Background: Body mass index and skeletal age are important indicators of individual growth and maturation. The recognition of their association could contribute to the prevention of childhood obesity and accelerated skeletal maturation. This study aimed to examine the effects of overweight and obesity on accelerated skeletal maturation in preschool children. Methods: Participants included 1330 children aged 3.1-6.6 years. The main outcomes were skeletal age assessed by left hand-wrist radiograph, and body mass index classified as thinness, normal weight, overweight and obesity. Results: The percentage of accelerated skeletal maturation increased with body mass index ( x 2 = 89.442, df = 3, P <0.01) and age group ( x 2 = 43.417, df = 5, P <0.01). Logistic regression analysis showed a higher risk of accelerated skeletal maturation in children with overweight and obesity than children with normal weight after adjusting for gender and age (Overweight, OR = 3.27, 95% CI : 2.20-4.87; Obese, OR = 4.73, 95% CI : 2.99-7.48). Conclusions: Accelerated skeletal maturation was associated with overweight and obesity in preschool children, and its prevalence increased with age. These findings suggest that parents and child-health managers should be aware of an existing risk of accelerated skeletal maturation in preschool children with overweight and obesity.

Background: Body mass index (BMI) and skeletal age (SA) are important indicators of individual growth and maturation. Although the results have not been unified, most studies indicated that accelerated skeletal maturation is associated with overweight/obesity. However, there have so far been insufficient studies about the association between accelerated skeletal maturation and overweight/obesity in preschoolers, particularly Asian children. A cross-sectional study was conducted on Chinese children to verify the association between accelerated skeletal maturation and overweight/obesity at preschool age.Methods: The study involved 1330 participants aged 3.1-6.6 years old (730 males and 600 females) in Shanghai, China. The skeletal age was determined according to the method of TW3-C RUS. Accelerated skeletal maturation was defined as relative SA (SA minus chronological age [CA]) ≥1.0 years. BMI was classified as thinness, normal weight, overweight, and obesity according to the International Obesity Task Force (IOTF) BMI cut-offs. The Chi-square was performed to determine the statistically significant difference in the frequency of accelerated skeletal maturation in BMI and age categories. The logistic regression model analyzed the association between accelerated skeletal maturation and overweight/obesity.Results: The percentage of accelerated skeletal maturation increased with BMI (7.8% of children in thinness group had accelerated skeletal maturation; the percentage increased to 30.8% in obese group. x2 = 89.442, df = 3, P <0.01) and age group (at age 3.5, 3.5% of participants had accelerated skeletal maturation; at age 6.0 years, this increased to 27.8%. x2 = 43.417, df = 5, P <0.01). Logistic regression analysis showed that children with overweight and obesity are more likely to have accelerated skeletal maturation than children with normal weight after adjusting for gender and age (Overweight, odds ratio [OR] = 3.27, 95% confidence interval [CI]: 2.20-4.87; Obese, OR = 4.73, 95% CI: 2.99-7.48). Conclusions: There is an association between accelerated skeletal maturation and overweight/obesity among preschool children. This study suggests that accelerated skeletal maturation might coexist with overweight/obesity in preschool children, and interventions, such as dietary modifications and increasing levels of physical activity, should be employed to prevent both accelerated skeletal maturation and overweight/obesity as early as preschool age.