在放射性污染，有效期短 ELISA法 抗原抗体反应 试剂成本低，操作简单 灵敏度低，定性或半定量 化学发光法 抗原抗体反应 操作简单，成本低，灵敏度较高，试剂较稳定 工作曲线随时间漂移 质谱分析法 质荷比大小 灵敏度高，样品用量小 设备昂贵，操作复杂 IGF-1：胰岛素样生长因子-1 
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表 2 中国汉族健康成人血清IGF-1参考值范围(ng/ml)[39]
性别 年龄分组(岁) 标准差 百分位数 -2 SD -1 SD 中位数 +1 SD +2 SD P2.5 P97.5 男性 18 233.4 292.4 366.2 458.4 573.4 235.5 568.3 19 176.8 232.6 304.7 397.6 516.8 178.8 511.5 20~24 139.0 189.8 256.5 343.7 456.5 140.8 451.4 25~29 113.8 159.5 219.9 298.7 400.5 115.4 395.9 30~34 97.2 138.4 192.8 263.3 353.4 98.6 349.3 35~39 86.5 124.2 173.5 236.7 316.5 87.9 312.9 40~44 79.9 114.9 160.1 217.6 289.1 81.1 286.0 45~49 75.8 108.6 150.8 203.9 269.5 76.9 266.6 50~54 72.7 103.8 143.6 193.6 255.3 73.8 252.6 55~59 69.3 98.8 136.8 184.7 244.1 70.4 241.4 60~64 64.5 92.2 128.4 174.9 233.4 65.4 230.8 65~69 57.1 82.5 116.6 161.8 220.7 58.0 218.1 ≥70 46.8 68.7 99.5 142.7 202.3 47.6 199.5 女性 18 202.8 286.1 380.8 486.0 601.5 205.9 596.7 19 166.4 238.0 323.9 424.5 540.1 169.0 535.2 20~24 139.0 200.6 277.3 370.6 481.7 141.2 476.9 25~29 117.7 171.4 239.7 324.6 427.9 119.6 423.3 30~34 101.0 148.6 209.8 286.3 380.0 102.7 375.9 35~39 87.8 130.8 186.0 255.0 339.1 89.3 335.4 40~44 77.1 116.7 167.2 229.6 305.0 78.5 301.7 45~49 68.1 105.2 151.9 209.0 276.9 69.4 274.0 50~54 60.2 95.1 138.8 191.5 253.4 61.5 250.8 55~59 52.8 85.6 126.5 175.5 232.7 54.0 230.3 60~64 45.4 75.7 113.6 159.3 212.7 46.5 210.4 65~69 37.7 64.5 98.9 140.9 190.8 38.7 188.6 ≥70 29.6 51.5 80.9 118.2 164.0 30.3 162.0 总体 18 208.1 286.7 374.1 469.7 573.1 211.1 568.8 19 160.8 231.9 314.8 409.5 515.7 163.5 511.3 20~24 130.1 192.1 267.4 356.5 459.6 132.3 455.2 25~29 109.3 163.1 230.2 311.6 408.3 111.2 404.1 30~34 95.1 142.0 201.6 275.1 363.8 96.7 360.0 35~39 85.0 126.7 180.1 246.4 327.0 86.5 323.5 40~44 77.8 115.6 164.0 224.2 297.6 79.1 294.4 45~49 72.1 107.1 151.8 207.2 274.4 73.4 271.5 50~54 67.0 100.0 141.8 193.5 255.8 68.2 253.1 55~59 61.4 92.8 132.5 181.3 239.9 62.5 237.4 60~64 54.3 84.3 122.3 168.8 224.2 55.3 221.8 65~69 45.2 73.5 109.6 153.7 206.0 46.2 203.8 ≥70 34.0 59.6 92.7 133.3 181.5 34.8 179.4 IGF-1：同表 1；SD：标准差
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[1] Rinderknecht E, Humbel RE. The amino acid sequence of human insulin-like growth factor Ⅰ and its structural homology with proinsulin[J]. J Biol Chem, 1978, 253:2769-2776. http://europepmc.org/abstract/MED/632300 [2] Salmon WJ, Daughaday WH. A hormonally controlled serum factor which stimulates sulfate incorporation by cartilage in vitro[J]. J Lab Clin Med, 1957, 49:825-836. https://www.ncbi.nlm.nih.gov/pubmed/2205697 [3] Clemmons DR. Clinical utility of measurements of insulin-like growth factor 1[J]. Nat Clin Pract Endocrinol Metab, 2006, 2:436-446. doi: 10.1038/ncpendmet0244 [4] Clemmons DR. IGF-Ⅰ assays:current assay methodologies and their limitations[J]. Pituitary, 2007, 10:121-128. doi: 10.1007/s11102-007-0032-z [5] Grimberg A, Divall SA, Polychronakos C, et al. Guide-lines for Growth Hormone and Insulin-Like Growth Factor-Ⅰ Treatment in Children and Adolescents:Growth Hormone Deficiency, Idiopathic Short Stature, and Primary Insulin-Like Growth Factor-Ⅰ Deficiency[J]. Horm Res Paediatr, 2016, 86:361-397. doi: 10.1159/000452150 [6] Granada ML. Biochemical following-up of treated acrome-galy. Limitations of the current determinations of IGF-1 and perspective[J]. Minerva Endocrinol, 2019, 44:143-158. [7] Skjaerbaek C, Frystyk J, Orskov H, et al. Differential changes in free and total insulin-like growth factor Ⅰ after major, elective abdominal surgery:the possible role of insulin-like growth factor-binding protein-3 proteolysis[J]. J Clin Endocrinol Meta, 1998, 83:2445-2449. https://www.ncbi.nlm.nih.gov/pubmed/9661626 [8] Lang CH, Fan J, Frost RA, et al. Regulation of the insulin-like growth factor system by insulin in burn patients[J]. J Clin Endocrinol Metab, 1996, 81:2474-2480. http://www.ncbi.nlm.nih.gov/pubmed/8675563 [9] Congote LF. Monitoring insulin-like growth factors in HIV infection and AIDS[J]. Clin Chim Acta, 2005, 361:30-53. doi: 10.1016/j.cccn.2005.05.001 [10] Nimptsch K, Pischon T. Obesity Biomarkers, Metabolism and Risk of Cancer:An Epidemiological Perspective[J]. Recent Results Cancer Res, 2016, 208:199-217. [11] Tas F, Bilgin E, Tastekin D, et al. Serum IGF-1 and IGFBP-3 levels as clinical markers for patients with lung cancer[J]. Biomed Rep, 2016, 4:609-614. doi: 10.3892/br.2016.629 [12] Rainato G, Fabricio AS, Zancan M, et al. Evaluating serum insulin-like growth factor 1 and insulin-like growth factor binding protein 3 as markers in prostate cancer diagnosis[J]. Int J Biol Markers, 2016, 31:e317-e323. doi: 10.5301/jbm.5000200 [13] Liu S, Liu Y, Jiang X. Prognostic significance of serum insulin-like growth factor-1 in patients with hepatocellular carcinoma following transarterial chemoembolization[J]. Exp Ther Med, 2016, 11:607-612. doi: 10.3892/etm.2015.2949 [14] Morgillo F, De Vita F, Antoniol G, et al. Serum insulin-like growth factor 1 correlates with the risk of nodal metastasis in endocrine-positive breast cancer[J]. Curr Oncol, 2013, 20:e283-e288. doi: 10.3747/co.20.1380 [15] 杜伟, 李芸, 毛笑非, 等.胰岛素样生长因子与系统性硬皮病的相关性[J].协和医学杂志, 2012, 3:370-374. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=xhyx201204002 [16] Furlanetto RW, Underwood LE, Van Wyk JJ, et al. Estimation of somatomedin-C levels in normals and patients with pituitary disease by radioimmunoassay[J]. J Clin Invest, 1977, 60:648-657. doi: 10.1172/JCI108816 [17] Frystyk J, Freda P, Clemmons DR. The current status of IGF-Ⅰ assays-a 2009 update[J]. Growth Horm IGF Res, 2010, 20:8-18. doi: 10.1016/j.ghir.2009.09.004 [18] Burns C, Rigsby P, Moore M, et al. The First International Standard For Insulin-like Growth Factor-1(IGF-1) for immunoassay:preparation and calibration in an international collaborative study[J]. Growth Horm IGF Res, 2009, 19:457-462. doi: 10.1016/j.ghir.2009.02.002 [19] Daughaday WH, Kapadia M, Mariz I. Serum somatomedin binding proteins:physiologic significance and interference in radioligand assay[J]. J Lab Clin Med, 1987, 109:355-363. http://www.ncbi.nlm.nih.gov/pubmed/2434590 [20] Nelson RW, Nedelkov D, Tubbs KA, et al. Quantitative mass spectrometric immunoassay of insulin like growth factor 1[J]. J Proteome Res, 2004, 3:851-855. doi: 10.1021/pr0499388 [21] Bystrom C, Sheng S, Zhang K, et al. Clinical utility of insulin-like growth factor 1 and 2; determination by high resolution mass spectrometry[J]. PLoS One, 2012, 7:e43457. doi: 10.1371/journal.pone.0043457 [22] Cox HD, Lopes F, Woldemariam GA, et al. Interlabora-tory agreement of insulin-like growth factor 1 concentrations measured by mass spectrometry[J]. Clin Chem, 2014, 60:541-548. doi: 10.1373/clinchem.2013.208538 [23] Juul A. Serum levels of insulin-like growth factor Ⅰ and its binding proteins in health and disease[J]. Growth Horm IGF Res, 2003, 13:113-170. doi: 10.1016/S1096-6374(03)00038-8 [24] Peters CJ, Dattani MT. How to use insulin-like growth factor 1(IGF1)[J]. Arch Dis Child Educ Pract Ed, 2012, 97:114-118. doi: 10.1136/archdischild-2011-300265 [25] Brabant G, von Zur MA, Wuster C, et al. Serum insulin-like growth factor Ⅰ reference values for an automated chemiluminescence immunoassay system:results from a multi-center study[J]. Horm Res, 2003, 60:53-60. http://onlinelibrary.wiley.com/resolve/reference/XREF?id=10.1159/000071871 [26] Clemmons DR. Consensus statement on the standardization and evaluation of growth hormone and insulin-like growth factor assays[J]. Clin Chem, 2011, 57:555-559. doi: 10.1373/clinchem.2010.150631 [27] Zapf J, Walter H, Froesch ER. Radioimmunological determination of insulinlike growth factors Ⅰ and Ⅱ in normal subjects and in patients with growth disorders and extrapancrea-tic tumor hypoglycemia[J]. J Clin Invest, 1981, 68:1321-1330. doi: 10.1172/JCI110379 [28] Inoue T, Watanabe N. Studies on plasma insulin-like growth factor (IGF)-Ⅰ levels in normal subjects and in patients with various endocrine and metabolic diseases using radioimmunoassay for synthetic IGF-Ⅰ (26-46)[J]. Nihon Naibunpi Gakkai Zasshi, 1986, 62:45-59. http://www.onacademic.com/detail/journal_1000039709857910_827f.html [29] 刘蓉, 史轶繁, 邓洁英, 等.中国正常儿童和青少年血清生长介素水平[J].中华儿科杂志, 1989, 27:330-334. http://www.wanfangdata.com.cn/details/detail.do?_type=perio&id=zhek19890605092 [30] Juul A, Bang P, Hertel NT, et al. Serum insulin-like growth factor-Ⅰ in 1030 healthy children, adolescents, and adults:relation to age, sex, stage of puberty, testicular size, and body mass index[J]. J Clin Endocrinol Metab, 1994, 78:744-752. [31] Juul A, Dalgaard P, Blum WF, et al. Serum levels of insulin-like growth factor (IGF)-binding protein-3(IGFBP-3) in healthy infants, children, and adolescents:the relation to IGF-Ⅰ, IGF-Ⅱ, IGFBP-1, IGFBP-2, age, sex, body mass index, and pubertal maturation[J]. J Clin Endocrinol Metab, 1995, 80:2534-2542. http://www.ncbi.nlm.nih.gov/pubmed/7543116 [32] 徐源.中国正常成人血清IGF-1的参考范围及其影响因素研究[D].北京: 中国医学科学院北京协和医学院, 2016. [33] Isojima T, Shimatsu A, Yokoya S, et al. Standardized centile curves and reference intervals of serum insulin-like growth factor-I (IGF-I) levels in a normal Japanese population using the LMS method[J]. Endocr J, 2012, 59:771-780. doi: 10.1507/endocrj.EJ12-0110 [34] Hyun SE, Lee BC, Suh BK, et al. Reference values for serum levels of insulin-like growth factor-Ⅰ and insulin-like growth factor binding protein-3 in Korean children and adolescents[J]. Clin Biochem, 2012, 45:16-21. doi: 10.1016/j.clinbiochem.2011.10.003 [35] Plengpanich W, Mangkala J, Buranasukajorn P, et al. Normal reference range of serum insulin-like growth factor (IGF)-Ⅰ in healthy Thai adults[J]. J Med Assoc Thai, 2008, 91:1681-1684. http://www.ncbi.nlm.nih.gov/pubmed/19127789 [36] Kong AP, Wong GW, Choi KC, et al. Reference values for serum levels of insulin-like growth factor (IGF-1) and IGF-binding protein 3(IGFBP-3) and their ratio in Chinese adolescents[J]. Clin Biochem, 2007, 40:1093-1099. doi: 10.1016/j.clinbiochem.2007.06.004 [37] Xu S, Gu X, Pan H, et al. Reference ranges for serum IGF-1 and IGFBP-3 levels in Chinese children during childhood and adolescence[J]. Endocr J, 2010, 57:221-228. doi: 10.1507/endocrj.K09E-200 [38] 崔立全.乌鲁木齐市汉族健康成人IGF-1的血清浓度测定[D].乌鲁木齐: 新疆医科大学, 2011. [39] Zhu H, Xu Y, Gong F, et al. Reference ranges for serum insulin-like growth factor Ⅰ (IGF-Ⅰ) in healthy Chinese adults[J]. PLoS One, 2017, 12:e185561. [40] Leung KC, Johannsson G, Leong GM, et al. Estrogen regulation of growth hormone action[J]. Endocr Rev, 2004, 25:693-721. doi: 10.1210/er.2003-0035 [41] Elkazaz AY, Salama K. The effect of oral contraceptive different patterns of use on circulating IGF-1 and bone mineral density in healthy premenopausal women[J]. Endocrine, 2015, 48:272-278. doi: 10.1007/s12020-014-0290-2 [42] Wang C. Trends in contraceptive use and determinants of choice in China:1980-2010[J]. Contraception, 2012, 85:570-579. doi: 10.1016/j.contraception.2011.10.014 [43] Friedrich N, Alte D, Volzke H, et al. Reference ranges of serum IGF-1 and IGFBP-3 levels in a general adult population:results of the Study of Health in Pomerania (SHIP)[J]. Growth Horm IGF Res, 2008, 18:228-237. doi: 10.1016/j.ghir.2007.09.005 [44] Rosario PW. Normal values of serum IGF-1 in adults:results from a Brazilian population[J]. Arq Bras Endocrinol Metabol, 2010, 54:477-481. doi: 10.1590/S0004-27302010000500008 [45] Scacchi M, Pincelli AI, Cavagnini F. Growth hormone in obesity[J]. Int J Obes Relat Metab Disord, 1999, 23:260-271. doi: 10.1038/sj.ijo.0800807 [46] Bayram F, Gedik VT, Demir O, et al. Epidemiologic survey:reference ranges of serum insulin-like growth factor 1 levels in Caucasian adult population with immunoradiometric assay[J]. Endocrine, 2011, 40:304-309. doi: 10.1007/s12020-011-9476-z [47] Hong Y, Brismar K, Hall K, et al. Associations between insulin-like growth factor-I (IGF-I), IGF-binding protein-1, insulin and other metabolic measures after controlling for genetic influences:results from middle-aged and elderly monozygotic twins[J]. J Endocrinol, 1997, 153:251-257. doi: 10.1677/joe.0.1530251 [48] Chen J, Zheng H, Bei JX, et al. Genetic structure of the Han Chinese population revealed by genome-wide SNP variation[J]. Am J Hum Genet, 2009, 85:775-785. doi: 10.1016/j.ajhg.2009.10.016 -
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