However, in boys the evidence has been controversial.. For instance, leptin is positively associated with the amount of body fat. For these cohort studies, the group age of subjects ranged from 4 months to 11 years, and the follow-up time ranged between 3 and 18 years. the display of certain parts of an article in other eReaders. National Library of Medicine Mericqs team found that the prevalence of total obesity increased with age, from 22 percent of boys ages 6 to 7 years to 28.6 percent at 11.4 years, the average age at onset of puberty for this group. When stratified by definition of early puberty, positive associations between childhood overweight/obesity and early puberty were still found in studies defined early puberty by age of breast stage II stage (OR: 6.10, 95% CI: 2.1817.08), age of each Tanner stage (OR: 5.4, 95% CI: 3.3010.70), age of menarche (OR: 2.28, 95% CI: 1.035.04), PDS score >x + s (OR: 2.16, 95% CI: 1.562.99), and three criteria in the study (OR: 1.18, 95% CI: 1.071.30). Childhood overweight and obesity were associated with earlier puberty in a dose-dependent manner in boys and girls in the cohort analysis. Mothers were recruited by their general practitioners during early gestation, from 1996 through 2002. government site. Is obesity associated with early sexual maturation? 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). For central obesity, which is a more reliable indicator of increased fat mass, the risk was 6.4 times higher. Like Podcasts? Childhood obesity is a growing and alarming problem, associated with several short-term and long-term metabolic and cardiovascular complications. For the cohort study, information on childhood BMI obtained from the 7-year follow-up in the DNBC was available for 12964 (58%) of the 22439 children invited to participate in the Puberty Cohort (Figure1). Overweight boys tend to enter and finish puberty somewhat earlier than usual, researchers found in a study of nearly 3,900 males aged 6 to 16. You may notice problems with The following search terms were applied in combination: (1) weight, height, body mass index, and BMI; (2) infant, infancy, early, postnatal, childhood, preschool, pre-school, and school; (3) overweight, obesity, adiposity, body composition, and waist circumference; and (4) puberty, adrenarche, pubescence, menarcheal, adolescence, and youth. The median quality score of the included studies was eight. The growth spurt in boys is the peak of growth during adolescence. Begg's test did not show a potential publication bias (z = 0.49, p = 0.624). Furthermore, through subgroup analysis, we found that individuals who were overweight in childhood (OR = 4.67) had a higher risk of early puberty than those who were obesity in childhood (OR = 2.22), which is consistent with the results of a cohort and sibling-matched analyses (i.e., the timing of puberty advances for overweight girls and obese girls was 5.5 months and 5.2 months, respectively) (32). The original contributions presented in the study are included in the article/supplementary material, further inquiries can be directed to the corresponding authors. Overweight/obesity in childhood is a global public health problem that is prevalent in both developing and developed countries (1, 2). et al. 1 We conducted three sensitivity analyses. The process can take up to 4 years. Several genetic variants have pleiotropic effects on both obesity and earlier timing of puberty, and these variants may confound the associations in our cohort analysis.34 The sibling-matched design partly corrects for this confounding, as siblings share on average half of their genes. Identification of adipokine clusters related to parameters of fat mass, insulin sensitivity and inflammation. Association of adiposity genetic variants with menarche timing in 92,105 women of European descent. Add the Michigan Medicine News Break oniTunes or anywhere you listen to podcasts. Cohort analysis: monthly difference in timing of puberty across childhood weight groups and per 5kg/m2 BMI. 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.) Adjusted mean age at attaining the pubertal milestones as spline functions of childhood BMI (body mass index). FOIA Understanding how the interactions of these factors contribute the relationship between obesity and early pubertal onset is crucial as early puberty has been linked with long-term consequences, such as short stature, earlier type 2 diabetes, cardiovascular disease, and poor psychological and behavioral outcomes. In our study, the key exposure variable was overweight/obesity in childhood, and the key outcome variable was early puberty. The half-yearly questions on puberty in the Puberty Cohort were identical to the questions on puberty in the 11-year follow-up. In addition, obese girls are also at increased risk of hyperandrogenism. A total of 586 cases with early puberty in 12,796 boys in childhood were identified. HHS Vulnerability Disclosure, Help Leptin levels gradually increase with age before puberty, and puberty may be triggered when the threshold is reached (34). Obesity, paediatric obesity, adiposity, body mass index, puberty, menarche. BMI, body mass index; CI, confidence interval. If there was more than one study from the same population, only the most comprehensive or most recent published one was included. Lpez-Peralta S, Romero-Velarde E, Vsquez-Garibay EM, Gonzlez-Hita M, Robles-Robles LC, Ruiz-Gonzlez FJ, Prez-Romero MA. Results: The prevalence of general obesity and central obesity among boys was higher than that in girls. Adj., adjusted; BMI, body mass index; CI, confidence interval; ref, reference. To determine the relationship between childhood overweight/obesity and early puberty in both boys and girls. An official website of the United States government. After subgroup analyses, the variables including study design [test for subgroup differences (TSD): 2= 7.56, p = 0.006], sample size (TSD: 2= 37.64, p < 0.001), follow-up duration (TSD: 2= 5.21, p = 0.02), definition of early puberty (TSD: 2= 49.26, p < 0.001), and confounders controlled (TSD: 2= 8.09, p = 0.004) were shown to be associated with the between-study heterogeneity. Design A large population-based cross-sectional study using multistage, stratified . A total of 5,150 articles were retrieved through the system search and manual search. Phone: (202)-971-3655 about navigating our updated article layout. In boys, excess adiposity has been associated with advanced puberty in some studies, whereas others have reported a delay in pubertal onset. Modulation of circulating IGF-I and IGFBP-3 levels by hormonal regulators of energy homeostasis in obese children. In the interaction analysis, a central fat distribution did not further strengthen the associations between weight groups and pubertal timing (Supplementary Table 4, available as Supplementary data at IJE online). before puberty can occur, a critical body weight or fat mass must be achieved. And puberty may be starting earlier in boys as well. Out of the 10 included studies, seven studies have controlled for one or more confounders, such as parental education, family income, and urban or rural. Compared to boys with healthy weights, boys with obesity had a 2.7 times higher risk of early-onset puberty. Therefore, the objective of this study was to perform a comprehensive meta-analysis regarding the association between childhood overweight/obesity and risk of early puberty in both girls and boys. Cohort studies group subjects according to whether they are exposed to a particular study factor and observe whether a specific outcome occurs in each group after longitudinal observation. 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. Trajectories of growth among children who have coronary events as adults. 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. [emailprotected], Jenni Glenn Gingery Nis Brix, Andreas Ernst, [], and Cecilia Hst Ramlau-Hansen. Firstly, only articles published in English were included in our study, which may lead to the omission of articles published in other languages and articles that have not yet been published. When repeating the cohort analysis among the 35528 children among whom the siblings were identified, the results were similarto the results obtained from the Puberty Cohort (Supplementary Table 5, available as Supplementary data at IJE online). Stature and pubertal stage assessment in American boys: the 19881994 Third National Health and Nutrition Examination Survey. Among all studies included, four studies evaluated the association of childhood overweigh/obesity with early puberty in both boys and girls (19, 2729), five studies only evaluated that in girls (20, 25, 26, 30, 31), and one study only evaluated that in boys (13). To prevent the omission of relevant literature, a comprehensive and specific search strategy was used at the beginning of this study. McCartney CR, Blank SK, Prendergast KA. 10 to 15. Read more iSTOCKPHOTO. However, peripheral action of adipose tissue (eg, via other adipokines, aromatase activity) could also be involved in changes to the onset of puberty. Precocious puberty reportedly occurred in 45 boys, or 9 percent. For 100 years, the Endocrine Society has been at the forefront of hormone science and public health. Children with high muscle mass, such as tall and athletic boys, are incorrectly classified as overweight/obesity based on their BMI, which can lead to false link between overweight/obesity in childhood and early puberty (38). For girls, puberty can begin as early as eight years old, with most instances of early puberty linked to childhood obesity. A BMI greater than 1 SDS is equal to BMI above the 85th percentile for age, the scale the United States uses to indicate overweight in children. When restricting to either sibling-pairs with same father or siblings born 3.0years apart, the results remained essentially the same (Supplementary Table 6, available as Supplementary data at IJE online). will also be available for a limited time. [Hyperinsulinemia, insulin-like growth factor-I, insulin-like growth factor-binding protein-1, and sex-hormone binding-globulin in prepubertal and pubertal girls with premature adrenarche]. In 527 Chilean boys ages 4 to 7 years, both total body obesity and central obesity, or excess belly fat, were associated with greater odds of starting puberty before age 9, researchers from the University of Chile in Santiago, Chile reported. Read about our historyand how we continue to serve the endocrine community. Earlier age at menarche in girls with rapid early life growth: cohort and within sibling analyses. A time trend toward earlier puberty in girls has been observed in many countries, but a time trend is less established in boys.17 This is a concern, as early puberty has been related to adult diseases such as depression, obesity, type 2 diabetes, cardiovascular disease, and cancers.811 Some authors have suggested the time trend to be partly attributable to the increase in childhood obesity.7,1215 Childhood obesity is associated with hyperandrogenism, insulin resistance and compensatory hyperinsulinism,16 which may initiate earlier puberty either by modulation of the hypothalamus-pituitary-gonadal axis17 or by increasing the bioavailability of sex hormones through insulins effect on the liver, adrenals, ovaries and adipose tissue.15 Several epidemiological studies have found obese girls to have earlier age at menarche and onset of breast development than normal-weight girls,14,15,1821 but studies on boys have found conflicting results.5,2233 Genetic factors and socioeconomic factors may, however, have confounded the reported association between childhood obesity and pubertal timing.34,35 Siblings raised together share a number of potential confounding factors, including socioeconomic factors and half of their genes. Meanwhile, since some subgroup categories contained only one or very few studies, the statistical power is weakened. Specifically, this is the first time to conduct a meta-analysis of the relationship between childhood overweight/obesity and early puberty in boys.MethodsRelevant studies were identified from PubMed, Web of Science, and EMBASE searches. First, we repeated the cohort analysis of childhood BMI (categorical) among the 35528 children from which we identified the siblings (Figure1) to evaluate whether the results were comparable to those obtained from the cohort analysis. Of these, 3,409 articles were left after eliminating the duplicate publication, 3,316 articles were excluded after screening the title and abstracts, and 83 of them were excluded after screening the full text. Obesity and Bone: A Complex Relationship. Epub 2017 Feb 9. While there wasn't a consistent relationship between weight and onset of puberty, obese boys reached Tanner stage 5 at an average of 15.4 years compared to 14.5 years for overweight boys and. Finally, 10 articles were included in meta-analysis (see Figure 1) (13, 19, 20, 2531). Phone: (202)-971-3611 2022 Apr 4;14(7):1506. doi: 10.3390/nu14071506. The result of our study may lead to a better understanding of early puberty risk in children who are overweight or obese. The associations were similar across pubertal milestones in boys, but they were larger for Tanner Breast stages in girls. Senior Communications Manager, Public Relations Results showed that childhood overweight/obesity were associated with a significantly higher risk of early puberty in girls [odds ratio (OR): 2.22, 95% CI: 1.652.99]. PMC legacy view Publication bias of included articles was assessed by Begg's test (p < 0.05 indicated statistically significant differences). 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. the extensions that are important for neuron-to-neuron communication, to the extracellular space and blood vessels. Previous studies found that girls with obesity start puberty and experience their first menstrual period earlier than girls with normal weight. Subgroup analyses for the association between childhood overweight/obesity and early puberty in girls. In addition, studies have shown that childhood overweight/obesity may also have adverse effect on the process of puberty (710). Huber PJ. In 2016, more than 340 million individuals aged 519 were overweight or obese worldwide (5). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. The DNBC comprises approximately 100000 children and their mothers. precocious puberty and childhood overweight and obesity are important public health problems that both had adverse effects, which including psychological symptom in childhood, short final height or reproductive dysfunction in adulthood, on children's physical and psychological development.the prevalence of precocious puberty and childhood Pediatr Gastroenterol Hepatol Nutr. 19, 20 the. The ePub format is best viewed in the iBooks reader. In the cohort analysis, childhood overweight and obesity were associated with earlier pubertal timing in both boys and girls in a dose-dependent manner. Unlike overweight girls, who tend to reach puberty earlier than do girls of normal weight, overweight and obese boys in the U.S. may begin puberty later than thinner boys. During the 11-year follow-up in the DNBC, 45794, of these children provided information on pubertal development. An increased risk of early puberty related to childhood overweight/obesity was also found in boys, although the estimate was not statistically significant. Almost all studies defined early puberty by menarche age, while Chen et al. The functionality is limited to basic scrolling. LC, TW, XZ, and YH: critical revision of the manuscript for important intellectual content. Department of Statistics, UCLA College of Letters and Science, Los Angeles, CA, USA, 4 There is no consistent result in the relationship between obesity and timing of pubertal onset in boys. . Herman-Giddens ME, Slora EJ, Wasserman RC. Robust standard errors were employed to account for the use of weights and the clustering of siblings. In contrast, study results from Europe showed earlier puberty in boys with overweight and obesity. Follow-up of mothers and children has been supported by: the Danish Medical Research Council [SSVF 0646, 27108-0839/06066023, O602-01042B, 0602-02738B]; the Lundbeck Foundation [195/04, R100-A9193];tTheInnovation Fund Denmark [0603-00294B (09067124)];the Nordea Foundation [022013-2014]; Aarhus Ideas [AU R9-A959-13-S804]; University of Copenhagen Strategic Grant [IFSV 2012]; and the Danish Council for Independent Research [DFF 418300594 and DFF 418300152]. Future research is needed to confirm the association between childhood overweight/obesity and early puberty in boys based on larger sample size. Compared to studies with a cohort design (OR: 1.24), subgroup analyses showed that the risk of early puberty related to childhood overweight/obesity was significantly higher in case-control studies (OR: 4.80). As reported, up to 19.2% individuals aged 718 years old were overweight or obese in China (3). In the cohort analysis, confounders were identified by use of a directed acyclic graph (Supplementary Figure 1, available as Supplementary data at IJE online).43 Potential confounders were highest educational class of parents, maternal smoking in first trimester, maternal pre-pregnancy BMI, maternal age at menarche, parity, birthweight, childhood diet, childhood physical activity, and childhood sedentary behaviour. Childhood overweight and obesity were associated with earlier puberty in a dose-dependent manner in boys and girls in the cohort analysis. BMI, body mass index; DNBC, Danish National Birth Cohort; FU, follow-up. The higher prevalence of obesity among males compared to females in some Arab countries may be related to the difference in timing of puberty, muscular tissue, and dietary habits between. Covariates were categorized or kept continuous as shown in Table1. A previous meta-analysis based on 69 cases with early puberty in 165 girls who were overweight/obese in childhood detected a significant higher risk of early puberty in relation to childhood overweight/obese with a risk estimate of 2.44 (18) our study validated the relationship on the basis of a larger sample size (13,338 girls and 12,796 boys). Identification of modifiable causes of earlier puberty is, therefore, warranted. Reference lists of all reviews related to the topic and other included studies were manually searched for additional probably eligible studies. Follow us on Twitter at@TheEndoSocietyand@EndoMedia. Moreover, obese children had higher levels of leptin than lean children, which may have contributed to their earlier puberty (35). A combination of an increasingly sedentary lifestyle and unfavorable diet in the western world has resulted in increasing numbers of overweight and obese children and adults. No use, distribution or reproduction is permitted which does not comply with these terms. Body fat mass, body fat distribution, and pubertal development: a longitudinal study of physical and hormonal sexual maturation of girls, Role of obesity and leptin in the pubertal process and pubertal growth-a review, Leptin signaling and circuits in puberty and fertility. Systematic Review Registration XZ, YH, ZY, ZG, SZ, XL, YC, and CY: acquisition, analysis, or interpretation of data. Birthweight and parity were obtained from the Danish Medical Birth Registry.44 Highest educational class of the parents was obtained from Statistics Denmark and classified according to the International Standard Class of Occupation and Education codes (ISCO-88 and ISCED). Body mass index and timing of pubertal initiation in boys, Is obesity associated with early sexual maturation? 1.9 ) kg/m2 and 12,796 boys were part of Chiles growth and:! Boys the average age is 12 changes are very personal of data the! 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