Influence of Socioeconomic Status and Body Mass Index on Bone Age

Abstract

Background/Aims: To evaluate the relationship of socioeconomic status (SES) and body mass index (BMI) with skeletal maturation in children from Marrakech (Morocco). Methods: SES, BMI z-score and bone age (BA) were measured in a cohort of 623 children (280 boys and 343 girls, chronological age (CA) ranged from 6.6 to 18.8 years, mean 14.1 years). BA estimation was performed with the Greulich and Pyle atlas. Two social groups (privileged and unfavorable SES) were defined. A multiple linear regression analysis was performed to assess the relationship between BA-CA and age-and sex-specific BMI z-score. Results: Global maturation delay was seen in the sample (BA-CA –0.56; SD 1.29). There was a significant relationship between skeletal maturation (BA-CA) and child BMI z-score among both genders. Bone age was more advanced in children with a greater BMI z-score. Privileged SES was positively associated with children’s BA-CA for girls but there was no association for boys. In the boys’ sample, there was no evidence that BA-CA variations with BMI z-score depended on socioeconomic status (p = 0.664). Whatever the gender of the child, a greater BMI z-score increases the maturation. Conclusion: The multiple linear regression analysis is an interesting approach to understand the links between skeletal maturation, BMI and SES. In Moroccan children, excess weight is associated with privileged SES.

Association of bone age with overweight and obesity in children in the age group of 8 to 11 years

“…Chaumoitre et al who did a study of the influence of BMI and socio economic status on bone age between 6 to 18years had most children between the age group of 15 years. 19 Most of the children from the obese group were from the age group of 8 to 9 years and most of the obese children were female (66.7%). Most children in the overweight children were from the age group of 8 to 9 years and were male.…”

Socioeconomic Status and Bone Mass in Spanish Adolescents. The HELENA Study

“…Some studies reported positive associations among SES and bone-related variables (i.e., bone age, whole-body BMC and BMD, and distal forearm and calcaneus BMD) in children and adolescents, after taking into account the role of confounders, such as age, sexual maturation, height, and weight [12][13][14][15]. In addition, Arabi et al [36] showed that boys and girls of higher SES tended to have higher BMD than those from a lower SES at the subtotal body (whole body minus head), lumbar spine, forearm, total hip, femoral neck, and trochanter sites.…”

“…Parental education and occupation were also included as measures of SES [12,13,[15][16][17]25]. In the present study, parental education included four categories: lower education, lower secondary education, higher secondary education, and higher education or university degree.…”

“…Because of its influence on PA and nutrition, it can be hypothesized that SES may play a role in the development of bone mass, yet this association is still poorly understood. Some studies have observed that the higher the SES, the higher the bone mass in children and adolescents [12][13][14][15], whereas others have observed the opposite [16] or no association [13,17,18]. Some of these studies have not taken into account relevant confounders, such as PA or lean mass, which make comparison and interpretation of the results difficult.…”

“…Although the methodology for assessing SES largely differs among studies, some SES indicators have been commonly used, such as parental education and occupation [12,13,[15][16][17]. The Family Affluence Scale (FAS) is another SES indicator that refers to the family expenditure and consumption and has shown to have a good validity in young population [19,20].…”