Correlation of body mass index and serum 25-hydroxyvitamin D levels with advanced bone age in children from northwest China: a cross-sectional study
Abstract
Background The relationship between advanced bone age (BA), obesity, and vitamin D status remains understudied in preschool Asian children, particularly in economically developing regions. This study examined the associations of overweight/obesity and vitamin D deficiency with advanced BA among children in northwest China. Methods A cross-sectional study was conducted involving 1,462 children aged 3–12 years who underwent physical examinations at Gansu Provincial Maternity and Child-Care Hospital (February 2019–October 2023). BA was assessed via left wrist X-ray using the Tanner-Whitehouse 3 (TW3) RUS (radius, ulna, and short bones) method, with inter-rater reliability verified by an intraclass correlation coefficient (ICC) of 0.92 (discrepancies resolved by a third senior pediatrician). Serum 25-hydroxyvitamin D [25(OH)D] was measured using electrochemical luminescence immunoassay [Cobas e601, Roche Diagnostics; detection range: 3–100 ng/mL; intra-batch coefficient of variation (CV) 1 year. The definition of advanced BA as BA-CA >1 year is widely adopted in clinical pediatric practice in China. Results The prevalence of advanced BA was 7.9%, with significantly higher rates in girls (11.9% vs. 3.4% in boys, P<0.001), children aged 9–12 years (19.4%), and those with overweight (17.1%) or obesity (16.9%) compared to normal weight children (5.8%, P<0.001). Body mass index (BMI) was positively correlated with advanced BA (Spearman ρ=0.361, P<0.001) and exhibited moderate…
How strong is the evidence?
Evidence Hub reads this as a cross-sectional, done in people. Its evidence level is 4 of 5 (Low · observational). Observational designs can show an association but not prove cause. Reported size: 1,462 participants or records.
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