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Retarded skeletal maturation in children with primary enuresis
Insights
Children with primary nocturnal enuresis (PNE) show delayed bone age maturation compared to controls. This skeletal maturation delay may indicate slower development of central nervous system regulatory functions in enuretic children.
Area of Science:
- Pediatric Endocrinology
- Child Neurology
- Skeletal Maturation
Background:
- Primary nocturnal enuresis (PNE) is a prevalent pediatric condition with complex causes.
- Understanding the underlying physiological factors in PNE is crucial for effective management.
Purpose of the Study:
- To investigate skeletal maturation and growth in children diagnosed with PNE.
- To compare bone age (BA) and chronological age (CA) in PNE patients versus a control group.
- To explore potential links between delayed maturation and PNE etiology.
Main Methods:
- A cohort of 35 children with PNE (ages 6-14) was assessed for growth and skeletal maturation.
- Bone age was determined using the TW-2 method and compared to chronological age.
- A control group of 22 children (ages 6-13) was used for comparison.
- Thyroid function tests (T4 and TSH) were conducted for PNE patients.
Main Results:
- No significant differences in mean height and weight percentiles were observed between the PNE and control groups.
- Children with PNE exhibited a significant lag in bone age compared to chronological age (mean difference: 1.46 years).
- A substantial portion of PNE patients (31%) showed a bone age retardation exceeding 24 months, with some cases over 36 months.
- Normal thyroid function was confirmed in all assessed PNE children.
Conclusions:
- Retarded bone age in children with PNE suggests a potential delay in skeletal maturation.
- This delay may reflect a broader pattern of delayed maturation in central nervous system regulatory functions.
- Further research is warranted to elucidate the neurodevelopmental aspects of primary nocturnal enuresis.
Abstract:
Primary nocturnal enuresis (PNE) is a common paediatric problem of multifactorial aetiology. Growth and skeletal maturation were studied in 35 otherwise healthy children with PNE, 26 boys and 9 girls aged 6-14 years, and comparison was made with a control (CTR) group of 19 boys and 3 girls aged 6-13 years of similar ethnic origin. There was no significant difference between the mean height and weight centiles of the two groups. Bone age (BA) determined by the TW-2 method showed a significant lag behind chronological age (CA); the CA-BA difference being 1.46 +/- 1.56 years in the PNE group and -0.08 +/- 0.8 years in the CTR group (P less than 0.001). In 11 of the PNE group (31%) the BA retardation was greater than 24 months: in 4 it was between 24 to 36 months and in 7 the difference was greater than 36 months. In all these children T4 and TSH were found to be normal. It is hypothesised that the retarded bone age in children with PNE may reflect delayed maturation of regulatory CNS functions.