DIAGNOSIS OF ENDOCRINE DISEASE: On the need for national-, racial-, or ethnic-specific standards for the assessment of bone maturation

Hochberg, Zèev

doi:10.1530/eje-15-0673

Cited by 6 publications

(8 citation statements)

References 28 publications

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“…These points also highlight the need for carefully constructed, regularly updated skeletal maturation standards, along with improved understanding of the complex relationship between the myriad environmental, nutritional, anthropometric, genetic, and other factors that influence development of the pediatric skeleton. (40) In conclusion, in a non-obese, otherwise healthy cohort in the United States, we have shown that skeletal maturation is more advanced in AA children compared to non-AA children, accounting for age, body composition, and sexual maturation. This observation is novel, because previous studies have suggested that excess adiposity and earlier pubertal timing are sufficient to explain the more advanced skeletal maturation observed in AA children.…”

Section: Discussionmentioning

confidence: 57%

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Relative Skeletal Maturation and Population Ancestry in Nonobese Children and Adolescents

McCormack

Chesi

Mitchell

et al. 2017

Journal of Bone and Mineral Research

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More rapid skeletal maturation in African-American (AA) children is recognized and generally attributed to an increased prevalence of obesity. The objective of the present study was to evaluate the effects of population ancestry on relative skeletal maturation in healthy, non-obese children and adolescents, accounting for body composition and sexual maturation. To do this, we leveraged a multiethnic, mixed-longitudinal study with annual assessments for up to 7 years (The Bone Mineral Density in Childhood Study and its ancillary cohort) conducted at five US clinical centers. Participants included 1592 children, skeletally immature (45% females, 19% AA) who were aged 5 to 17 years at study entry. The primary outcome measure was relative skeletal maturation as assessed by hand-wrist radiograph. Additional covariates measured included anthropometrics, body composition by dual-energy X-ray absorptiometry (DXA), and Tanner stage of sexual maturation. Using mixed effects longitudinal models, without covariates, advancement in relative skeletal maturation was noted in self-reported AA girls (~0.33 years, p<0.001) and boys (~0.43 years, p<0.001). Boys and girls of all ancestry groups showed independent positive associations of height, lean mass, fat mass, and puberty with relative skeletal maturation. The effect of ancestry was attenuated but persistent after accounting for covariates: for girls, 0.12 years (ancestry by self-report, p = 0.12) or 0.29 years (ancestry by admixture, p = 0.004); and for boys, 0.20 years (ancestry by self-report, p = 0.0038) or 0.29 years (ancestry by admixture, p = 0.004). In summary, we conclude that advancement in relative skeletal maturation was associated with AA ancestry in healthy, non-obese children, independent of growth, body composition, and puberty. Further research into the mechanisms underlying this observation may provide insights into the regulation of skeletal maturation.

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Section: Discussionmentioning

confidence: 57%

Section: Discussionmentioning

confidence: 99%

Relative Skeletal Maturation and Population Ancestry in Nonobese Children and Adolescents

McCormack

Chesi

Mitchell

et al. 2017

Journal of Bone and Mineral Research

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“…Both GP and TW3 SAs have been labeled as the "current gold standards" for assessing skeletal maturity [99], while others refer to TW3 as the "gold standard" [102]. TW3 rather than TW2 has been recommended for use clinically [54] and as the "method of first choice" [52].…”

Section: Characteristics Of Players Who Had the Same Maturity Status mentioning

confidence: 99%

Tanner–Whitehouse Skeletal Ages in Male Youth Soccer Players: TW2 or TW3?

et al. 2017

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Background. The Tanner-Whitehouse radius-ulna-short bone protocol (TW2 RUS SA) is a widely used indicator of maturity status. The scale for converting ratings to an SA has been revised (TW3 RUS SA) which may have implications for studies of youth athletes.Objectives. To compare TW2 and TW3 RUS SAs in an international sample of youth soccer players and to compare distributions of players by maturity status defined by each SA Methods. SA assessments with the TW RUS method were collated for 1831 soccer players 11-17 years from 8 countries. RUS scores were converted to TW2 and TW3 SAs using the appropriate tables. SAs were compared within chronological age (CA) groups. The difference of SA minus CA with each method was used to classify players as late, average or early maturing. Concordance of maturity classifications with TW2 and TW3 SAs was evaluated with Cohen's Kappa coefficients.Results. For the same RUS score, SAs were systematically and substantially reduced with TW3 compared to TW2; mean differences ranged, on average, from -0.97 to -1.16 years. Kappa coefficients indicated fair concordance of maturity classifications based on TW2 and TW3 SAs.Conclusion. TW3 SAs were systematically lower than corresponding TW2 SAs in youth soccer players. The differences between scales have major implications for the classification of players by maturity status, which is central to many talent development programs.

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“… 29 Other authors argue that a unified international standard of bone maturity should be maintained for comparing health, nutrition, and quality of life of all children, regardless of their race, nationality, and ethnicity. 30 In this study, we selected the GP method, because it is the most popular method in Taiwan.…”

Section: Discussionmentioning

confidence: 99%

Recent pubertal timing trends in Northern Taiwanese children: Comparison with skeletal maturity

Chow

Chou

Tung

et al. 2020

Journal of the Chinese Medical Association

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Background: International studies have reported an early age of onset of puberty in girls and boys. However, the current situation of puberty onset in Taiwanese children is unknown. In this study, the timing of menarche and pubertal change in testicular volume (TV) in Taiwanese children was examined, and bone age (BA) was used as an internal somatic maturity scale and compared with the chronological age (CA) at pubertal timing. Methods: Clinical data from October 1, 2010, to March 31, 2018, were retrospectively collected from a general hospital in Taipei. The data of patients who were diagnosed with endocrine/genetic disorders were excluded. Clinical data included CA, timing of menarche, and X-ray images of TV and BA. BA was determined by a senior pediatrician and a senior pediatric radiologist. The reliability and validity of BA readings were tested. Collected data were analyzed statistically. Results: Overall, TV records of 241 boys and the menarche timing data of 98 girls were collected from 1823 children. CA for menarche was 11.35 ± 1.06 years (mean ± SD), and BA for menarche was 12.95 ± 0.80 years. CA and BA at TV = 15 mL in male puberty was 12.32 ± 1.22 and 13.46 ± 0.68 years, respectively. A stronger correlation was observed between TV and BA than between TV and CA during the pubertal period. Conclusion: The secular trend of earlier puberty timing continues. The decline rate of menarche timing was approximately 0.43 years per decade in the past 30 years. Among boys, an advance of more than 1 year in pubertal timing age was observed over the past 20 years. BA and TV showed high correlation during puberty.

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DIAGNOSIS OF ENDOCRINE DISEASE: On the need for national-, racial-, or ethnic-specific standards for the assessment of bone maturation

Cited by 6 publications

References 28 publications

Relative Skeletal Maturation and Population Ancestry in Nonobese Children and Adolescents

Relative Skeletal Maturation and Population Ancestry in Nonobese Children and Adolescents

Tanner–Whitehouse Skeletal Ages in Male Youth Soccer Players: TW2 or TW3?

Recent pubertal timing trends in Northern Taiwanese children: Comparison with skeletal maturity

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