Independence of the body composition index from nutritional status affecting bone maturation
Huiping Su1, Yan Li1,2, Zhongwei Xu1
1Department of Endocrinology, Shenzhen Children's Hospital, Shenzhen, China.
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.
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