Adiposity Status, Trajectories, and Earlier Puberty Onset: Results From a Longitudinal Cohort Study

Abstract

Context Adiposity is associated with earlier puberty onset in girls, but such an association among boys is controversial. Objective To estimate the association of prepubertal adiposity status, trajectories, and the earlier puberty onset based on a cohort study. Design, Setting, and Participants A total of 1322 children were included in 2017, with a mean age of 8.1±0.6 years for girls and 9.1±0.6 years for boys, and followed up every 6 months until October 2020. Anthropometric profiles, including BMI, WC, and body composition indicators, were used to determine adiposity status. Group-based trajectory model was used to identify trajectory groups of anthropometric profiles. The pubertal development was assessed through clinical inspection and palpation by using The Tanner rating map and Prader orchidometer. Covariate information was obtained through questionnaires. Main Outcome Measures The clinical assessment of testicular volume for boys and breast stage for girls was acquired. Results Childhood adiposity was associated with an increased risk of earlier puberty onset. Body composition was more sensitive to earlier puberty onset than BMI and WC. Boys and girls with high-level body fat percentage had an increased risk of earlier puberty onset, compared with those with low-level body fat percentage. However, boys and girls with high-level FFM (fat-free mass)/FM (fat mass) had a decreased risk of earlier puberty onset, compared with those with low-level FFM/FM. The high-level trajectories of the rapid increase in anthropometric profiles, in addition to FFM/FM, were also significantly associated with a higher risk of earlier puberty onset. Conclusions Prepubertal adiposity and distinct trajectories were associated with earlier puberty onset. It’s important to maintain healthy adiposity status in preventing earlier puberty onset in children.

Rapid increases in BMI waist to height ratio during adolescence and subsequent neurobehavioral deficits

“…In addition, obesity may constitute a chronic stressor and in turn impair brain functions involved in affective control, by inducing chronic inflammation, dysfunctions in the hypothalamic–pituitary–adrenal axis [31], and dysregulations of adipokines [33]. In line with previous findings [25, 34], our study also found that girls with the trajectory of increasing adiposity had earlier menarche ages and menarche age was associated with BMI/WHtR trajectories, which may suggest a risk of the metabolic‐reproductive interplay among female adolescents with early menarche ages involving adipokines (leptin and ghrelin), hormones (insulin), and lipid, as well as critical signaling pathways (AMPK/SIRT, mTOR) that may integrate the peripheral metabolism and central circuits [35]. Furthermore, the associations between the “rapidly increasing” BMI z score/WHtR trajectory and subsequent neurobehavioral deficits remained significant when taking pubertal timing into consideration (additionally adjusting for menarche age in girls), indicating that rapidly increasing adiposity or abdominal obesity from ages 11 to 15 years may be an independent risk factor for neurobehavioral deficits among female adolescents.…”

Pubertal timing in children with Silver Russell syndrome compared to those born small for gestational age

“…Yanhui et al. have also recently showed an association between prepubertal adiposity and earlier puberty onset both in females and in males ( 35 ).…”

The critical BMI hypothesis for puberty initiation and the gender prevalence difference: Evidence from an epidemiological survey in Beijing, China

“…Previous studies found that the values of weight, height, WC (33), BMI, and WHtR (32) in precocious puberty children were higher than those in peer normal children. Children with high-level of body fat as well as those with a rapid increase in anthropometric profiles were more sensitive to earlier puberty onset (24) (25). However, based on the relatively small number of studies available, more findings about the effect of fat distribution on pubertal development in girls should be done in the future.…”

“…Previous studies found that the values of weight, height, WC ( 33 ), BMI, and WHtR ( 32 ) in precocious puberty children were higher than those in peer normal children. Children with high-level of body fat as well as those with a rapid increase in anthropometric profiles were more sensitive to earlier puberty onset ( 24 ). Our results, together with data reported by others, indicated the importance to maintain healthy adiposity status in preventing earlier puberty onset in children.…”

“…As well as obesity, body fat distribution has lately been found to be associated with sexual development. Boys and girls with a high-level body fat percentage ( 24 ) and waist-to-height ratio (WHtR) ( 25 ) had increased risks of earlier puberty in comparison with those with a low-level body fat percentage and WHtR. However, in the majority of studies, overweight/obesity is defined by BMI level, which was not effective for providing information on fat distribution.…”