1.Resveratrol promotes mitophagy via the MALAT1/miR-143-3p/RRM2 axis and suppresses cancer progression in hepatocellular carcinoma.
Chun-Yan FENG ; Cheng-Song CAI ; Xiao-Qian SHI ; Zhi-Juan ZHANG ; Dan SU ; Yun-Qing QIU
Journal of Integrative Medicine 2025;23(1):79-92
OBJECTIVE:
Resveratrol (Res) is a promising anticancer drug against hepatocellular carcinoma (HCC), but whether its anti-HCC effects implicate mitophagy remains unclear. Therefore, we aimed to explore the specific role of Res in mitophagy and the related mechanisms during the treatment of HCC.
METHODS:
HepG2 cells and tumor-grafted nude mice were used to investigate the effects of low-, middle- and high-dose of Res on HCC progression and mitophagy in vitro and in vivo, respectively. A series of approaches including cell counting kit-8, flow cytometry, wound healing and transwell assays were used to evaluate tumor cell functions. Transmission electron microscopy, immunofluorescence and Western blotting were used to assess mitophagy. Mitochondrial oxygen consumption rate, reactive oxygen species and membrane potential were used to reflect mitochondrial function. After disrupting the expression of metastasis-associated lung adenocarcinoma transcript 1 (MALAT1), miR-143-3p, and ribonucleoside reductase M2 (RRM2), the effects of the MALAT1/miR-143-3p/RRM2 axis on cell function and mitophagy under Res treatment were explored in vitro. Additionally, dual-luciferase reporter and chromatin immunoprecipitation were used to confirm interactions between target genes.
RESULTS:
Res significantly inhibited the proliferation and promoted apoptosis of HCC cells in vitro, while significantly suppressing tumor growth in a dose-dependent manner and inducing mitophagy and mitochondrial dysfunction in vivo. Interestingly, MALAT1 was highly expressed in HCC cells and its knockdown upregulated miR-143-3p expression in HCC cells, which subsequently inhibited RRM2 expression. Furthermore, in nude mice grafted with HCC tumors and treated with Res, the expression of MALAT1, miR-143-3p and RRM2 were altered significantly. In vitro data further supported the targeted binding relationships between MALAT1 and miR-143-3p and between miR-143-3p and RRM2. Therefore, a series of cell-based experiments were carried out to study the mechanism of the MALAT1/miR-143-3p/RRM2 axis involved in mitophagy and HCC; these experiments revealed that MALAT1 knockdown, miR-143-3p mimic and RRM silencing potentiated the antitumor effects of Res and its activation of mitophagy.
CONCLUSION
Res facilitated mitophagy in HCC and exerted anti-cancer effects by targeting the MALAT1/miR-143-3p/RRM2 axis. Please cite this article as: Feng CY, Cai CS, Shi XQ, Zhang ZJ, Su D, Qiu YQ. Resveratrol promotes mitophagy via the MALAT1/miR-143-3p/RRM2 axis and suppresses cancer progression in hepatocellular carcinoma. J Integr Med. 2025; 23(1): 79-91.
Humans
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MicroRNAs/genetics*
;
Liver Neoplasms/metabolism*
;
Carcinoma, Hepatocellular/metabolism*
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Mitophagy/drug effects*
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Resveratrol/pharmacology*
;
Animals
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Mice, Nude
;
RNA, Long Noncoding/genetics*
;
Hep G2 Cells
;
Mice
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Disease Progression
;
Mice, Inbred BALB C
2.Interferon-λ1 improves glucocorticoid resistance caused by respiratory syncytial virus by regulating the p38 mitogen-activated protein kinase signaling pathway.
Li PENG ; Yao LIU ; Fang-Cai LI ; Xiao-Fang DING ; Xiao-Juan LIN ; Tu-Hong YANG ; Li-Li ZHONG
Chinese Journal of Contemporary Pediatrics 2025;27(8):1011-1016
OBJECTIVES:
To investigate the effect of interferon-λ1 (IFN-λ1) on glucocorticoid (GC) resistance in human bronchial epithelial cells (HBECs) stimulated by respiratory syncytial virus (RSV).
METHODS:
HBECs were divided into five groups: control, dexamethasone, IFN-λ1, RSV, and RSV+IFN-λ1. CCK-8 assay was used to measure the effect of different concentrations of IFN-λ1 on the viability of HBECs, and the sensitivity of HBECs to dexamethasone was measured in each group. Quantitative real-time PCR was used to measure the mRNA expression levels of p38 mitogen-activated protein kinase (p38 MAPK), glucocorticoid receptor (GR), and MAPK phosphatase-1 (MKP-1). Western blot was used to measure the protein expression level of GR in cell nucleus and cytoplasm, and the nuclear/cytoplasmic ratio of GR was calculated.
RESULTS:
At 24 and 72 hours, the proliferation activity of HBECs increased with the increase in IFN-λ1 concentration in a dose- and time-dependent manner (P˂0.05). Compared with the RSV group, the RSV+IFN-λ1 group had significant reductions in the half-maximal inhibitory concentration of dexamethasone and the mRNA expression level of p38 MAPK (P<0.05), as well as significant increases in the mRNA expression levels of GR and MKP-1, the level of GR in cell nucleus and cytoplasm, and the nuclear/cytoplasmic GR ratio (P<0.05).
CONCLUSIONS
IFN-λ1 can inhibit the p38 MAPK pathway by upregulating MKP-1, promote the nuclear translocation of GR, and thus ameliorate GC resistance in HBECs.
Humans
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p38 Mitogen-Activated Protein Kinases/genetics*
;
Glucocorticoids/pharmacology*
;
Receptors, Glucocorticoid/analysis*
;
Dual Specificity Phosphatase 1/physiology*
;
Dexamethasone/pharmacology*
;
Drug Resistance/drug effects*
;
Respiratory Syncytial Viruses
;
Interferons/pharmacology*
;
MAP Kinase Signaling System/drug effects*
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Epithelial Cells/drug effects*
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Signal Transduction/drug effects*
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Cells, Cultured
3.RXRα modulates hepatic stellate cell activation and liver fibrosis by targeting CaMKKβ-AMPKα axis.
Lijun CAI ; Meimei YIN ; Shuangzhou PENG ; Fen LIN ; Liangliang LAI ; Xindao ZHANG ; Lei XIE ; Chuanying WANG ; Huiying ZHOU ; Yunfeng ZHAN ; Gulimiran ALITONGBIEKE ; Baohuan LIAN ; Zhibin SU ; Tenghui LIU ; Yuqi ZHOU ; Zongxi LI ; Xiaohui CHEN ; Qi ZHAO ; Ting DENG ; Lulu CHEN ; Jingwei SU ; Luoyan SHENG ; Ying SU ; Ling-Juan ZHANG ; Fu-Quan JIANG ; Xiao-Kun ZHANG
Acta Pharmaceutica Sinica B 2025;15(7):3611-3631
Hepatic stellate cells (HSCs) are the primary fibrogenic cells in the liver, and their activation plays a crucial role in the development and progression of hepatic fibrosis. Here, we report that retinoid X receptor-alpha (RXRα), a unique member of the nuclear receptor superfamily, is a key modulator of HSC activation and liver fibrosis. RXRα exerts its effects by modulating calcium/calmodulin-dependent protein kinase kinase β (CaMKKβ)-mediated activation of AMP-activated protein kinase-alpha (AMPKα). In addition, we demonstrate that K-80003, which binds RXRα by a unique mechanism, effectively suppresses HSC activation, proliferation, and migration, thereby inhibiting liver fibrosis in the CCl4 and amylin liver NASH (AMLN) diet animal models. The effect is mediated by AMPKα activation, promoting mitophagy in HSCs. Mechanistically, K-80003 activates AMPKα by inducing RXRα to form condensates with CaMKKβ and AMPKα via a two-phase process. The formation of RXRα condensates is driven by its N-terminal intrinsic disorder region and requires phosphorylation by CaMKKβ. Our results reveal a crucial role of RXRα in liver fibrosis regulation through modulating mitochondrial activities in HSCs. Furthermore, they suggest that K-80003 and related RXRα modulators hold promise as therapeutic agents for fibrosis-related diseases.
4.Comparison of clinical laboratory characteristics between elderly and non-elderly patients with rheumatoid arthritis
Fanglan CAI ; Yanjuan CHEN ; Zitian AO ; Mei TIAN ; Juan XIAO ; Jing ZHAO ; Yong CHEN
Chinese Journal of Geriatrics 2025;44(9):1260-1267
Objective:To compare the clinical characteristics and laboratory findings between elderly rheumatoid arthritis(ERA)with those of non-elderly rheumatoid arthritis(NERA)patients.Methods:A cross-sectional study was conducted.The study collected laboratory indicators of 1, 286 ERA and 3, 211 NERA patients admitted to the Affiliated Hospital of Zunyi Medical University between January 2015 and December 2022, including inflammatory indicators, complete blood count, liver/kidney function tests, blood lipid, and glycated hemoglobin(HbA 1c), etc. Results:Erythrocyte sedimentation rate, high-sensitivity C-reactive protein and rheumatoid factor in ERA patients were higher than those in NERA patients( t=13.940, 8.453, 3.400, all P<0.001). Hemoglobin, red blood cell count, red blood cell distribution width, albumin and total protein in ERA patients were lower than those in NERA patients( t=2.380, 6.546, 1.954, 12.800, 10.490, all P<0.05). The levels of aspartate aminotransferase, alkaline phosphatase, γ-glutamyl transferase, total bile acid, globulin, lactate dehydrogenase, creatinine and urea nitrogen in ERA patients were higher than those in NERA patients( t=3.366, 3.422, 2.760, 4.520, 3.676, Z=8.678, t=10.630, 17.640, all P<0.05). The levels of uric acid, alanine aminotransferase, total cholesterol, triglyceride, blood glucose and HbA 1c in female ERA patients were higher than those in NERA group( t=6.009, 1.100, 2.111, 3.954, 4.262, 2.667, all P<0.05). Decreased RBC, ALB, TP, GLB( OR=0.279, 95% CI: 0.133-0.582; OR=0.867, 95% CI: 0.809-0.930; OR=0.948, 95% CI: 0.903-0.996; OR=0.817, 95% CI: 0.798-0.833), and increased ALT, AST, Scr, BUN, LDL-C and TC( OR=1.013, 95% CI: 0.997-1.018; OR=1.046, 95% CI: 1.015-1.079; OR=1.026, 95% CI: 1.005-1.047; OR=1.034, 95% CI: 1.019-1.051; OR=1.373, 95% CI: 1.088-1.733; OR=1.266, 95% CI: 1.022-1.569)were independent influencing factors of ERA. Conclusions:ERA patients exhibit elevated inflammatory markers and are more prone to anemia, liver and kidney function damage, and malnutrition.Furthermore, female ERA patients are more likely to have abnormal uric acid, alanine aminotransferase, blood lipids, and blood glucose.
5.Antimicrobial resistance surveillance in the bacterial strains isolated from pediatric intensive care units in China:results from 2020 to 2022
Jing LIU ; Huiyuan YAN ; Gangfeng YAN ; Guoping LU ; Pan FU ; Chuanqing WANG ; Danqun JIN ; Wenjia TONG ; Chenyu ZHANG ; Jianli CHEN ; Yi LIN ; Jia LEI ; Yibing CHENG ; Qunqun ZHANG ; Kaijie GAO ; Yuanyuan CHEN ; Shufang XIAO ; Juan HE ; Li JIANG ; Huimin XU ; Yuxia LI ; Hanghai DING ; Hehe CHEN ; Yao ZHENG ; Qunying CHEN ; Ying WANG ; Hong REN ; Chenmei ZHANG ; Zhenjie CHEN ; Mingming ZHOU ; Yucai ZHANG ; Yiping ZHOU ; Zhenjiang BAI ; Saihu HUANG ; Lili HUANG ; Weiguo YANG ; Weike MA ; Qing MENG ; Pengwei ZHU ; Yong LI ; Yan XU ; Yi WANG ; Yanqiang DU ; Huijun CAI ; Bizhen ZHU ; Huixuan SHI ; Shaoxian HONG ; Yukun HUANG ; Meilian HUANG
Chinese Journal of Infection and Chemotherapy 2025;25(3):303-311
Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2%)and gram-negative organisms(60.8%).The top three organisms were S.aureus(13.6%,1 453/10 688),A.baumannii(10.0%,1 067/10 688),and coagulase-negative Staphylococcus(9.9%,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1%,19.4%,8.8%,30.9%,67.4%,and 28.8%,respectively.Overall,more than 50%of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25%of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80%of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3%in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.
6.Construction of A Chiral Separation Method Using Polystyrene-cyclodextrin Metal-organic Framework Coating for Open-tubular Capillary Electrochromatography
Yan ZHANG ; Hao-Yu LI ; Cai LIU ; Rong-Yue ZHANG ; Xiao-Nan HE ; Juan QIAO
Chinese Journal of Analytical Chemistry 2025;53(10):1751-1760
By using a strategy of leveraging the ability of metal-organic frameworks(MOFs)materials to precisely regulate the spatial orientation of cyclodextrins(CD),a polystyrene-modified γ-cyclodextrin metal-organic frameworks(PS-CD-MOFs)capillary coating was established and applied to the chiral separation of amino acids in open-tubular capillary electrochromatography(OT-CEC)based on the excellent film-forming property of polystyrene(PS).Characterization results by Fourier transform infrared spectroscopy(FT-IR),X-ray diffraction(XRD)indicated that PS was successfully grafted onto the surface of CD-MOFs.The modification significantly improved the structural stability and thermal stability of CD-MOFs while maintaining the integrity of the MOFs.The PS-CD-MOFs coated capillary electrophoresis system exhibited excellent performance in separating dansylated amino acid enantiomers(Dns-D,L-AAs).Specifically,under the optimal separation conditions(Sodium dodecyl sulfate/boric acid buffer system,20 cm capillary,and 10 kV effective voltage),good separation was achieved for D,L-methionine(D,L-Met)and D,L-serine(D,L-Ser).Further quantitative analysis showed that Dns-D,L-Met presented a good linear relationship in the concentration range of 10.0-1500.0 μmol/L,with a correlation coefficient close to 0.998,demonstrating high sensitivity and repeatability.Not only did it overcome the problem that traditional CD(used as additives in capillary electrophoresis)could not precisely control the spatial orientation of chiral resolvents,but also it solved the issues of insufficient stability and bonding amount of CD-MOFs coatings by utilizing the excellent film-forming property of polymers on the inner wall of capillaries.This study provided an efficient and controllable new strategy for construction of chiral separation stationary phases.
7.Antimicrobial resistance surveillance in the bacterial strains isolated from pediatric intensive care units in China:results from 2020 to 2022
Jing LIU ; Huiyuan YAN ; Gangfeng YAN ; Guoping LU ; Pan FU ; Chuanqing WANG ; Danqun JIN ; Wenjia TONG ; Chenyu ZHANG ; Jianli CHEN ; Yi LIN ; Jia LEI ; Yibing CHENG ; Qunqun ZHANG ; Kaijie GAO ; Yuanyuan CHEN ; Shufang XIAO ; Juan HE ; Li JIANG ; Huimin XU ; Yuxia LI ; Hanghai DING ; Hehe CHEN ; Yao ZHENG ; Qunying CHEN ; Ying WANG ; Hong REN ; Chenmei ZHANG ; Zhenjie CHEN ; Mingming ZHOU ; Yucai ZHANG ; Yiping ZHOU ; Zhenjiang BAI ; Saihu HUANG ; Lili HUANG ; Weiguo YANG ; Weike MA ; Qing MENG ; Pengwei ZHU ; Yong LI ; Yan XU ; Yi WANG ; Yanqiang DU ; Huijun CAI ; Bizhen ZHU ; Huixuan SHI ; Shaoxian HONG ; Yukun HUANG ; Meilian HUANG
Chinese Journal of Infection and Chemotherapy 2025;25(3):303-311
Objective This study aimed to investigate the antimicrobial resistance profiles of bacterial strains isolated from pediatric intensive care units(PICU)in China for better antimicrobial therapy.Methods Clinical isolates were collected from 17 institutions,including tertiary care children's hospitals and pediatric department of tertiary general hospitals in China from January 1,2020 to December 31,2022.Antimicrobial susceptibility testing was carried out according to a unified protocol using Kirby-Bauer method or automated systems.Results were interpreted according to the breakpoints released by the Clinical and Laboratory Standards Institute(CLSI)in 2020.Results A total of 10 688 isolates were collected,including gram-positive organisms(39.2%)and gram-negative organisms(60.8%).The top three organisms were S.aureus(13.6%,1 453/10 688),A.baumannii(10.0%,1 067/10 688),and coagulase-negative Staphylococcus(9.9%,1 058/10 688).Multi-drug resistant organisms(MDROs)were very common in children.The prevalence of methicillin-resistant Staphylococcus aureus(MRSA),carbapenem-resistant Enterobacterales(CRE),carbapenem-resistant E.coli,carbapenem-resistant K.pneumoniae(CRKP),carbapenem-resistant A.baumannii(CRAB),and carbapenem-resistant P.aeruginosa(CRPA)was 41.1%,19.4%,8.8%,30.9%,67.4%,and 28.8%,respectively.Overall,more than 50%of Enterobacteriales isolates were resistant to cephalosporins,while nearly 25%of Enterobacteriales isolates were resistant to carbapenems.MDROs were highly resistant to commonly used antibiotics.More than 80%of CRE and CRAB strains were resistant to all beta-lactam antibiotics.CRE and CRAB showed low resistance rates to tigecycline and polymyxin.CRPA showed lower resistance rates to piperacillin,beta-lactamase inhibitor combinations than the resistance rates to third and fourth generation cephalosporins.All of the Staphylococcus and Enterococcus isolates were susceptible to vancomycin and tigecycline.None of PRSP strains isolated from meningitis and nonmeningitis samples were resistant to rifampicin,vancomycin,or linezolid.The prevalence of β-lactamase-negative ampicillin-resistant(BLNAR)strains was 43.3%in Haemophilus influenzae.Conclusions MDROs were prevalent in PICU.It is necessary to establish an effective multidisciplinary team(MDT)to control the antimicrobial resistance.
8.Comparison of clinical laboratory characteristics between elderly and non-elderly patients with rheumatoid arthritis
Fanglan CAI ; Yanjuan CHEN ; Zitian AO ; Mei TIAN ; Juan XIAO ; Jing ZHAO ; Yong CHEN
Chinese Journal of Geriatrics 2025;44(9):1260-1267
Objective:To compare the clinical characteristics and laboratory findings between elderly rheumatoid arthritis(ERA)with those of non-elderly rheumatoid arthritis(NERA)patients.Methods:A cross-sectional study was conducted.The study collected laboratory indicators of 1, 286 ERA and 3, 211 NERA patients admitted to the Affiliated Hospital of Zunyi Medical University between January 2015 and December 2022, including inflammatory indicators, complete blood count, liver/kidney function tests, blood lipid, and glycated hemoglobin(HbA 1c), etc. Results:Erythrocyte sedimentation rate, high-sensitivity C-reactive protein and rheumatoid factor in ERA patients were higher than those in NERA patients( t=13.940, 8.453, 3.400, all P<0.001). Hemoglobin, red blood cell count, red blood cell distribution width, albumin and total protein in ERA patients were lower than those in NERA patients( t=2.380, 6.546, 1.954, 12.800, 10.490, all P<0.05). The levels of aspartate aminotransferase, alkaline phosphatase, γ-glutamyl transferase, total bile acid, globulin, lactate dehydrogenase, creatinine and urea nitrogen in ERA patients were higher than those in NERA patients( t=3.366, 3.422, 2.760, 4.520, 3.676, Z=8.678, t=10.630, 17.640, all P<0.05). The levels of uric acid, alanine aminotransferase, total cholesterol, triglyceride, blood glucose and HbA 1c in female ERA patients were higher than those in NERA group( t=6.009, 1.100, 2.111, 3.954, 4.262, 2.667, all P<0.05). Decreased RBC, ALB, TP, GLB( OR=0.279, 95% CI: 0.133-0.582; OR=0.867, 95% CI: 0.809-0.930; OR=0.948, 95% CI: 0.903-0.996; OR=0.817, 95% CI: 0.798-0.833), and increased ALT, AST, Scr, BUN, LDL-C and TC( OR=1.013, 95% CI: 0.997-1.018; OR=1.046, 95% CI: 1.015-1.079; OR=1.026, 95% CI: 1.005-1.047; OR=1.034, 95% CI: 1.019-1.051; OR=1.373, 95% CI: 1.088-1.733; OR=1.266, 95% CI: 1.022-1.569)were independent influencing factors of ERA. Conclusions:ERA patients exhibit elevated inflammatory markers and are more prone to anemia, liver and kidney function damage, and malnutrition.Furthermore, female ERA patients are more likely to have abnormal uric acid, alanine aminotransferase, blood lipids, and blood glucose.
9.IgA nephropathy with mesangial type Ⅲ collagen deposition:2 cases report
Jie-Bo HUANG ; Xiao-Fan CAI ; Zhong-Hua ZHAO ; Zhi-Gang ZHANG ; Qiang SHEN ; Hao WANG ; Hui-Juan WU
Fudan University Journal of Medical Sciences 2024;51(3):426-430
As interstitial collagen,type Ⅲ collagen(Col Ⅲ)does not express in normal glomeruli.However,in Col Ⅲ nephropathy,a large amount of Col Ⅲ deposit in the mesangial and subendothelial area of the glomeruli.IgA nephropathy with Col Ⅲ deposition was extremely rare.In this article,we reported two cases of such disease.After treating with immunosuppressive agents or traditional Chinese medicine decoction,the renal function of the two patients remained stable and the urinary protein levels reduced significantly.
10.Association of different ages and pubertal developmental stages with reference intervals of thyroid function indices in adolescent females
Yi-Zhou CAI ; Dan-Dan HE ; Ying-Ying WANG ; Xiao-Hua LIU ; Xiao-Li XU ; Lin-Juan DONG ; Nian LIU ; Dan-Dan YU ; Na WANG
Fudan University Journal of Medical Sciences 2024;51(4):566-573
Objective To investigate the trends of major thyroid function indices in Chinese adolescent females at different ages and the differences from adult reference intervals.Methods A total of 791 female students from 4 junior high schools were enrolled in the study by selecting one junior high school in each of the following locations:Minhang District of Shanghai,Haimen City of Jiangsu Province,Yuhuan City of Zhejiang Province,and Deqing County of Zhejiang Province from Oct to Nov 2017 and from Jan to Mar 2019.The subjects were subjected to physical examination as well as thyroid hormone levels;and the Pubertal Developmental Events Self-Assessment Scale(PDS)was used to evaluate the staging of pubertal development.Follow-ups were conducted after 2 years,with the same survey content.Thyroid function levels were assessed in 5 age groups between 11 to 15 years old,95%CI were calculated,and mixed linear models were used to analyze the effects of age and pubertal developmental stage on hormone levels.Results The reference intervals for thyroid stimulating hormone(TSH),free triiodothyronine(FT3)and free thyroxine(FT4)in adolescent females differed significantly from those of adults,with misclassification rates ranging from 2.98%to 5.17%.Statistically significant differences were found for age,pubertal development staging,and the interaction of age and pubertal staging after correcting for BMI,waist circumference(all P<0.05).TSH levels were more affected by age before the completion of pubertal development,the level of the 12-year-old group was higher than that of the 11-year-old group(P=0.001 2)and the 13-year-old group(P<0.000 1);FT3 levels showed greater variability with age during late pubertal stage,with levels significantly higher at 13 years of age than at 11 and 12 years of age(P<0.0001),and gradually decreasing after 13 years of age(P<0.000 1).In contrast,FT4 levels were generally less affected by age between 11 and 15 years of age,with levels slightly higher at 13-15 years of age than at 11-12 years of age(P<0.000 1).Conclusion The levels of TSH,FT3,and FT4,as indicators of thyroid function in adolescent females,differ significantly from those of adults,and are differently affected by age and the stages of pubertal development;further refinement of the reference intervals for age-and pubertal-development-specific thyroid indicators is necessary.

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