Bone age evaluation in an ethnically diverse cohort of children with premature adrenarche

Bone age (BA) advancement is an important consideration in the diagnostic workup of children with premature adrenarche. In this diverse cohort, BMI status, sex, race, and ethnicity were significantly associated with BA advancement, suggesting that both metabolic and demographic factors influence skeletal maturation. While BA advancement in obesity and premature adrenarche is recognized, this study underscores their combined effects and the variability across populations. These findings point to limitations in current BA standards and support the need for individualized interpretation. Further research should explore how BA advancement in obesity and across ethnic groups affects adult height and long-term outcomes.