Pediatric Endocrinology Unit, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil.
Molecular Medicine Laboratory, Santa Casa de São Paulo School of Medical Sciences, 112 Dr. Cesário Mota Jr. St., São Paulo, CEP 01221-020, Brazil.
Pediatr Radiol. 2019 Aug;49(9):1185-1191. doi: 10.1007/s00247-019-04435-z. Epub 2019 May 31.
Bone age determination is usually employed to evaluate growth disorders and their treatment. The Greulich-Pyle method is the simplest and most frequently used type of evaluation, but it presents huge interobserver variability. The BoneXpert is a computer-automated method developed to avoid significant bone age variability among distinct observers.
To compare the BoneXpert and Greulich-Pyle methods of bone age determination in eutrophic children and adolescents, as well as in overweight and obese pediatric patients.
The sample comprised 515 participants, 253 boys (159 eutrophic, 53 overweight and 41 obese) and 262 girls (146 eutrophic, 76 overweight and 40 obese). Left hand and wrist radiographs were acquired for bone age determination using both methods.
There was a positive correlation between chronological age and Greulich-Pyle, chronological age and BoneXpert, and Greulich-Pyle and BoneXpert. There was a significant increase (P<0.05) in bone age in both the Greulich-Pyle and BoneXpert methods in obese boys when compared to eutrophic or overweight boys of the same age. In girls, there was an increase in bone age in both obese and overweight individuals when compared to eutrophic girls (P<0.05). The Greulich-Pyle bone age was advanced in comparison to that of BoneXpert in all groups, except in obese boys, in which bone age was similarly advanced in both methods.
The BoneXpert computer-automated bone age determination method showed a significant positive correlation with chronological age and Greulich-Pyle. Furthermore, the impact of being overweight or obese on bone age could be identified by both methods.
骨龄测定通常用于评估生长障碍及其治疗。Greulich-Pyle 法是最简单和最常用的评估方法，但它存在巨大的观察者间变异性。BoneXpert 是一种计算机自动方法，旨在避免不同观察者之间显著的骨龄变异性。
比较 BoneXpert 和 Greulich-Pyle 两种骨龄测定方法在营养良好的儿童和青少年以及超重和肥胖的儿科患者中的应用。
该样本包括 515 名参与者，253 名男孩（159 名营养良好、53 名超重和 41 名肥胖）和 262 名女孩（146 名营养良好、76 名超重和 40 名肥胖）。使用两种方法对左手和腕关节进行 X 线摄影以确定骨龄。
Greulich-Pyle 与实际年龄、BoneXpert 与实际年龄以及 Greulich-Pyle 与 BoneXpert 之间存在正相关关系。与同龄的营养良好或超重男孩相比，肥胖男孩的 Greulich-Pyle 和 BoneXpert 骨龄均显著增加（P<0.05）。与营养良好的女孩相比，肥胖和超重女孩的两种方法的骨龄均增加（P<0.05）。与 BoneXpert 相比，除肥胖男孩外，所有组的 Greulich-Pyle 骨龄均提前，而在肥胖男孩中，两种方法的骨龄均提前。
BoneXpert 计算机自动骨龄测定方法与实际年龄和 Greulich-Pyle 呈显著正相关。此外，两种方法都可以识别超重或肥胖对骨龄的影响。
