Evidence map›Paper›PMID 42903116›Full record

ArticleFrontiers in endocrinology2026

Sex, BMI, skeletal maturation, and height among children and adolescents in high-altitude Xizang: a cross-sectional study.

Lihui Yang, Xiaoyong Yuan, Xiaolong Wu, Shuyou Meng, Xuemei Lv, Zhining Zhang

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Article in Frontiers in endocrinology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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5 · Who and what money

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6 authors.

Lihui YangDepartment of Science and Education, People's Hospital of Xizang Autonomous Region, Lhasa, Xizang, China.
Xiaoyong YuanDepartment of Endocrinology, Peking University First Hospital, Beijing, China.
Xiaolong WuSchool of Medicine, Tibet University, Lhasa, Xizang, China.
Shuyou MengDepartment of Endocrinology, People's Hospital of Xizang Autonomous Region, Lhasa, Xizang, China.
Xuemei LvDepartment of Endocrinology, People's Hospital of Xizang Autonomous Region, Lhasa, Xizang, China.
Zhining ZhangGraduate School of Medicine, Kyoto University, Kyoto, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Skeletal maturation influences the interpretation of childhood height, but its relationship with sex, body mass index (BMI), and attained height in children living at high altitude remains incompletely characterized. We examined concurrent associations among sex, BMI, bone-age deviation, and height relative to national reference values in children and adolescents living in Lhasa, Xizang. Methods: This cross-sectional study included 199 participants aged 3-16 years (101 girls and 98 boys). Bone-age deviation was defined as bone age minus chronological age. Height difference and BMI difference were calculated relative to age- and sex-specific national reference values. Multivariable linear regression incorporated centered chronological age and its quadratic term, ethnicity, BMI difference, and pubertal status, with HC3 heteroscedasticity-consistent standard errors. Statistical indirect associations through bone-age deviation were estimated using 5,000 participant-level bootstrap resamples. Results: Mean bone-age deviation was -0.64 ± 1.14 years. After adjustment, boys had a 0.65-year lower bone-age deviation than girls (95% CI, -0.96 to -0.33; P < 0.001). Each 1-kg/m² increase in BMI difference was associated with a 0.06-year increase in bone-age deviation (95% CI, 0.01 to 0.10; P = 0.010). Each 1-year increase in bone-age deviation was associated with a 2.76-cm greater height difference from the national reference (95% CI, 1.82 to 3.70; P < 0.001). The sex-related statistical indirect association through bone-age deviation was -1.78 cm (percentile 95% CI, -2.89 to -0.83; BCa 95% CI, -3.02 to -0.90). The corresponding direct association had confidence intervals spanning zero. Principal findings were generally retained in sensitivity analyses using grouped Tanner stages and after exclusion of influential or extreme observations. Conclusion: In this Lhasa sample, boys showed greater skeletal maturation delay than girls, and skeletal maturity was strongly associated with current height relative to national references. Higher BMI relative to the corresponding reference was associated with more advanced skeletal maturation. These cross-sectional findings describe statistical associations and do not establish temporal mediation or an altitude-specific causal effect.

Indexed as

AltitudeBody HeightBody Mass IndexBone DevelopmentAdolescentAge Determination by SkeletonChildChild, PreschoolChinaCross-Sectional StudiesFemaleHumansMaleSex Factorsbody mass indexbone agechildren and adolescentshigh altitudelinear growthpubertal developmentskeletal maturationXizang

Identifiers

PMID42903116
PMCPMC13680247

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.