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Updated: Dec 7, 2025
Assessment of Child Anthropometry in a Large Epidemiologic Study
Published on: February 2, 2017
Accelerated skeletal maturation is associated with overweight and obesity as early as preschool age: a
Dandan Ke1, Dajiang Lu2, Guang Cai3
1Graduate School of Health and Sports Science, Juntendo University, 1- 1 Hiraka-gakuendai, Inzai-city, Chiba, 270-1695, Japan.
Insights
Accelerated skeletal maturation is linked to overweight and obesity in preschool children. Early interventions focusing on diet and physical activity are recommended to prevent both conditions.
Area of Science:
- Pediatric endocrinology
- Growth and development studies
- Public health and nutrition
Background:
- Body mass index (BMI) and skeletal age (SA) are key growth indicators.
- Accelerated skeletal maturation is often linked to overweight/obesity, but data in preschoolers, especially Asian children, is limited.
- This study investigated the association between accelerated skeletal maturation and overweight/obesity in Chinese preschoolers.
Purpose of the Study:
- To examine the relationship between accelerated skeletal maturation and overweight/obesity in preschool-aged children.
- To provide evidence for early intervention strategies targeting both skeletal maturation and weight status.
Main Methods:
- A cross-sectional study of 1330 Chinese children aged 3.1-6.6 years in Shanghai.
- Skeletal age determined by TW3-C RUS; accelerated maturation defined as SA-CA ≥1.0 years.
- BMI classified using IOTF criteria; Chi-square and logistic regression used for analysis.
Main Results:
- Accelerated skeletal maturation prevalence increased with BMI (7.8% in thinness to 30.8% in obesity) and age.
- Overweight children had 3.27 times higher odds, and obese children 4.73 times higher odds, of accelerated skeletal maturation compared to normal weight.
- Significant associations were found between BMI categories, age, and accelerated skeletal maturation (P < 0.01).
Conclusions:
- A significant association exists between accelerated skeletal maturation and overweight/obesity in preschool children.
- Accelerated skeletal maturation and overweight/obesity may coexist and warrant early, combined interventions.
- Recommendations include dietary modifications and increased physical activity from preschool age.
Background:
Body mass index (BMI) and skeletal age (SA) are important indicators of individual growth and maturation. Although the results have not been unified, most studies indicated that accelerated skeletal maturation is associated with overweight/obesity. However, there have so far been insufficient studies about the association between accelerated skeletal maturation and overweight/obesity in preschoolers, particularly Asian children. A cross-sectional study was conducted on Chinese children to verify the association between accelerated skeletal maturation and overweight/obesity at preschool age.
Methods:
The study involved 1330 participants aged 3.1-6.6 years old (730 males and 600 females) in Shanghai, China. The skeletal age was determined according to the method of TW3-C RUS. Accelerated skeletal maturation was defined as relative SA (SA minus chronological age [CA]) ≥1.0 years. BMI was classified as thinness, normal weight, overweight, and obesity according to the International Obesity Task Force (IOTF) BMI cut-offs. The Chi-square was performed to determine the statistically significant difference in the frequency of accelerated skeletal maturation in BMI and age categories. The logistic regression model analyzed the association between accelerated skeletal maturation and overweight/obesity.
Results:
The percentage of accelerated skeletal maturation increased with BMI (7.8% of children in thinness group had accelerated skeletal maturation; the percentage increased to 30.8% in obese group. x2 = 89.442, df = 3, P < 0.01) and age group (at age 3.5, 3.5% of participants had accelerated skeletal maturation; at age 6.0 years, this increased to 27.8%. x2 = 43.417, df = 5, P < 0.01). Logistic regression analysis showed that children with overweight and obesity are more likely to have accelerated skeletal maturation than children with normal weight after adjusting for gender and age (Overweight, odds ratio [OR] = 3.27, 95% confidence interval [CI]: 2.20-4.87; Obese, OR = 4.73, 95% CI: 2.99-7.48).
Conclusions:
There is an association between accelerated skeletal maturation and overweight/obesity among preschool children. This study suggests that accelerated skeletal maturation might coexist with overweight/obesity in preschool children, and interventions, such as dietary modifications and increasing levels of physical activity, should be employed to prevent both accelerated skeletal maturation and overweight/obesity as early as preschool age.
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