Browse > Article
http://dx.doi.org/10.5223/pghn.2020.23.1.89

Factors associated with Advanced Bone Age in Overweight and Obese Children  

Oh, Min-Su (Department of Pediatrics, Jeju National University School of Medicine)
Kim, Sorina (Department of Pediatrics, Jeju National University School of Medicine)
Lee, Juyeon (Department of Pediatrics, Jeju National University School of Medicine)
Lee, Mu Sook (Division of Diagnostic and Interventional Radiology, Keimyung University Dongsan Medical Center)
Kim, Yoon-Joo (Department of Pediatrics, Jeju National University School of Medicine)
Kang, Ki-Soo (Department of Pediatrics, Jeju National University School of Medicine)
Publication Information
Pediatric Gastroenterology, Hepatology & Nutrition / v.23, no.1, 2020 , pp. 89-97 More about this Journal
Abstract
Purpose: Obese children may often present with advanced bone age. We aimed to evaluate the correlation between factors associated with childhood obesity and advanced bone age. Methods: We enrolled 232 overweight or obese children. Anthropometric and laboratory data, and the degree of nonalcoholic fatty liver disease (NAFLD) were measured. We analyzed factors associated with advanced bone age by measuring the differences between bone and chronological ages. Results: The normal and advanced bone age groups were comprised of 183 (78.9%) and 49 (21.1%) children, respectively. The prevalence of advanced bone age significantly increased as the percentiles of height, weight, waist circumference, and body mass index (BMI) increased. BMI z-score was higher in the advanced bone age group than in the normal bone age group (2.43±0.52 vs. 2.10±0.46; p<0.001). The levels of insulin (27.80±26.13 μU/mL vs. 18.65±12.33 μU/mL; p=0.034) and homeostatic model assessment-insulin resistance (6.56±6.18 vs. 4.43±2.93; p=0.037) were significantly higher, while high density lipoprotein-cholesterol levels were lower (43.88±9.98 mg/dL vs. 48.95±10.50 mg/dL; p=0.005) in the advanced bone age group compared to those in the normal bone age group, respectively. The prevalence of advanced bone age was higher in obese children with metabolic syndrome than in those without (28.2% vs. 14.7%; p=0.016). The prevalence of advanced bone age was higher in obese children with a more severe degree of NAFLD. Conclusion: Advanced bone age is associated with a severe degree of obesity and its complications.
Keywords
Obesity; Children; Bone age; Metabolic syndrome; Nonalcoholic fatty liver disease;
Citations & Related Records
Times Cited By KSCI : 4  (Citation Analysis)
연도 인용수 순위
1 Tanner JM, Healy MJR, Goldstein H, Cameron N. Assessment of skeletal maturity and prediction of adult height (TW3 method). London: W.B. Saunders, 2001.
2 Klein KO, Newfield RS, Hassink SG. Bone maturation along the spectrum from normal weight to obesity: a complex interplay of sex, growth factors and weight gain. J Pediatr Endocrinol Metab 2016;29:311-8.   DOI
3 Sopher AB, Jean AM, Zwany SK, Winston DM, Pomeranz CB, Bell JJ, et al. Bone age advancement in prepubertal children with obesity and premature adrenarche: possible potentiating factors. Obesity (Silver Spring) 2011;19:1259-64.   DOI
4 Lee HS, Shim YS, Jeong HR, Kwon EB, Hwang JS. The association between bone age advancement and insulin resistance in prepubertal obese children. Exp Clin Endocrinol Diabetes 2015;123:604-7.   DOI
5 Gurnurkar S, Arheart KL, Messiah SE, Mankodi A, Carrillo A. Skeletal maturation and predicted adult height in children with premature adrenarche. J Pediatr Endocrinol Metab 2014;27:69-74.   DOI
6 Corvalan C, Uauy R, Mericq V. Obesity is positively associated with dehydroepiandrosterone sulfate concentrations at 7 y in Chilean children of normal birth weight. Am J Clin Nutr 2013;97:318-25.   DOI
7 Keane VA. Assessment of growth. In: Kliegman RM, Stanton BF, St. Geme III JW, Schor NF, Behrman RE, eds. Nelson textbook of pediatrics. 20th ed. Philadelphia: Elsevier, 2016.
8 Baker S, Barlow S, Cochran W, Fuchs G, Klish W, Krebs N, et al. Overweight children and adolescents: a clinical report of the North American Society for Pediatric Gastroenterology, Hepatology and Nutrition. J Pediatr Gastroenterol Nutr 2005;40:533-43.   DOI
9 He Q, Karlberg J. Bmi in childhood and its association with height gain, timing of puberty, and final height. Pediatr Res 2001;49:244-51.   DOI
10 Russell DL, Keil MF, Bonat SH, Uwaifo GI, Nicholson JC, McDuffie JR, et al. The relation between skeletal maturation and adiposity in African American and Caucasian children. J Pediatr 2001;139:844-8.   DOI
11 Wu S, Aguilar AL, Ostrow V, De Luca F. Insulin resistance secondary to a high-fat diet stimulates longitudinal bone growth and growth plate chondrogenesis in mice. Endocrinology 2011;152:468-75.   DOI
12 Pinhas-Hamiel O, Benary D, Mazor-Aronovich K, Ben-Ami M, Levy-Shraga Y, Boyko V, et al. Advanced bone age and hyperinsulinemia in overweight and obese children. Endocr Pract 2014;20:62-7.   DOI
13 Vos MB, Abrams SH, Barlow SE, Caprio S, Daniels SR, Kohli R, et al. NASPGHAN clinical practice guideline for the diagnosis and treatment of nonalcoholic fatty liver disease in children: recommendations from the Expert Committee on NAFLD (ECON) and the North American Society of Pediatric Gastroenterology, Hepatology and Nutrition (NASPGHAN). J Pediatr Gastroenterol Nutr 2017;64:319-34.   DOI
14 Pludowski P, Litwin M, Niemirska A, Jaworski M, Sladowska J, Kryskiewicz E, et al. Accelarated skeletal maturation in children with primary hypertension. Hypertension 2009;54:1234-9.   DOI
15 Burt Solorzano CM, McCartney CR. Obesity and the pubertal transition in girls and boys. Reproduction 2010;140:399-410.   DOI
16 De Leonibus C, Marcovecchio ML, Chiarelli F. Update on statural growth and pubertal development in obese children. Pediatr Rep 2012;4:e35.
17 Kang KS. Nutritional counseling for obese children with obesity-related metabolic abnormalities in Korea. Pediatr Gastroenterol Hepatol Nutr 2017;20:71-8.   DOI
18 Oh MS, Kim S, Jang JH, Park JY, Kang HS, Lee MS, et al. Associations among the degree of nonalcoholic fatty liver disease, metabolic syndrome, degree of obesity in children, and parental obesity. Pediatr Gastroenterol Hepatol Nutr 2016;19:199-206.   DOI
19 Grant-Guimaraes J, Feinstein R, Laber E, Kosoy J. Childhood overweight and obesity. Gastroenterol Clin North Am 2016;45:715-28.   DOI
20 Marcovecchio ML, Chiarelli F. Obesity and growth during childhood and puberty. World Rev Nutr Diet 2013;106:135-41.   DOI
21 Johnson W, Stovitz SD, Choh AC, Czerwinski SA, Towne B, Demerath EW. Patterns of linear growth and skeletal maturation from birth to 18 years of age in overweight young adults. Int J Obes 2012;36:535-41.   DOI
22 Stovitz SD, Demerath EW, Hannan PJ, Lytle LA, Himes JH. Growing into obesity: patterns of height growth in those who become normal weight, overweight, or obese as young adults. Am J Hum Biol 2011;23:635-41.   DOI
23 Moon JS, Lee SY, Nam CM, Choi JM, Choe BK, Seo JW, et al. 2007 Korean national growth charts: review of developmental process and an outlook. Korean J Pediatr 2008;51:1-25.   DOI
24 Chu MA, Choe BH. Obesity and metabolic syndrome among children and adolescents in Korea. J Korean Med Assoc 2010;53:142-52.   DOI
25 Saadeh S, Younossi ZM, Remer EM, Gramlich T, Ong JP, Hurley M, et al. The utility of radiological imaging in nonalcoholic fatty liver disease. Gastroenterology 2002;123:745-50.   DOI
26 Lambert M, Paradis G, O'Loughlin J, Delvin EE, Hanley JA, Levy E. Insulin resistance syndrome in a representative sample of children and adolescents from Quebec, Canada. Int J Obes 2004;28:833-41.   DOI
27 Cho KY, Park H, Seo JW. The relationship between lifestyle and metabolic syndrome in obese children and adolescents. Korean J Pediatr Gastroenterol Nutr 2008;11:150-9.   DOI