It was often difficult to determine the time sequence of exposure and outcome, so its causal verification ability was weak. 2022 Apr 4;14(7):1506. doi: 10.3390/nu14071506. The team found a positive and statistically significant association between total body obesity and precocious puberty from four to seven years of age, with 45 boys (9.1%) starting puberty early. The behavior of maximum likelihood estimates under nonstandard conditions. In studies with a case-control design, the risk of early puberty related to childhood overweight/obesity (OR: 4.80, 95% CI: 1.8512.43; p<0.001) was significantly higher than that in studies with a cohort design (OR: 1.24, 95% CI: 1.081.43; p = 0.020). Girls grow 2-8 inches (5-20 centimeters) taller, while boys grow 4-12 inches (10-30 centimeters) taller. The younger siblings BMI at 7years was comparable to the older siblings BMI: mean difference 0.0 (standard deviation: 1.9) kg/m2. Meta-analytic pooling of these risk estimates yielded a summary OR of 2.22 (95% CI 1.652.99), with substantial heterogeneity (I2 = 94%, p < 0.001). For girls, puberty can begin as early as eight years old, with most instances of early puberty linked to childhood obesity. Talk to our Chatbot to narrow down your search. The process can take up to 4 years. Obesity could still be to blame, but a closer examination is needed, Kelsey said. Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life. In girls, it can. The .gov means its official. The new PMC design is here! Obesity may contribute to early onset of puberty in . The Chi-square test was used to estimate whether the variance between studies was ascribed to chance and the I2 statistic was used to estimate the proportion of total variation in prevalence evaluations owing to statistical heterogeneity instead of sampling error. Relation of age at menarche to race, time period, and anthropometric dimensions: the Bogalusa Heart Study, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021264649, Obesity: BMI of 95 percentile Overweight: 85th BMI to 94th percentile, Early menarche was defined as age at menarche earlier than 12 years. Lee JM, Kaciroti N, Appugliese D, Corwyn RF, Bradley RH, Lumeng JC. Two authors independently screened studies published in English prior to 10 January 2021, which reported overweight/obesity and early puberty. Based on the underlying mechanisms between the childhood overweight/obesity and early puberty, we ventured to speculate that there might be a link between childhood overweight/obesity and early puberty in boys. doi: 10.4081/pr.2012.e35. Obesity and sex steroid changes across puberty: evidence for marked hyperandrogenemia in pre- and early pubertal obese girls, Birth weight, early life weight gain and age at menarche: a systematic review of longitudinal studies, Link between body fat and the timing of puberty, Effects of obesity on human sexual development. The impact of childhood body mass index on timing of puberty, adult stature and obesity: a follow-up study based on adolescent anthropometry recorded at Christ's Hospital (1936-1964, BMI in childhood and its association with height gain, timing of puberty, and final height. Girls are not the only ones who go through puberty early if they have obesity. We thank all our colleagues working in Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, and Department of Plastic Surgery of Third Xiangya Hospital, Central South University. Recent changes in pubertal timing in healthy Danish boys: associations with body mass index, Association between overweight and early sexual maturation in Portuguese boys and girls, Timing of puberty in overweight versus obese boys, Is obesity associated with early sexual maturation? Barker DJP, Osmond C, Forsen TJ, Kajantie E, Eriksson JG.. Our findings showed that for girls the associate between overweight/obesity and early puberty is definite or strong whereas for males, such an association is possible, prompting that future studies need to further explore the possible relationship between overweight/obesity and early puberty in boys. Heterogeneity in the risk estimates of early puberty was partially explained by study design, sample size, follow-up duration, definitions of early puberty and confounders controlled. Information on current status of the following pubertal milestones was collected: voice break (yes, no), first ejaculation (yes, no; if yes: year and month), menarche (yes, no; if yes: year and month), acne (yes, no), axillary hair (yes, no) and Tanner stages (1 to 5) for pubic hair development and breast development or genital development.40,41 Tanner stages were illustrated with line drawings assisted by a short description of each stage. Moreover, obese children had higher levels of leptin than lean children, which may have contributed to their earlier puberty (35). Both of them showed relatively lower risk estimates for early puberty than the estimate in the published meta-analysis, with an odds ratio of 1.11 and 1.79, respective. No use, distribution or reproduction is permitted which does not comply with these terms. Here is a general timeline for physical changes that occur during puberty for boys: Puberty Event. The methodological quality of studies was assessed using the Newcastle-Ottawa Scale (NOS) for quality assessment of cohort and case-control studies by two researchers (XZ and YH.) Compared to boys with healthy weights, boys with obesity had a 2.7 times higher risk of early-onset puberty. A central fat distribution did not strengthen the association between childhood weight groups and pubertal timing. Further, erectile dysfunction, low testosterone concentrations. Secondary sexual characteristics and menses in young girls seen in office practice: a study from the Pediatric Research in Office Settings network. The model assumption of normally distributed residuals was inspected by plotting the non-parametric cumulative incidence function based on the Turnbull Estimator against the normal distribution in R (x64 3.3.1).46,47 The assumption of constant variance across covariates was inspected by stratifying these plots on levels of covariates. Sensitivity analyses were conducted to evaluate the robustness of the meta-analysis results, i.e., repeating meta-analyses were conducted after excluding one included study at a time and comparing the results before and after exclusion. Childhood obesity is a growing and alarming problem, associated with several short-term and long-term metabolic and cardiovascular complications. NSP-value >0.05; *P-value <0.01; **P-value <0.001; ***P-value <0.0001. the association between obesity and early puberty onset in girls led to the frisch hypothesis, which suggested that menarche occurs once girls reach a specific weight (originally defined as 48 kg).11 the frisch hypothesis has been widely investigated, and is now not considered to be very plausible. On the basis of a large sample size, we received a more convincing result. Thus, the non-shared confounders were birth date (for adjustment of calendar time) and the same potential confounders as in the cohort analysis, except maternal age at menarche and highest educational class of parents, which were both shared by the sibling-pairs. There is no consistent result in the relationship between obesity and timing of pubertal onset in boys. This is in line with conclusions from most reviews.14,15,1821 Although most studies have been cross-sectional with risk of reverse causation,14,15,1921 a recent review of longitudinal studies has now addressed the temporality of exposure and outcome.18 This review reported that higher body weight and weight gain in childhood were consistently associated with earlier age at menarche.18 However, confounding may induce spurious associations in observational studies. Design A large population-based cross-sectional study using multistage, stratified . For example, when case-control studies are used to explore the relationship between smoking and lung cancer, lung cancer patients are likely to have recall bias on their past smoking dose and frequency due to the long incubation period of lung cancer. In addition, studies have shown that childhood overweight/obesity may also have adverse effect on the process of puberty (710). Moreover, through subgroup analysis, we found that overweight girls (OR=4.67, 95% CI: 1.6013.63) enter puberty earlier than obese girls (OR=2.22, 95% CI: 1.652.99). Cohort analysis: monthly difference in timing of puberty across childhood weight groups and per 5kg/m2 BMI. Eriksson JG, Forsen T, Tuomilehto J, Osmond C, Barker DJ.. When modelling all pubertal milestones simultaneously, the pubertal milestones were attained earlier in: overweight boys: 3.1 [95% confidence interval (CI): 4.5, 1.7] months, overweight girls: 5.5 (95% CI: 7.1, 3.9) months, obese boys: 3.5 (95% CI: 5.1, 2.0) months, obese girls: 5.2 (95% CI: 7.1, 3.4) months compared with normal weight (BMI < 85th percentile) children. We are experimenting with display styles that make it easier to read articles in PMC. Systematic Review Registration Puberty looks different, in terms of both reproductive hormones and breast maturation, in girls with excess total body fat, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. In addition, there is currently no study to quantitatively summarize the associations between childhood overweight/obesity and early puberty in boys; this lack of information is a major obstacle for the risk assessment of early puberty in children who are assessed as overweight/obesity. Some factors that lead to earlier puberty in obese children include an increase in multiple hormones, including leptin, insulin, and sex hormones (estrogen and androgens). After subgroup analyses, the variables including sample size (TSD: 2= 6.40, p = 0.01) and confounders controlled (TSD: 2=12.31, p < 0.001) were shown to be associated with the between-study heterogeneity. The NOS was composed of eight items. Accessibility All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Ma T, Li YH, Chen MM, Ma Y, Gao D, Chen L, Ma Q, Zhang Y, Liu JY, Wang XX, Dong YH, Ma J. Beijing Da Xue Xue Bao Yi Xue Ban. De Leonibus C, Marcovecchio ML, Chiarelli F. Pediatr Rep. 2012 Dec 6;4(4):e35. Our findings add to the growing evidence that supports a causal interpretation of the association of childhood overweight and obesity with earlier pubertal timing. Among these singletons were 888 brothers and 812 sisters (Figure1). Adjusted mean age at attaining the pubertal milestones as spline functions of childhood BMI (body mass index). This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). Weight Limits The Role of Weight and Puberty in Boys. In the United States, the prevalence of obesity in 6 to 11-year-old children rose from 7% in 1980 to nearly 18% in 2012. Finally, 10 articles were included in meta-analysis (see Figure 1) (13, 19, 20, 2531). It's an intensive three years! When stratified by confounders controlled, positive associations between childhood overweight/obesity and early puberty were still found in studies that have none of the confounders controlled (OR: 2.12, 95% CI: 1.433.14), and studies that had one or more confounders controlled (OR: 1.04, 95% CI: 1.001.08). Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation. After the publication of this study, two cohort studies with a large sample size (3,109 and 1,126 individuals respective) were performed (19, 20). 18 as such, alterations in diet and exercise exert a powerful influence on pubertal maturation. and transmitted securely. Leptin levels gradually increase with age before puberty, and puberty may be triggered when the threshold is reached (34). 1 Some males mature faster than their peers, and some physical changes may be more gradual than others. Additional support was obtained from: the Danish Regional Committees; the Pharmacy Foundation; the Egmont Foundation; the March of Dimes Birth Defects Foundation; the Health Foundation; and other minor grants. Previous studies found that girls with obesity start puberty and experience their first menstrual period earlier than girls with normal weight. Federal government websites often end in .gov or .mil. Copyright 2022 Regents of the University of Michigan. Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. 2022. On the other hand, in boys, few research reported an association between obesity and pubertal development, and the results are inconsistent; Some studies found a link between obesity and. Sensitivity analysis for the association of childhood overweight/obesity and early puberty in boys. Maternal smoking in first trimester, maternal pre-pregnancy BMI, and maternal age at menarche were obtained from the first interview in pregnancy scheduled around week 12. Body growth. . 2010 Sep;140(3):399-410. doi: 10.1530/REP-10-0119. The median age difference for the siblings was 2.3 (range: 1.05.0) years. Data were compatible with these assumptions (data not shown). Lebrethon MC, Vandersmissen E, Grard A, Parent AS, Junien JL, Bourguignon JP. Colleen Williams https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021264649, PROSPERO CRD42021264649. "Prevention of obesity would prevent a slight delay in timing of puberty," Kaplowitz says. , Viner R exercise and nutrition 0.624 ) obesity and puberty in males and 2019, involving a total of 5,150 articles were through. Vandersmissen E, Vsquez-Garibay EM, Gonzlez-Hita M, Meccariello L, Caraffa A. Int Mol! 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