骨成熟影响因素的研究进展

Factors affecting skeletal maturation

骨成熟是指从骨化中心的出现到骨骺和干骺端形状的改变和增大直至骨骺融合的过程。通常以骨龄来衡量骨发育成熟的程度,反映儿童生长发育的水平。骨成熟的过程受到多种因素的影响,主要包括内分泌因素(雌激素、肾上腺激素、生长激素和甲状腺激素)与非内分泌因素(营养、慢性疾病、环境/饮食和遗传等)。目前尚未对其建立科学的评价体系,部分影响因素(如胰岛素样生长因子-1、瘦素、性激素结合球蛋白、胰岛素等)的作用仍结论不一。故该文就骨成熟影响因素的研究进展作一简要综述,为儿童生长发育评估、疾病诊断和治疗效果评价、个体化方案制定提供依据,也为进一步研究提供参考。

Skeletal maturation is a complex process involving the appearance of ossification centers,the width and capping of the epiphysis,and the fusion of the epiphysis.Bone age is considered to be a valuable tool in assessing children′s skeletal maturity and evaluating growth.Many factors influence the progress of skeletal maturation,which are mainly devided into endocrine and non-endocrine ones.The former include estrogen,adrenal hormone,growth hormone,and thyroid hormone.The latter contain nutrition,chronic disease,environment or diet,genetics,etc.But there is not a scientific system that has been established.Whether some factors are responsible for skeletal maturation is still controversial,such as insulin-like growth factor-1,leptin,sex hormone binding globulin,insulin and so on.This review focuses on the factors affecting skeletal maturation.It is expected to develop individualized programs in the clinical evaluation and management of children with growth and related diseases,and to provide references for further research.