Background: The bone age (BA) assess the skeletal maturity and determine the children linear growth. Mexican children have a slightly delay in skeletal maturity before 10 years, but they reach in mean a BA 1 year in advance at the end of the puberty. On the other hand, Mexico has a high prevalence of childhood obesity and the adiposity has been associated with the BA advance in other populations. For the above, the overweight and obesity could be impact in the growth potential of Mexican children.
Aim: To compare the skeletal maturation of Mexican children and adolescents according to nutritional status; and to analyze the effect of the body mass index (BMI) changes on BA acceleration and the adult height prediction.
Methods: We conducted a cross-sectional study. We included 915 healthy children of Mexico City's Metropolitan area between 2017 and 2018 (range 5 to 19 years). The anthropometric measures of participants and their parents were obtained by trained staff. A hand PA radiography was taken and analyzed using BoneXpert software to determine automated BA and the adult height prediction (AHP). We constructed the BA curves with the average of the difference between BA and chronological age (CA) as function of CA by gender. We compare the curves of BA according to nutritional status (overweight and obesity vs eutrophics). In a second phase we follow-up 56 children for 1 year. We analyzed the impact of BMI changes on BA progression, growth velocity and adult height prediction.
Results: As shown in Figure 1, the boys with overweight or obesity have an acceleration in BA at 7.9 years of age and they are 1.8 years of BA ahead at the end of the puberty; in comparison, eutrophic boys have slightly BA delayed until 13.5 years (P<0.01). On the other hand, the girls with overweight or obesity had BA acceleration at 8 years, and they are 1.6 years of BA ahead at the end of the puberty; in comparison, eutrophic girls have slightly BA delayed until 11.5 years (P<0.01). In the follow-up, we identify that for each Z-score of increase in the BMI, the AHP decrease 0.9 cm (95% CI 0.2 to 1.7).
Conclusion: Mexican children and adolescents with overweight and obesity have BA acceleration at younger age in comparison with eutrophic children. The increase in the Z-score of BMI reduce the growth potential and the AHP.
19 - 21 Sep 2019
European Society for Paediatric Endocrinology