长春地区6 231例儿童青少年骨龄状况分析

Bone age status of 6 231 children and adolescents in Changchun area

摘要

目的 分析长春地区儿童青少年的骨龄分布特征及其关键影响因素(性别、年龄、营养状况),为该地区儿童生长发育评估及相关疾病干预提供数据支持。方法 采用横断面研究,收集并分析2021年1月—2024年6月于长春中医药大学附属医院儿童诊疗中心儿童保健科就诊的2~18岁儿童青少年的体格检查及骨龄(BA)数据。骨龄采用中华05法评估,计算骨龄与生理年龄的差值(BAD)。使用多元logistic回归等方法分析影响因素。结果 研究共纳入6 231名儿童青少年,骨龄提前或滞后(|BAD|≥1岁)的检出率为37.63%(2 345/6 231)。整体平均BAD为(0.17±1.12)岁。骨骼发育存在性别差异,女童BAD高于男童,差异有统计学意义(t=8.501,P＜0.05)。营养状况是骨龄差异的核心影响因素,与正常体重组相比,肥胖组儿童骨龄提前的风险显著增加(OR=4.109,P<0.001),其中男性平均BAD达到(1.04±1.12)岁,女性为(1.20±1.01)岁。年龄分层显示,7岁后儿童的骨龄开始普遍超越生理年龄(P<0.001)。结论 长春地区儿童青少年的骨骼发育受性别、年龄和营养状况的显著影响。女童骨骼发育普遍早于男童。超重与肥胖是导致骨龄提前的主要风险因素,提示应将体重管理作为儿童生长发育保健的关键环节。

Abstract

Objective To analyze the characteristics of bone age (BA) distribution and its key influencing factors—specifically gender, age, and nutritional status—among children and adolescents in the Changchun region, in order to provide data support for growth assessment and intervention strategies for related disorders. Methods A cross-sectional study was conducted involving children and adolescents aged 2 - 18 years who visited the Department of Child Health Care at the Children′s Medical Center, Affiliated Hospital of Changchun University of Chinese Medicine, between January 2021 and June 2024. Physical examination and BA data were collected. BA was assessed using the China 05 method, and the bone age difference (BAD) was calculated as BA minus chronological age (CA). Multivariate logistic regression analysis was employed to identify influencing factors. Results A total of 6 231 participants were enrolled. The prevalence of significant BA deviation (|BAD|≥1 year), indicating either advanced or delayed development) was 37.63% (2 345/6 231).The overall mean BAD was (0.17±1.12) year. Significant gender differences in skeletal development were observed, with females exhibiting higher BAD values than males (t=8.501, P<0.05). Nutritional status emerged as a core influencing factor; compared to the normal-weight group, the obesity group showed a significantly increased risk of advanced bone age (OR=4.109, P<0.001), with mean BAD values reaching (1.04±1.12)years for males and (1.20±1.01) years for females. Age stratification analysis indicated that after age 7, BA generally exceeded chronological age (P<0.001). Conclusions Skeletal development among children and adolescents in Changchun region is significantly influenced by gender, age, and nutritional status. Generally, skeletal maturation in females precedes that in males. Overweight and obesity are identified as the primary risk factors for advanced bone age, suggesting that weight management should be prioritized as a critical component of pediatric growth and development healthcare.

关键词

生长发育 / 青少年 / 骨龄 / 肥胖

Key words

growth and development / adolescents / bone age / obesity

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基金资助

吉林省自然科学基金(20200201486JC);吉林省科技发展计划项目(20230203103SF)