目的 分析甘肃地区学龄前和学龄期儿童骨龄提前与超重/肥胖关系,以推动该地区儿童的营养干预和健康教育。方法 选取2019年2月—2023年10月期间于甘肃省妇幼保健院儿保科体检的1 462名3~12岁儿童(男698例,女764例)为研究对象。采用左手腕部X线片评估骨龄,同时根据体质量指数(BMI)标准将研究对象分为低体重组、正常组、超重组和肥胖组。分析不同性别、营养状态及年龄段的骨龄状态,并进一步探讨超重/肥胖与骨龄提前的相关性。 结果 总体分析人群中,低体重、超重和肥胖儿童占比分别为7.11%、8.41%和13.34%,骨龄提前和骨龄落后的儿童比例分别为7.87%和35.16%。女童骨龄提前的比例显著高于男童(11.91% vs. 3.44%,χ2=71.296,P<0.05)。9~12岁儿童骨龄提前的比例(19.40%)显著高于6~8岁组(7.62%,P<0.05)和3~5岁组(1.01%,χ2=119.802,P<0.05)。与BMI正常儿童(5.77%)相比,超重(17.07%)和肥胖儿童(16.92%)中骨龄提前的比例显著升高(χ2=99.176,P<0.05)。超重和肥胖均为骨龄提前的危险因素,OR值分别2.488(95%CI:1.435~4.314,P<0.05)和2.330(95%CI:1.463~3.710,P<0.001)。BMI与骨龄年龄差呈显著正相关(r=0.361,P<0.001)。此外,BMI在预测骨龄提前中的AUC为0.735(95%CI:0.684~0.786,P<0.001),其最优截断值为16.699kg/m2(敏感度0.696,特异性0.739,约登指数0.435)。结论 甘肃地区不同营养状态下儿童骨龄存在显著差异,超重和肥胖与骨龄提前呈显著正相关。建议定期监测超重及肥胖儿童骨龄,以便早期干预,促进儿童健康生长发育。
Abstract
Objective To investigate the correlation of advanced bone age (BA) with overweight/obesity in preschool and school-aged children from Gansu, in order to promote the nutritional intervention and health education in this region. Methods A total of 1 462 children (698 boys, 764 girls) aged 3-12 years who underwent health examinations at the Department of Child Health Care, Gansu Provincial Maternity and Child Health Care Hospital from February 2019 to October 2023 were included.Bone age was assessed using left-hand wrist radiographs, and participants were categorized into underweight, normal weight, overweight, and obese groups based on body mass index (BMI) criteria.Bone age status was analyzed across different sexes, nutritional statuses, and age groups, and the association between overweight/obesity and advanced bone age was further explored. Results In the overall study population, the proportions of underweight, overweight, and obese children were 7.11%, 8.41%, and 13.34%, respectively.The prevalence of advanced bone age and delayed bone age was 7.87% and 35.16%, respectively.Girls had a significantly higher rate of advanced bone age than boys (11.91% vs.3.44%, χ2=71.296, P<0.05).Children aged 9-12 years exhibited a significantly higher rate of advanced bone age (19.40%) compared to those aged 6-8 years (7.62%, P<0.05) and 3 - 5 years (1.01%, χ2=119.802, P<0.05).Compared to normal-weight children (5.77%), the prevalence of advanced bone age was significantly higher in overweight (17.07%) and obese children (16.92%) (χ2=99.176, P<0.05).Both overweight and obesity were identified as risk factors for advanced bone age, with odds ratios (ORs) of 2.488 (95% CI:1.435-4.314, P<0.05) and 2.330 (95% CI:1.463-3.710, P<0.001), respectively.BMI showed a significant positive correlation with bone age difference (r=0.361, P<0.001).Furthermore, the area under the curve (AUC) of BMI in predicting advanced bone age was 0.735 (95%CI:0.684-0.786, P<0.001), with an optimal cutoff value of 16.699 kg/m2(sensitivity was 0.696, specificity was 0.739, Youden index was 0.435). Conclusions Significant differences in bone age are observed among children with varying nutritional status in Gansu, with overweight and obesity strongly associated with advanced bone age.Regular bone age monitoring in overweight and obese children is recommended for early intervention to promote healthy growth and development.
关键词
营养 /
体质量指数 /
骨龄 /
相关性 /
儿童
Key words
nutrition /
body mass index /
bone age /
correlation /
children
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基金
兰州市科技计划项目(2022-5-86);甘肃省卫生健康行业科研计划项目(GSWSKY2021-040);甘肃省自然科学基金项目(23JRRA1378)
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