Skeletal maturity of the hand in an East African group from Sudan

Am J Phys Anthropol. 2017 Aug;163(4):816-823. doi: 10.1002/ajpa.23247. Epub 2017 May 15.

Abstract

Objectives: Studies of skeletal maturity from Africa indicate a delay, reflected in a negative relative skeletal age (RSA). This study aims to evaluate the influence of age, socioeconomic status (SES) and nutritional status on skeletal maturation in a large sample of children from North Sudan.

Materials: The sample consisted 665 males and 1018 females from 3-25 years from Khartoum. Height, weight, age of menarche and, SES were recorded of patients attending for dental treatment.

Methods: Skeletal age was assigned from hand-wrist radiographs using the Greulich-Pyle (GP) atlas (1952). RSA (difference between skeletal and chronological ages) was compared in groups divided by age, sex, height-for-age and body-mass-index z scores, and SES. Spearman's correlation and student t-test was used to compare groups.

Results: Delayed skeletal age was noted across all age in boys. In girls, a delay was observed between ages 6-10, while advancement occurred between ages 13-18. Maturity was delayed in low height groups (p < .05) and low SES groups. RSA was negatively associated with HAZ in low SES males (R = -0.0.27, p < .001) and low SES females (R = -0.32, p < .001).

Conclusions: There were statistically significant skeletal delays in North Sudanese males and most pre-menarche females, low height and low SES groups. Post-menarche females were advanced relative to males and GP references. Low SES impacts were statistically correlated to skeletal delay.

Keywords: bone age; hand-wrist; socioeconomic status; undernutrition.

MeSH terms

  • Adolescent
  • Adult
  • Age Determination by Skeleton / methods*
  • Black People / statistics & numerical data*
  • Body Weights and Measures / standards*
  • Child
  • Child, Preschool
  • Female
  • Hand Bones / diagnostic imaging*
  • Humans
  • Infant
  • Male
  • Malnutrition
  • Menarche
  • Models, Statistical
  • Reference Values
  • Social Class
  • Sudan / epidemiology
  • Young Adult