The aim of this study was to explore whether skeletal bone age (biological maturation marker) and sex moderate the association between the phase angle with muscular strength and aerobic fitness in children and adolescents with diagnosed with HIV. The sample consisted of 62 children and adolescents (aged 8-15 years) diagnosed with HIV. The phase angle was determined using bioelectrical impedance analysis. Muscular strength was assessed by handgrip strength, and aerobic fitness was assessed by an incremental test on a cycle ergometer. Skeletal bone age and sex were determined through hand and wrist x-rays (Greulich-Pyle method) and a questionnaire, respectively. Both simple and multiple linear regression models were performed, and moderation models with P ≥ 0.05 were constructed. Among male children and adolescents with both normal and early skeletal bone age, muscular strength directly impacted phase angle values (b = 0.0197, P = 0.0001; b = 0.0286, P < 0.0001, respectively). However, for female children and adolescents, regardless of skeletal bone age, muscular strength did not influence the phase angle. In male children and adolescents with both normal and early skeletal bone age, aerobic fitness directly influenced the phase angle (b = 0.0007, P = 0.0001; b = 0.011, P = 0.0001, respectively). Similarly, in female children and adolescents with early skeletal bone age, aerobic fitness directly impacted the phase angle (b = 0.0006, P = 0.0282). Skeletal bone age and sex moderated the relationship between phase angle and both muscular strength and aerobic fitness, especially in children and adolescents with normal and early skeletal bone age, and predominantly in boys.
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