Molinari L, Gasser T, Largo R H
Abteilung Wachstum und Entwicklung, Universitätskinderklinik, Steinwiesstrasse 75, CH-8032 Zurich, Switzerland.
Ann Hum Biol. 2004 Jul-Aug;31(4):421-35. doi: 10.1080/03014460410001723969.
Longitudinal data on bone age progression is scarce.
The study aimed to present reference values for Tanner-Whitehouse 3 (TW3) bone age score and score increments, and to provide means and standard deviations of appearance time for all TW3 stages. Gender differences and differences between radio ulna and short bones (RUS) and carpal bone (CB) scores were studied.
Bone age data collected for ages 3 months to 20 years in 232 subjects during the First Zurich Longitudinal Study (1954-1976) were used. Smoothed empirical percentiles of TW3 RUS and CB scores for age, of score increments for age and of score increments for attained score are presented. Means and standard deviations of the appearance times are calculated by parametric censored regression.
There are clear differences between the RUS and CB scores and between the genders. Boys are delayed with respect to girls, with different delays for RUS and CB. For RUS, differences in maturation reflect the known differences of physical growth, with a later and more intense peak in boys. For CB, there is little difference in timing and intensity. However, girls reach the final score about 2 years earlier than boys. The consistently earlier mean appearance times in girls indicate that skeletal maturation is, already in childhood, more rapid in girls than in boys. There are significant gender differences in the sequence of appearance.
Reference values for TW3 score and score increments and mean appearance times for stages add to existing knowledge and indicate important RUS/CB and gender differences, whose sources are largely unknown.
关于骨龄进展的纵向数据稀缺。
本研究旨在给出坦纳-怀特豪斯3型（TW3）骨龄评分及评分增量的参考值，并提供所有TW3分期出现时间的均值和标准差。研究了性别差异以及桡尺骨和短骨（RUS）与腕骨（CB）评分之间的差异。
使用了在第一次苏黎世纵向研究（1954 - 1976年）期间收集的232名3个月至20岁受试者的骨龄数据。给出了TW3 RUS和CB评分随年龄、评分增量随年龄以及评分增量随已得分数的平滑经验百分位数。出现时间的均值和标准差通过参数删失回归计算得出。
RUS和CB评分之间以及性别之间存在明显差异。男孩相对于女孩发育延迟，RUS和CB的延迟情况不同。对于RUS，成熟度的差异反映了已知的身体生长差异，男孩的峰值出现较晚且更强烈。对于CB，在时间和强度上差异不大。然而，女孩比男孩提前约2年达到最终评分。女孩始终较早的平均出现时间表明，骨骼成熟在儿童期就已经在女孩中比在男孩中更快。在出现顺序上存在显著的性别差异。
TW3评分及评分增量的参考值以及各分期的平均出现时间丰富了现有知识，并表明了重要的RUS/CB和性别差异，其来源在很大程度上尚不清楚。
