Department of Oncology & Metabolism, University of Sheffield, Sheffield, UK.
College of Applied Medical Sciences, Najran University, Najran, Saudi Arabia.
Eur Radiol. 2019 Jun;29(6):2910-2923. doi: 10.1007/s00330-018-5792-5. Epub 2019 Jan 7.
To determine whether the Greulich and Pyle (G&P) atlas is applicable when applied to populations of different ethnicity.
A systematic review of studies published between 1959 and 15th February 2017 identified from the Embase, MEDLINE and Cochrane databases was undertaken. Quality of the studies was assessed using the National Institute for Health and Care Excellence tool. Meta-analysis used mean differences and standard deviations as summary statistics for the difference between bone age (BA) and chronological age (CA).
A total of 49 studies were included of which 27 (55%) were related to Caucasian populations. Of the 49 eligible studies, 35 were appropriate for further meta-analysis. In African females, meta-analysis showed a significant mean difference between BA and CA of 0.37 years (95% CI 0.04, 0.69). In Asian males, meta-analysis showed significant differences between BA and CA of -1.08, -1.35, -1.07, -0.80 and 0.50 years for chronological ages of 6, 7, 8, 9 and 17 years, respectively. Meta-analysis showed no significant differences between BA and CA in African males, Asian females, Caucasians and Hispanics.
The G&P standard is imprecise and should be used with caution when applied to Asian male and African female populations, particularly when aiming to determine chronological age for forensic/legal purposes.
• In African females, bone age is significantly advanced when compared to the G&P standard. • In Asian males, bone age is significantly delayed between 6 and 9 years old inclusive and significantly advanced at 17 years old when compared to the G&P standard. • The G&P atlas should be used with caution when applied to Asian and African populations, particularly when aiming to determine chronological age for forensic/legal purposes.
确定格雷尔利克-派尔（G&P）图谱在不同种族人群中的适用性。
对 1959 年至 2017 年 2 月 15 日期间在 Embase、MEDLINE 和 Cochrane 数据库中发表的研究进行了系统评价。使用英国国家卫生与临床优化研究所的工具评估研究质量。采用均数差和标准差作为骨龄（BA）与实际年龄（CA）差异的汇总统计量进行荟萃分析。
共纳入 49 项研究，其中 27 项（55%）与白种人群有关。在 49 项合格研究中，有 35 项适合进一步进行荟萃分析。在非洲女性中，荟萃分析显示 BA 与 CA 之间存在 0.37 年（95%CI：0.04，0.69）的显著平均差异。在亚洲男性中，荟萃分析显示，在 CA 为 6、7、8、9 和 17 岁时，BA 与 CA 之间的差异分别为-1.08、-1.35、-1.07、-0.80 和 0.50 年。荟萃分析显示，在非洲男性、亚洲女性、白种人和西班牙裔中，BA 与 CA 之间无显著差异。
G&P 标准不精确，在用于确定法医学/法律目的的实际年龄时，特别是在用于评估非洲女性和亚洲男性时，应谨慎使用。
与 G&P 标准相比，非洲女性的骨龄明显提前。
在亚洲男性中，6 岁至 9 岁的 BA 明显滞后，而 17 岁时 BA 明显提前。
在用于评估法医学/法律目的的实际年龄时，G&P 图谱在用于亚洲和非洲人群时应谨慎，特别是在用于评估法医学/法律目的的实际年龄时。
