US Evaluation of Bone Age in Rural Ecuadorian Children: Association with Anthropometry and Nutrition.

Background Stunted growth and development is a serious global public health problem. A limited number of field measures exist that can be used to evaluate stunting and its underlying biologic mechanisms. Purpose To assess bone age using tablet-based US in young children living in a rural community in Ecuador, where stunting is prevalent, and to evaluate the associations between bone age, anthropometry, and diet. Materials and Methods From June through August 2017, tablet-based US was used to assess bone age in young children within their homes in rural Cotopaxi, Ecuador. Bone age scores (BAZs) were assigned using the standards of Greulich and Pyle. Anthropometric data were collected using international protocols; scores were generated from World Health Organization Child Growth Standards. Groups were compared using the Student test. Univariate analyses and generalized linear regression modeling were applied to test the association between bone age and anthropometry, adjusting for covariates including age, sex, dietary intake, and morbidities. Results A total of 128 children (mean age, 33.9 months ± 1.8 [standard deviation]; 59 girls, 69 boys) were evaluated. Mean BAZ was -1.20 ± 1.16. Mean BAZ was lower in children with stunted growth (-1.42 ± 1.18) than in children without stunted growth (-0.98 ± 1.10, = .04). In adjusted analysis, BAZ was associated with the following variables: height-for-age score (β coefficient, 0.26; 95% confidence interval [CI]: 0.05, 0.46; = .01), female sex (β coefficient, 0.51; 95% CI: 0.15, 0.88; = .006), number of times eggs were consumed in the previous 24 hours (β coefficient, 0.22; 95% CI: 0.05, 0.38; = .009), number of times savory or salty snacks were consumed in the previous 24 hours (β coefficient, 0.42; 95% CI: 0.15, 0.68; = .002), and ownership of pig livestock, which was a binary variable (β coefficient, -0.46; 95% CI: -0.82, -0.09; = .01). Conclusion Bone age determined using tablet-based US was lower in children who had stunted growth and was associated with diet in a cohort of children living in rural Ecuador. © RSNA, 2020 See also the editorial by Dillman and Ayyala in this issue.