Peer-reviewed article
Independence of the body composition index from nutritional status affecting bone maturation.
Huiping Su, Yan Li, Zhongwei Xu, Yue Shang, Qiru Su et al. ·
Summary
Written by AI, not yet AICS's view · claude-haiku-4-5-20251001This peer-reviewed study examined bone maturation in 3,780 children aged 6-15 years in Shenzhen, China, using body composition measurements and bone age assessments. The researchers found that visceral fat area and handgrip strength were associated with advanced bone maturation independently of body mass index. The study produced reference curves for bone age stratified by sex, age, and pubertal stage to better evaluate bone development in children.
Key points
- 10.1% of boys and 9.9% of girls showed bone age advancement of 2 years or more
- Visceral fat area rank correlated positively with bone age advancement in both boys and girls
- Relative handgrip strength rank correlated positively with bone age advancement in boys only
- Body composition indices were associated with bone maturation independent of nutritional status
- Standard reference curves were established for bone age minus chronological age stratified by sex, age, and pubertal stage
Limitations
This is a cross-sectional descriptive study that does not evaluate the effectiveness of an intervention or causality. The study measures associations between body composition and bone maturation but cannot determine whether these relationships are causal or how they might be modified.
Abstract
BACKGROUND: To examine the characteristics and factors associated with bone maturation among children aged 6-15 years in Shenzhen, stratified by sex, age, and pubertal stage. METHODS: The Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen, China' data on body mass index, body composition, bone age (BA), and biochemical examinations were analyzed. The Z-score of BA minus chronological age (ZBA-CA) was calculated for the same sex, age, and pubertal stage. RESULTS: We included 3780 students aged 6-15 years, comprising 2091 (55.3%) boys and 1689 (44.7%) girls. The proportions of children with BA advancement ≥2 years were 10.1% for boys and 9.9% for girls. We established the standard deviation curves of BA-CA for boys and girls with normal weights at different ages under different pubertal stages. Visceral fat area rank (VFA-R) and relative handgrip strength rank (RHGS-R) correlated positively with ZBA-CA at each quantile in boys, while only VFA-R correlated positively in girls. CONCLUSIONS: Bone maturation should be evaluated according to sex, age, nutritional status, and pubertal stage. VFA-R and RHGS-R were positively correlated with ZBA-CA, independent of the nutritional status. IMPACT STATEMENT: We produced the first standard deviation curves of bone age minus chronological age (BA-CA) for children aged 6-15 years, stratified by sex, age and pubertal stage, to evaluate bone maturation. Our findings revealed that body composition index might affect bone maturation independent of nutritional status. Body mass index, commonly used to evaluate obese children with advanced bone age, does not account for differences and relationship between body composition and bone maturation. These findings offer valuable insights for clinical practice to formulate targeted interventions for slowing down bone maturation and improving growth-related disorders' management in children.