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The association between bone age advancement and insulin in prepubertal children with obesity


Obesity is associated with bone age (BA) advancement of unclear etiology. In animal study, insulin may directly modulate skeletal growth. Our objective was to investigate the association with BA maturation and insulin levels in children with overweight and obesity.


In this cross-sectional study of 103 prepubertal children, anthropometric data and hormonal values during oral glucose tolerance test were measured. Subjects were divided into two groups by the difference between BA and chronological age (CA) (noted as BA-CA).


The study population included 49 (47.6%) males and 54 (52.4%) females with a mean age of 7.6 ± 1.6 years. The advanced bone age group defined as BA-CA>1 year (n=53) had significantly higher HOMA-IR, fasting insulin levels and lower quantitative insulin sensitivity check index (QUICKI). Also, BA-CA was significantly correlated with fasting insulin (r=0.315, P<0.001), HOMA-IR (r=0.288, P<0.001), and QUICKI (r=-0.353, P<0.001). In multiple regression analysis, fasting insulin was identified as significant independent predictors for BA-CA.


Skeletal age is more advanced in overweight and obese children with hyperinsulinemia and insulin resistance. These findings suggest that insulin may modulate skeletal growth.

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This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver ( applies to the data made available in this article, unless otherwise stated.

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Lee, H.S., Jeong, H.R., Kwon, E. et al. The association between bone age advancement and insulin in prepubertal children with obesity. Int J Pediatr Endocrinol 2015 (Suppl 1), P71 (2015).

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