The pubertal transition in 179 healthy Danish children: associations between pubarche, adrenarche, gonadarche, and body composition

Abstract

Background: Pubertal onset is usually defined by breast development in girls and testicular growth in boys. Pubarche is defined as the attainment of pubic hair and is considered as a sign of pubertal transition. Pubarche is preceded by a gradual increase in production of adrenal androgens, DHEA and D4-androstenedione (Adione), a process termed adrenarche. Objective: To study the natural course of pubertal transition and the associations with adrenarche, body fat, and linear growth. Design and methods: A longitudinal study of 179 healthy children (89 girls) with higher socioeconomic background examined every 6 months for 5 years. Pubic hair stage, breast stage, genital stage, testicular volume (TV), height, weight, and four skinfolds were measured. Results: In girls, median age (25th and 75th percentiles) at thelarche (B2C) was 10.1 years (9.3-10.9). In boys, median age at attaining a TV O3 ml was 11.5 years (10.9-12.0). Median age at pubarche (PH2C) was 10.9 years (10.3-11.4) in girls and 11.6 years (10.8-12.4) in boys. Only 6.8% (4/59) of the girls and 24.6% (15/61) of the boys developed pubic hair as the first isolated sign of puberty. Serum DHEAS and Adione increased with age, although the increase in Adione was most pronounced in girls. No associations between early age at thelarche/testicular growth and increased body fat (BMI and sum of four skinfolds) were observed. Conclusion: Danish children rarely experience pubarche as the first sign of puberty. No associations between age at pubertal onset and body composition were found. Circulating levels of Adione, but not DHEAS, increased with the onset of puberty, although with large interindividual variability.

Longitudinal Changes in Circulating Testosterone Levels Determined by LC-MS/MS and by a Commercially Available Radioimmunoassay in Healthy Girls and Boys during the Pubertal Transition

“…One girl included had only three blood samples. Other aspects from this study have previously been published [10,11,12]. …”

Validity of Self-Assessment of Pubertal Maturation

“…3 Pubic hair usually follows testicular growth and breast development in boys and girls, respectively. 4 The age at pubertal onset varies between genders and individuals and is known to be influenced by many factors such as ethnicity, nutrition, genetics, and environment. [5][6][7][8] For clinical or epidemiologic studies in which exact pubertal stages are required, many aspects must be taken into consideration.…”

Contributions of CAG repeat length in the androgen receptor gene and androgen profiles to premature pubarche in Korean girls

“…Although biochemical adrenarche begins around the age of 6.0 years [1], Marshall and Tanner [31] reported that the mean age at development of Tanner stage II pubic hair was 11.7 years among girls in 1969. Recent studies have suggested that the mean onset age of pubarche is around 10.0 years in both Denmark and Lithuania [5,32] but 12.3 years, 1 year after breast budding, in Korea [33]. The median age at diagnosis of pubarche in NP girls was 8.9 years and only two girls were over 10 years of age (10.4 and 10.8 years) when they entered pubarche.…”