[This corrects the article DOI: 10.3389/fnut.2026.1760511.].

Background:Childhood obesity represents a major global public health challenge. Its escalating prevalence poses significant risks to children's health and long-term development. While existing family-school collaborative interventions have demonstrated preliminary efficacy, the multifactorial etiology of obesity and the difficulty in sustaining outcomes highlight the need for further optimization of management models. We propose an innovative tripartite collaborative model, led by professional healthcare institutions to integrate family, school, and medical resources. This study aims to systematically evaluate the comprehensive effectiveness of this model in preventing and managing childhood obesity. Methods:This is a two-arm, open-label, cluster-sampled interventional study with a matched design, based on the "Dietary intake, Regular exercise, Education, Assessment, and Monitoring" (DREAM) framework. Eligible children and adolescents will be clustered by school. A one-academic-year intervention will be conducted in two matched schools. The intervention group will receive a comprehensive DREAM intervention facilitated by the Family-School-Healthcare collaborative model, while the control group will maintain conventional practices without additional interventions. The primary outcome is the change in body mass index (BMI) from baseline. Secondary outcomes include changes in obesity prevalence, anthropometric measurements, body composition, and metabolic indicators. Discussion:This study will implement and evaluate a novel Family-School-Healthcare collaborative management model, emphasizing the critical role of medical institutions in managing obesity as a chronic disease. Beyond BMI, the study will incorporate health-related metabolic indicators to provide a comprehensive assessment of the intervention effectiveness. The findings are expected to yield crucial evidence for the scientific prevention and control of childhood obesity, offering substantial theoretical and practical significance for the optimization of public health strategies. Trial Registration:Chinese Clinical Trial Registry (ChiCTR), ID: ChiCTR2300076418. Registered on 08 October 2023. Protocol version: 1.0.

Abstract Background Temple syndrome (TS14) is a rare imprinting disorder caused by dysregulation of imprinted genes in the 14q32 region. Although several cohorts have been reported, pediatric data from China are still lacking. This study aimed to characterize the clinical features in Chinese children with TS14 and evaluate their response to recombinant human growth hormone (rhGH), including outcomes associated with initiating treatment before two years of age. Methods A multicenter retrospective review was conducted involving seven children diagnosed with TS14 across six pediatric centers in China. Clinical characteristics, growth parameters, genetic testing, and treatment outcomes were extracted from medical records. Molecular diagnosis was established by methylation-specific assays, with additional molecular-genetic testing performed as indicated. Changes in height standard deviation score (SDS) were analyzed descriptively. Results Seven patients (1 male, 6 females) were included, with a median age at diagnosis of 2.0 (IQR: 0.67–7.33) years. Maternal UPD(14) was confirmed in one case and strongly suspected in three cases, whereas in the remaining three cases the underlying mechanism could not be determined. Most patients were small for gestational age (71.4%) and all exhibited growth retardation, delayed language development, dysmorphic features, with feeding difficulties (85.7%), and hypotonia (71.4%). All three older children subsequently developed central precocious puberty. Six patients who were initiated on rhGH therapy before puberty (median age at initiation, 2.42 years), achieved a mean height SDS increase of 1.19 after one year. Among the three patients treated before age two, the mean height SDS gain was 1.15, with caregiver-reported improvements in motor and language development, and no adverse events reported. Conclusions This inaugural TS14 cohort from China shows clinical features largely consistent with those reported in international cohorts, with a high frequency of precocious puberty among older patients. rhGH therapy yielded substantial short-term gains in height, and initiation of treatment before age two was accompanied by caregiver-reported developmental improvements, although standardized developmental assessments were not available. Early genetic diagnosis and timely intervention are essential, while long-term outcomes require further study.

Narrative medicine is a pedagogical tool for cultivating empathy, communication skills, and humanistic care. The application of narrative medicine methods has several limitations in paediatric training, particularly in China. This pilot study explored the preliminary association between narrative medicine training and the enhancement of empathy and communication skills among Chinese medical students during paediatric endocrinology rotations. Ten undergraduate medical students from Shenzhen University participated in 9.5 weeks of narrative medicine training (11 sessions), which was conducted in small groups during the hospitalization and post-discharge phases. The Jefferson Scale of Empathy and the Doctor–Patient Communication Behaviour Scale were administered before and after the intervention to evaluate the medical students’ empathy and communication skills. The differences in the pre-and post-intervention scores were compared using paired t tests. Compared with the baseline scores, the total Jefferson Scale of Empathy scores significantly increased post-intervention (133.10 ± 4.25 vs. 95.97 ± 8.90, P < 0.05), with increases in the scores of 19 items (P < 0.001 after correction for multiple testing). Similarly, compared with the baseline scores, the post-intervention total Doctor–Patient Communication Behaviour Scale scores significantly increased (155.45 ± 5.76 vs. 133.52 ± 3.81, P < 0.05), with all 6 items demonstrating significant increases (P < 0.001 after correction for multiple testing). Although the reported score changes are notable, they should be considered in the context of the study’s small sample size, the lack of a comparison group, and the potential influence of confounding factors. Narrative medicine training is associated with the potential to improve empathy and communication skills in paediatric contexts, which provides preliminary evidence for promoting the application of narrative medicine in the humanities training of paediatricians. Given the relatively late introduction of narrative medicine in China, its application in the training of Chinese medical students presents greater prospects and opportunities for the accumulation of more experience.

OBJECTIVE:To develop and validate a rapid, evidence-based benefit-risk assessment index for off-label drug use in pediatrics, thereby promoting standardized clinical decision-making. METHODS:Under the auspices of the Guangdong Pharmaceutical Association, a multidisciplinary expert panel from pediatrics, pharmacy, methodology, and ethics was convened. Systematic literature searches informed a preliminary index framework. Three Delphi rounds refined indicators. Weights were assigned using the analytic hierarchy process. Expert-based validation involved 20 hematology-oncology experts assessing 10 cases; intraclass correlation coefficient (ICC) and Spearman's correlations evaluated reliability and validity. RESULTS:The index consists of 2 primary dimensions (benefits: 56 points; risks: 44 points), 10 third-level, and 40 fourth-level indicators, with five prerequisites (e.g., no alternatives, informed consent). The ICC was 0.77 (good reliability); Spearman's correlations were rs = 0.97 (benefits) and rs = 0.68 (risks) (both p < 0.05), indicating strong alignment with expert consensus. Junior experts showed lower correlations (benefits rs = 0.89; risks rs = 0.56) than seniors (benefits rs = 0.97; risks rs = 0.78), highlighting the system's role in standardizing assessments. CONCLUSION:This quantitative index provides an evidence-based tool for pediatric off-label drug decisions, supporting clinicians, policymakers, and standardization efforts.

BACKGROUND:The purpose of the study was to evaluate the accuracy, safety, and usability of a real-time Continuous Glucose Monitoring (CGM) system compared with venous blood glucose (vBG) in children and adolescents. METHODS:The study enrolled 81 participants aged from 3 to 17 at three sites in China. Two sensors (GS1, SiBionics, Shenzhen) were inserted on the back of each upper arm for up to 14 days for each participant. A variety of analyses were conducted for evaluating accuracy by comparing the CGM readings and vBG values, including 20%/20 agreement rate, the mean absolute relative difference (MARD), the Clarke error grid, and consensus error grid analyses. Safety was measured by adverse event (AE) monitoring. AEs were documented, and the incidence rate was calculated. Usability was evaluated by self-reported questionnaires. RESULTS:Data from 80 participants were analyzed. Our results demonstrated high accuracy of the real-time CGM system. The 20%/20 agreement rate across all glycemic ranges was 93.9%. The MARD value was 8.7%. The results of the Clarke and consensus error grid analyses in zone A + B were 99.6% and 100%, respectively. The average score of usability was 95.3 ± 7.6, reflecting high satisfaction. The CGM also showed high safety, given that only 3 device-related AEs in 2 participants were reported , and no serious adverse events (SAEs) were reported. CONCLUSION:The real-time CGM system demonstrated high accuracy, safety, and usability in the glycemic monitoring of children and adolescents.

ObjectiveWe developed novel diagnostic prediction models for central precocious puberty (CPP) diagnosis in girls based on machine learning.MethodsIn this retrospective study, 2148 girls with PP from 4 centers in China were included, and divided into training group (n = 1048), validation group (n = 262), test group 1 (n = 270), test group 2 (n = 278), and test group 3 (n = 290). Diagnostic prediction models were developed based on logistic regression, linear support vector machine (SVM), RandomForest, XGBoost and fully connected neural network. Model discrimination was assessed with C-statistics and accuracy rates. Model calibration was analyzed by calibration curves.ResultsA total of eight independent predictors were screened by Lasso regression, including chronological age, disease course, height SDS, basal luteinizing hormone, bone age (BA) - chronological age (CA), height SDS for bone age, uterine volume, and larger ovarian volume. Among the five established prediction models, the SVM model demonstrated optimal performance, achieving AUC values of 0.850 in internal validation and 0.827 in external validation, accuracy rates of 78.6% in internal validation and 72.1% average in external validations. The model is displayed on the website: https://wuwenyong.shinyapps.io/CPPpredict/.ConclusionsThe SVM prediction model can assist diagnose CPP. Through the internal and multi-center external validations, the model showed good degree of discrimination and calibration.

Isolated growth hormone deficiency Type II (IGHD II) is a rare autosomal dominant disorder caused by heterozygous GH1 gene mutations. Recombinant human GH (rhGH) has long been the standard therapy, but long-term real-world data on long-acting GH (LAGH) in patients with IGHD II are limited. The coexistence of IGHD II with Chiari malformation type 1 (CM1) presents additional clinical challenges. We report an 8-year follow-up of a male patient diagnosed at 4 years 3 months with severe short stature (80.2 cm, -6.43 standard deviation score [SDS]). Endocrine evaluation revealed profound GH deficiency (peak GH 0.23 ng/mL) and markedly low insulin-like growth factor-1 (IGF-1) (<25 ng/mL). Magnetic resonance imaging showed pituitary hypoplasia (height 1 mm) and suspected CM1. Genetic sequencing identified a previously classified pathogenic, de novo heterozygous splice site mutation in GH1 intron 3 (c.291+1G>A). However, his cognitive evaluation indicated significant impairment at age 12 years. Initiation of weekly LAGH at 4.2 years resulted in rapid catch-up growth (height SDS +2.75 in the first year) and sustained normalization of IGF-1. The therapy was well tolerated over 8 years, with no adverse events or radiological progression of CM1. This is the first and longest reported real-world follow-up of weekly LAGH in a genetically confirmed IGHD II patient with CM1, supporting its safety and efficacy. The patient's cognitive impairment prompts reflection on the possibility that earlier detection and treatment might contribute to improved intellectual outcomes. This represents the longest real-world follow-up of weekly LAGH in genetically confirmed IGHD II complicated by CM1.

IntroductionContinuous energy restriction may be associated with poor adherence and a risk of muscle mass loss in pediatric obesity management. This study evaluated the effects of a structured “5 + 2” dietary management model—cycling 5 weekdays of calorie-restricted diet with 2 weekend days of high-protein diet—supported by standardized supplements and professional supervision.MethodsIn this prospective, non-randomized controlled trial conducted in Shenzhen, China, 84 children with persistent obesity (median age 11.1 years) were enrolled. The intervention group (N = 31) followed an 8-week “5 + 2” protocol with dietitian-led behavioral guidance and satiety-enhancing supplements, followed by a 12-week follow-up period. Controls (N = 53) received conventional weight-loss advice. Propensity score matching was employed to balance baseline cohorts (N = 74; 30 intervention, 44 control). Changes in weight, body composition, metabolic parameters, and behavior were assessed at weeks 8 and 20.ResultsAt week 8, the intervention group achieved significantly greater weight loss (−1.42 ± 1.73 kg vs. −0.44 ± 1.54 kg, p = 0.015) and body mass index (BMI) standard deviation score (SDS) reduction (−0.21 ± 0.14 vs. -0.11 ± 0.14, p = 0.005) compared to controls. The median behavior score in the intervention group improved significantly from 66.0 to 82.0 (p < 0.001), with marked increases in self-weighing frequency and physical activity. At the 20-week follow-up (post-summer break), the intervention group maintained greater reductions in body fat mass (−1.42 ± 3.41 vs. +1.84 ± 3.67 kg, p < 0.001) and greater skeletal muscle gain (3.90 ± 3.46 vs. 2.21 ± 2.36 kg, p = 0.031) than the control group, with significantly lower fat mass index (FMI) Z-scores and higher muscle mass index (MMI) Z-scores. Linear regression identified boys (β = −0.758, p = 0.015), older children (β = −0.240, p = 0.003) and children with higher baseline adherence (β = −0.356, p = 0.004) as key predictors for BMI SDS reduction.ConclusionThe “5 + 2” dietary management model was associated with favorable changes in body composition and health-related behaviors in children with obesity and may represent a practical dietary management strategy.

Little research has explored the association of exposure to phthalates and phenols with obesity in Chinese children and adolescents, especially with regard to co-exposure. The mechanisms by which exposure to phthalates or phenols contributes to obesity in children and adolescents remain unclear. Therefore, this case-control study was aimed at examining the effects of multiple phthalate and phenol exposures on obesity and further exploring the potential key role of insulin. The cross-sectional study involved 293 pairs of children and teenagers with obesity and normal weight matched on age (± 1 year) and sex. In addition, 21 urinary endocrine-disrupting chemicals (EDCs), including 11 phthalate metabolites and 10 phenols, were measured. The associations of individual EDCs and EDC mixtures with obesity were investigated using conditional logistic regression models, weighted quantile sum (WQS) analyses, and Bayesian kernel machine regression (BKMR). Mediation analyses were performed to evaluate the mediated effects of insulin on the relationships between EDCs and obesity. In the single-EDC model, the highest quartiles of mono-iso-butyl phthalate (MiBP), mono-2-ethyl-5-hydroxyhexyl phthalate (MEHHP), mono-2-carboxymethylhexyl phthalate (MCMHP), and bisphenol A (BPA) were positively associated with obesity compared to their lowest quartiles. In mixed-exposure analyses, the WQS and BKMR model results consistently suggested that exposure to phthalate and phenol mixtures showed a positive association with obesity. BPA was identified as an essential exposure in the mixture with dominant effects on obesity in children and adolescents. Further mediation analysis revealed that insulin partly mediated the relationship between BPA and obesity, with the proportion of mediation at 50.13

Abstract Objectives To prospectively evaluate the correlation between the attenuation imaging (ATI) parameter and hepatic steatosis in overweight (OW)/obese (OB) children, and to establish normal ATI reference values from a prospectively enrolled cohort of healthy children. Materials and methods A total of 653 prospectively enrolled children were categorized into OW, OB, and normal control groups based on body mass index (BMI). Ultrasonographic hepatic steatosis grading and ATI measurements were independently assessed by two radiologists. Hepatic steatosis was graded visually as none, mild, moderate, or severe. Results The final study cohort consisted of 97 OW, 292 OB, and 264 control children. Median attenuation coefficient obtained with ATI for normal control group, OW group, and OB group were 0.51, 0.54, and 0.64 dB/cm/MHz, respectively. Statistically significant differences in ATI values were observed among all three groups (all p < 0.001). In the combined OW/OB subgroup, ATI values demonstrated a significant weak to strong positive correlation with age, height, weight, BMI, skin-to-liver distance, serum alanine aminotransferase, aspartate aminotransferase, triglycerides, and uric acid (all p < 0.05). Additionally, ATI values increased stepwise with the severity of hepatic steatosis and showed a statistically significant positive correlation with steatosis grade, with higher grades corresponding to greater ATI values (η² = 0.626, p < 0.001). Conclusions ATI values exhibit a significant stepwise increase across healthy, OW, and OB pediatric cohorts, and correlate with anthropometric/metabolic profiles and ultrasonographic steatosis severity. This evidence positions ATI as a non-invasive tool to grade severity and monitor treatment response in metabolic-associated steatotic liver disease. Critical relevance statement ATI shows significant increases across pediatric weight groups, correlating with metabolic profiles and steatosis severity, positioning it as a non-invasive metabolic-associated steatotic liver disease assessment tool. Key Points The ATI value increased significantly in a stepwise manner from healthy controls to OW and OB children, confirming its sensitivity to fat-related liver changes. ATI correlates significantly with most metabolic and anthropometric parameters in OW and OB children, suggesting its utility in reflecting metabolic status. ATI values increase progressively with hepatic steatosis severity and show a strong positive correlation with ultrasonographic steatosis grade. Graphical Abstract

Recombinant human growth hormone (rhGH) treatment for idiopathic short stature (ISS) in China faces challenges including delayed initiation, poor persistence, limited adoption of advanced therapies, and conservative dosing. This study characterized real-world temporal and geographical patterns of rhGH therapy and identified associated socioeconomic factors. Data from two nationwide registries comprising 24,384 children with ISS initiating rhGH were analyzed. Predictors of treatment effectiveness were identified via linear regression. Provincial variations and temporal trends were assessed via descriptive analysis and seasonal-trend decomposition. Spearman correlation was used to examine associations between treatment patterns and socioeconomic indicators. The median rhGH initiation age was 8.45 years. Most patients (81.3

Objective:Novel obesity indices, the body roundness index (BRI) and a body shape index (ABSI), have been proved to be superior over body mass index (BMI) for predicting metabolic syndrome and cardiovascular events in adults. However, their performance in pediatric populations remains unexplored. Study design:A large-scale cross-sectional study, Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen (EMSNGS) project, was conducted in 2021 including 4,794 children and adolescents aged 6-17 years. Quantile regression models were used to analyse factors influencing ABSI and BRI. Associations between the 2 novel obesity indices and cardiovascular metabolic risk index (CMRI) were evaluated using logistic regression and receiver operating characteristic (ROC) curves. Results:In total, 1,971 participants (1,131 boys, 840 girls) exhibited CMRI ≥1. BRI was associated with pubertal development and weight status in both sexes. ABSI was only associated with weight status. BRI was associated with CMRI ≥1, whereas ABSI was not (P > 0.05). Compared with waist-to-hip ratio, waist-to-height ratio, and BMI, BRI at the 75th percentile (BRI P75th) demonstrated optimal sensitivity-specificity balance. The area under the ROC curve (95% CI), sensitivity, specificity, and Youden index were 0.752 (0.732-0.771), 71.3%, 79.1%, and 0.504 for boys and 0.693 (0.670-0.716), 61.8%, 76.8%, and 0.386 for girls, respectively. Conclusion:After adjustment for sex and pubertal stages, BRI P75th remained significantly associated with elevated cardiometabolic risk in children and adolescents, supporting its potential utility as an early screening indicator.

The study aimed to investigate the prevalence of osteoporosis in children and adolescents with transfusion-dependent thalassemia (TDT) and evaluate the diagnostic value of different osteoporosis indicators. Clinical data were collected from children and adolescents with TDT treated with blood transfusion between March 2022 and January 2024 at Huizhou Central People’s Hospital and Huizhou First Hospital. The patients were grouped according to the presence of osteoporosis (International Society for Clinical Densitometry [ISCD] criteria). Of 138 patients included in the study, 48 (34.8

Sitosterolemia represents a rare autosomal recessive disorder of lipid metabolism, defined by the pathological accumulation of phytosterols—notably sitosterol and campesterol—in both plasma and tissues. This biochemical aberration precipitates severe clinical sequelae, including premature atherosclerosis, hemolytic anemia, and arthritis. The etiology is firmly established as loss-of-function mutations in ABCG5 and ABCG8, which encode critical sterol efflux transporters. This review systematically dissects the molecular genetic architecture of sitosterolemia, offering a comprehensive evaluation of the ABCG5/ABCG8 mutation spectrum. Our analysis encompasses canonical homozygous and compound heterozygous variants, while also addressing the emerging significance of monoallelic heterozygous mutations. We further examine how specific genotypic alterations impair transporter function and correlate with phenotypic severity. Moreover, by synthesizing recent findings, we investigate whether heterozygous carriers manifest subclinical traits characterized by incomplete penetrance and assess their associated pathogenic risks. Ultimately, this work establishes a robust theoretical framework to advance precise diagnosis, refine genetic counseling strategies, and facilitate personalized clinical management of sitosterolemia.

Within the bone microenvironment, the intricate interplay and regulation among matrix components form a complex network. Disentangling this network is crucial for uncovering potential therapeutic targets in bone pathology. Osteocalcin (OCN), the most abundant non-collagenous bone protein, is an essential node within this network. However, the function of OCN in bone mineralization remains controversial. By combining in vitro and in vivo approaches, we evaluated the function and mechanism of OCN and its derived peptides on bone formation and mineralization. CRISPR/Cas9-mediated OCN knockout mice exhibited reduced bone mineral density, compromised biomechanical strength, and impaired osteogenic differentiation in BMSCs. Raman spectroscopy revealed diminished crystal size and atomic order in Hydroxyapatite (HAp) of OCN- /- bone. Further studies using atomic force microscopy and nano-isothermal titration calorimetry identified OCN and its derived peptide OC22 as enhancers of collagen stiffness via affinity for HAp. These findings establish OCN as a positive regulator of bone mineralization, and provide mechanistic insights for targeting bone-related pathologies.

BACKGROUND:To examine the characteristics and factors associated with bone maturation among children aged 6-15 years in Shenzhen, stratified by sex, age, and pubertal stage. METHODS:The Evaluation and Monitoring on School-based Nutrition and Growth in Shenzhen, China' data on body mass index, body composition, bone age (BA), and biochemical examinations were analyzed. The Z-score of BA minus chronological age (ZBA-CA) was calculated for the same sex, age, and pubertal stage. RESULTS:We included 3780 students aged 6-15 years, comprising 2091 (55.3%) boys and 1689 (44.7%) girls. The proportions of children with BA advancement ≥2 years were 10.1% for boys and 9.9% for girls. We established the standard deviation curves of BA-CA for boys and girls with normal weights at different ages under different pubertal stages. Visceral fat area rank (VFA-R) and relative handgrip strength rank (RHGS-R) correlated positively with ZBA-CA at each quantile in boys, while only VFA-R correlated positively in girls. CONCLUSIONS:Bone maturation should be evaluated according to sex, age, nutritional status, and pubertal stage. VFA-R and RHGS-R were positively correlated with ZBA-CA, independent of the nutritional status. IMPACT STATEMENT:We produced the first standard deviation curves of bone age minus chronological age (BA-CA) for children aged 6-15 years, stratified by sex, age and pubertal stage, to evaluate bone maturation. Our findings revealed that body composition index might affect bone maturation independent of nutritional status. Body mass index, commonly used to evaluate obese children with advanced bone age, does not account for differences and relationship between body composition and bone maturation. These findings offer valuable insights for clinical practice to formulate targeted interventions for slowing down bone maturation and improving growth-related disorders' management in children.

BackgroundCentral obesity in children represents a significant public health concern due to its strong association with an elevated risk of metabolic and cardiovascular disorders. The systemic immune inflammation index (SII) has been implicated in the pathophysiology of obesity-related chronic inflammation. Despite its potential relevance, the specific relationship between central obesity and SII in the pediatric population remains insufficiently explored. The objective of this study was to examine the relationship between SII and central obesity, with a particular focus on the potential of SII as a predictor of central obesity and a means of preventing obesity at an early stage of life.MethodsWaist-to-height ratio (WHtR), subcutaneous fat, and visceral fat were employed as obesity proxies. Central obesity was defined according to WHtR with a cutoff value of 0.46. The implications of SII on central obesity were examined in a sample of 4,730 individuals in 2021 and validated through a prospective study involving 1,425 subjects in 2023. Cross-sectional associations between SII and central obesity were examined using binomial logistic regression models and generalized linear models. The restricted cubic spline regression was used to explore the non-linear relationship between SII and obesity indicators. In a prospective study, we employed a modified Poisson regression model to investigate the potential causal relationship between SII and central obesity.ResultsCross-sectionally, adolescents in the highest quartile of SII levels exhibited the greatest risk for central obesity(OR=3.07, 95% CI:2.45~3.87) when compared to those in the lowest quartile. Subgroup analyses showed that higher SII was associated with central obesity. Longitudinally, individuals in the highest SII quartile were found to have the highest risk of developing central obesity (RR=1.83, 95% CI:1.18~2.83) over time.

Bone age assessment and adult height prediction are essential for evaluating pediatric growth. Traditional methods rely on manual radiographic interpretation, which is subjective, time-consuming, and prone to inter-observer variability. This study presents an automated approach using a cascaded deep learning model to assess bone age and predict adult height from pediatric hand radiographs, aiming to improve diagnostic objectivity and efficiency. A total of 8,242 left-hand radiographs from Chinese children were retrospectively collected. Bone age was annotated by experienced pediatric endocrinologists using the China-05 standard. The model employed Yolact for instance segmentation to detect and classify bone structures, followed by parallel ResNet-18 subnetworks to grade ossification centers in the radius, ulna, and metacarpal/phalangeal bones. Predicted grades were integrated using a standardized scoring system to estimate bone age. A regression model then predicted adult height based on these features. The model achieved a Pearson correlation of 0.98 ( p<0.001 ) for bone age and 0.94 ( p<0.001 ) for adult height predictions. Bland-Altman analysis showed minimal bias and narrow limits of agreement. Mean absolute errors were 0.25 years for bone age and 1.75 cm for adult height. Average inference time was 7.8 seconds, significantly enhancing clinical efficiency. The proposed cascaded deep learning model delivers accurate, efficient, and reliable bone age assessment and adult height prediction, offering strong potential for clinical integration in pediatric growth evaluation.