Skeletal Maturity in Adolescence: Evaluating Bone Development and Age Metrics

Background/Objectives: Bone maturation and development are crucial for growth and development, especially in children and adolescents; however, some qualitative methods, such as Greulich & Pyle, do not provide accurate data. Our aim is to verify whether skeletal age (SA) can predict and correlate with bone mineral content (BMC), bone mineral density (BMD), and body composition (BC). Methods: A cross-sectional study was conducted on 115 male adolescents (ages 12.1-15.8 years). Skeletal age was assessed using the Tanner-Whitehouse 3 (TW3) method, while BMC, BMD, and BC were measured using full-body DXA. Anthropometric data, including height and body mass, were also recorded. Statistical analysis included descriptive methods and bivariate correlation coefficients. Results: SA was significantly correlated with stature (r = 0.598, p = 0.001) and body mass (r = 0.517, p = 0.001), showing a stronger association than chronological age (CA) for these variables. Body composition variables, including lean mass (LM) (r = 0.521, p = 0.001) and fat tissue (FT) (r = 0.522, p = 0.001), also showed a stronger correlation with SA than CA. However, associations between SA and bone parameters were weaker: BMC (r = 0.103, p = 0.275) and BMD (r = 0.161, p = 0.086) did not reach statistical significance. When stratified by SA/CA tertiles, individuals in the highest tertile exhibited slightly greater BMC (1439 ± 108.32 g) and BMD (1.028 ± 0.127 g/cm²), though without a significant effect. These findings suggest a dynamic but complex relationship between skeletal age and bone development. Conclusions: SA demonstrates a stronger association with anthropometric and body composition variables than CA, highlighting its potential as a predictor of growth used in conjunction with LM and FM. However, its relationship with BMD and BMC remains inconclusive, warranting further longitudinal research, considering limitations regarding nutritional intake.