title: Determinants of Advanced Bone Age in Childhood Obesity .
abstract: BACKGROUND
  Childhood obesity is associated with advanced bone age (BA). Previous studies suggest that androgens, oestrogens, sex hormone-binding globulin, and insulin are responsible for this phenomenon, but results are contradictory and might be biased by confounders. We aim to elucidate this matter by applying a multivariate approach.
  
  
  METHODS
  We performed a correlation analysis of BA standard deviation score (SDS) with age- and sex-specific SDS for androgens, oestrogens, and with indicators of insulin secretion derived from oral glucose tolerance testing, in a group of obese children. A multivariate analysis was performed to investigate which parameters were independently predictive of BA SDS.
  
  
  RESULTS
  In this cohort (n = 101; mean age 10.9 years; mean BA 11.8 years; mean BMI SDS 3.3), BMI SDS was significantly correlated to BA SDS (r = 0.55, p < 0.001). In a regression analysis in the total cohort (B = 0.27, p < 0.001) as well as in females (B = 0.34, p = 0.042), males (B = 0.31, p = 0.006), and pubertal children (B = 0.32, p = 0.046), dehydroepiandrosterone sulphate (DHEAS) showed a positive, independent association with BA SDS. No association with indicators of insulin secretion was found.
  
  
  CONCLUSIONS
  BMI SDS is highly correlated to BA SDS in obese children. Increased DHEAS has a central role in advanced BA in obese children. .
authors.affiliation: Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Cornelis J
authors.initials: CJ
authors.lastname: de Groot
authors.affiliation: Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Adriaan
authors.initials: A
authors.lastname: van den Berg
authors.affiliation: Department of Clinical Chemistry and Laboratory Medicine, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Bart E P B
authors.initials: BEPB
authors.lastname: Ballieux
authors.affiliation: Department of Radiology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Herman M
authors.initials: HM
authors.lastname: Kroon
authors.affiliation: Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.|Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Edmond H H M
authors.initials: EHHM
authors.lastname: Rings
authors.affiliation: Willem-Alexander Children's Hospital, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jan M
authors.initials: JM
authors.lastname: Wit
authors.affiliation: Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, the Netherlands.
authors.forename: Erica L T
authors.initials: ELT
authors.lastname: van den Akker
mesh_terms: D000293:Adolescent; D000728:Androgens / Q000097:blood*; D015519:Bone Density; D002648:Child; D003687:Dehydroepiandrosterone / Q000097:blood*; D004967:Estrogens / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D009765:Obesity / Q000378:metabolism* / Q000473:pathology; D011627:Puberty / Q000378:metabolism*
chemical_list: D000728:Androgens; D004967:Estrogens; D003687:Dehydroepiandrosterone
keywords: Androgens; Bone age; Dehydroepiandrosterone ; Insulin; Obesity