obesity and puberty in males

Int J Epidemiol. Therefore, updating the extent of the association of childhood overweight/obesity with risk of early puberty in girls is necessary, which would help to add important data to the knowledge base. Childhood BMI was derived from height (cm) and weight (kg) reported by the mothers at a median age of 7.1 (25th75th percentile: 7.07.2) years. Trajectories of growth among children who have coronary events as adults. 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. Concurrently, the percentage of obese individuals aged in the 12 to 19-year-old population rose from 5 to nearly 21% (4). More specifically, among children aged 5 or 6, those with obesity were 2.7 times more likely to start puberty early, and those with excess abdominal fat were more likely to reach puberty before the age of 9. On the basis of a large sample size, we received a more convincing result. BMI, body mass index; SD, standard deviation. Weight Limits The Role of Weight and Puberty in Boys. Earlier menarche in girls is associated with increased risk of adult obesity, type 2 diabetes and breast cancer. will also be available for a limited time. the extensions that are important for neuron-to-neuron communication, to the extracellular space and blood vessels. https://www.dnbc.dk/-/media/arkiv/projekt-sites/dnbc/kodeboeger/pubertetsundersoegelsen/english_pubertyfollowup_codebook_final.pdf? Meanwhile, we also analyzed the association between childhood overweight/obese and puberty in boys. 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. 81973137 and 82173608). The first phase involves height increases from 20 to 25 percent. Parental education, family income, birth weight, breastfeeding, gestational age, and in-utero smoking. Boys with obesity enter puberty at an earlier age than average, according to a study that will be presented Sunday at ENDO 2019, the Endocrine Societys annual meeting in New Orleans, La. To look for dose-dependent patterns, we also included childhood BMI as restricted cubic splines with three knots at 14, 16 and 18kg/m2. An increased risk of early puberty related to childhood overweight/obesity was also found in boys, although the estimate was not statistically significant. The most important difference between cohort studies and case-control studies is the ability to demonstrate causation. BMI, body mass index; CI, confidence interval. FOIA The 2014 Danish references from birth to 20 years for height, weight and body mass index, Variations in the pattern of pubertal changes in boys, Variations in pattern of pubertal changes in girls, Causal diagrams for epidemiologic research, The Statistical Analysis of Interval-Censored Failure Time Data, A hybrid algorithm for computation of the nonparametric maximum likelihood estimator from censored data, The empirical distribution function with arbitrarily grouped, censored and truncated data, Role of the waist/height ratio in the cardiometabolic risk assessment of children classified by body mass index. Denzer C, Weibel A, Muche R, Karges B, Sorgo W, Wabitsch M. Pubertal development in obese children and adolescents, Link between body fat and the timing of puberty. For girls, puberty can begin as early as eight years old, with most instances of early puberty linked to childhood obesity. 2017;88(1):101-110. doi: 10.1159/000455968. 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). Childhood overweight and obesity were associated with earlier pubertal timing even after adjustment for unobserved time-stable confounders shared within families. During the 11-year follow-up in the DNBC, 45794, of these children provided information on pubertal development. government site. Some U.S. studies have found that obesity delayed puberty, whereas another study showed that only overweight but not obesity induced earlier puberty in boys. The exposure of interest was overweight . It ranged from 19 stars and assessed the quality of each study based on three modules: selection, comparability, and outcome (cohort studies) or exposure (case-control studies). However, our data were compatible with the normal distribution. Evidence points to the hormone leptin, which is produced by fat cells, as one of the likely culprits, says, Elias and her team have published a new study in the journal, How Stem Cells Grow into Structures That Could Aid Understanding of Infertility, New Insights on Sperm Production Lay Groundwork for Solving Male Infertility, Induced Pluripotent Stem Cells Harnessed to Reliably Create Embryo-like Structures. MeSH For girls, puberty can begin as early as eight years old, with most instances of early puberty linked to childhood obesity. All rights reserved. Its possible that leptin is speeding up the development of these structures in the base of the brain.. What we think this means is that brain development is not completed and that puberty starts only when the entire neuropil, including blood vessels and components of the extracellular space, is ready, says Elias. This can be exploited in a sibling-matched design, which removes confounding by time-stable and shared factors.36. 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. McCartney CR, Blank SK, Prendergast KA. Besides, detailed analyses were conducted for more diverse subgroups. Generating an ePub file may take a long time, please be patient. Considering that some studies included in this meta-analysis have not controlled for the key confounders of early puberty, such as race, birth weight and physical activity, it is possible that the increased risks found in this study partly due to differences in these risk factors of early puberty between overweight/obesity in childhood and the reference groups. Feb. 2, 2010&#151; -- Researchers may have found yet another reason not to let boys become obese-- it could delay their puberty. Pediatr Gastroenterol Hepatol Nutr. An American Cancer Society study of 404,576 men demonstrated the link: being overweight increases a man's risk by 8%, being obese boosts risk by 20%, and being severely obese increases risk by 34%. A comparison of the association in American boys versus girls. Copyright 2022 Regents of the University of Michigan. 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. Exp Clin Endocrinol Diabetes. Random effects model meta-analysis was used as a tool to calculate combined ORs and 95% CIs (22). Bone mineral density and body composition in normal weight, overweight and obese children. 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. Subgroup analyses for the association between childhood overweight/obesity and early puberty in boys are shown in Table 6. The inclusion of titles and abstracts was intentionally expanded with a view to obtaining more relevant studies. In the sibling-matched study, higher BMI was associated with earlier age at attaining most pubertal milestones in girls, but only a tendency toward earlier pubertal timing was observed in boys. Here is a general timeline for physical changes that occur during puberty for boys: Puberty Event. 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. A study from Spain noted that BMI and age of pubertal onset were correlated in boys, but body fat mass was not correlated with pubertal onset. De Simone M, Danubio ME, Amicone E, Verrotti A, Gruppioni G, Vecchi F. Age of onset of pubertal characteristics in boys aged 614 years of the Province of L'Aquila (Abruzzo, Italy). In addition, obese girls are also at increased risk of hyperandrogenism. Nov. 3, 2013 14 Girls are starting puberty at younger ages - a full year earlier than previously reported in some cases - and the main factor associated with early breast development is. MORE FROM THE LAB: Subscribe to our weekly newsletter. 1 The ORs for the association reported by included studies ranged from 1.11 to 9.00. The questionnaire is available online.42. The potential relationship between childhood obesity and earlier puberty onset has major public health implications. Precocious puberty reportedly occurred in 45 boys, or 9 percent. Accessibility Both areas lie in the hypothalamus at the base of the brain where the capillaries are relatively opened, allowing circulating molecules to flow easily, increasing the communication between the peripheral organs and the brain explains Elias, who was recently elected as a 2020 fellow of the American Association for the Advancement of Science. An official website of the United States government. However, case-control studies divided subjects into groups according to whether they suffered from a specific disease or not, and analyzed the association between exposure and outcome through retrospective collection of exposure to a specific factor in the past in each group. Our findings add to the growing evidence that supports a causal interpretation of the association of childhood overweight and obesity with earlier pubertal timing. A few studies found puberty is delayed in obese males - possibly because of excess estrogen in the body. Tanner stage 2 (dashed line), Tanner stage 5 (solid line), voice break (dashed line), first ejaculation (solid line) and menarche (solid line). Puberty is second to the prenatal period in terms of rapid growth as the long bones stretch to their final, adult size. 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. 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. Among these singletons were 888 brothers and 812 sisters (Figure1). Development of adiposity, obesity and age at menarche: an 8-year follow-up study in Portuguese schoolgirls. Early adiposity rebound in childhood and risk of Type 2 diabetes in adult life. 2022 Copyright Endocrine Society. This study was supported by National Natural Science Foundation Program of China (Grant Nos. Childhood overweight and obesity were associated with earlier puberty in a dose-dependent manner in boys and girls in the cohort analysis. Xu YY, Sun L, Guo X, Zhang J, Lou XM, Wang H, et al.. Careers, Edited by: Dartagnan Pinto Guedes, Universidade Norte do Paran, Brazil, Reviewed by: Tuck Seng Cheng, University of Oxford, United Kingdom; Paul B. Kaplowitz, Children's National Hospital, United States, This article was submitted to Children and Health, a section of the journal Frontiers in Pediatrics, These authors have contributed equally to this work and share first authorship. Li W, Liu Q, Deng X, Chen Y, Liu S, Story M. Association between obesity and puberty timing: a systematic review and meta-analysis. Whereas those with excess belly fat had almost 6.4 higher odds of puberty before age. 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). In the sibling-matched analysis, we used a between-within model to obtain the within sibling-pair association as the mean age difference in age at attaining each of the pubertal milestones per 5kg/m2 higher childhood BMI (continuous).52 To remove confounding by shared factors, we included both childhood BMI (continuous) and the mean childhood BMI for each sibling-pair (continuous).36,52 To remove confounding by non-shared confounders, we adjusted for the childs own non-shared confounders as well as the non-shared confounder of the other sibling.36 We used a mixed effect model to model each sibling-pair as a random intercept using STATAs -meintreg- procedure.52. We will refer to the analysis of these children as the cohort analysis. 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. In our study, the key exposure variable was overweight/obesity in childhood, and the key outcome variable was early puberty. There is clear evidence indicating that obesity leads to early appearance of pubertal signs in girls. 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. Therefore, the results of this study should be extended with caution. and transmitted securely. 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. In the cohort analysis, mothers of obese children were more likely to be lower educated, to be smokers, to have higher pre-pregnancy BMI, to have earlier age at menarche and to have higher parity than mothers of normal-weight children (Table1; Supplementary Tables 1 and 2, available as Supplementary data at IJE online). et al. Growth of testicles and scrotal sac. Would you like email updates of new search results? Senior Communications Manager, Public Relations Adjusted mean age at attaining the pubertal milestones as spline functions of childhood BMI (body mass index). Sensitivity analysis for the association of childhood overweight/obesity and early puberty in girls. In the cohort analysis, childhood overweight and obesity were associated with earlier pubertal timing in both boys and girls in a dose-dependent manner. Puberty is second to the prenatal period in rapid growth as the long bones stretch to their final adult size. Phone: (202)-971-3655 Day FR, Elks CE, Murray A, Ong KK, Perry JR.. Puberty timing associated with diabetes, cardiovascular disease and also diverse health outcomes in men and women: the UK Biobank study, Pubertal timing and adult obesity and cardiometabolic risk in women and men: a systematic review and meta-analysis, Public health implications of altered puberty timing, Pubertal timing and the development of psychopathology in adolescence and beyond, Childhood obesity: public-health crisis, common sense cure. NCI CPTC Antibody Characterization Program. Begg's test did not show a potential publication bias (z = 0.49, p = 0.624). meta-analysis, childhood, early puberty, puberty time, overweight, obesity, Prevalence of obesity and trends in body mass index among US children and adolescents, 19992010, Empirical changes in the prevalence of overweight and obesity among Chinese students from 1985 to 2010 and corresponding preventive strategies, Prevalence and trends in obesity among China's children and adolescents, 19852010, Prevalence of childhood and adult obesity in the United States, 20112012, Bmi in childhood and its association with height gain, timing of puberty, and final height. This may bias the estimates if the assumption of normally distributed residuals is violated. A comparison of the association in American boys versus girls. 2007 Jan;115(1):17-23. doi: 10.1055/s-2006-957350. For the sibling-matched study, 1700 brothers and sisters were included among 86820 live-born singletons from the DNBC. For instance, among boys age 5 or 6, those with obesity had nearly 2.7 times the odds of starting puberty early, and those with central obesity had almost 6.4 higher odds of puberty before age 9, Mericq reported. 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. No use, distribution or reproduction is permitted which does not comply with these terms. Sensitivity analysis were performed by repeating the meta-analysis after the exclusion of each included study; results showed that exclusion of any single study did not materially alter the risk estimate of early puberty in boys (ORs ranged between 1.09 and 1.47; see Table 5). The strength of this meta-analysis is the large sample size which involving 13,338 girls and 12,796 boys, and thereby can enhance statistical power, providing more precise and reliable risk estimates. Buyken AE, Karaolis-Danckert N, Remer T.. Association of prepubertal body composition in healthy girls and boys with the timing of early and late pubertal markers. First, studies would be taken into account if they reported on overweight/obesity and early puberty and were published in English. The following data were extracted: first author, year of publication, study period, geographic region, gender, study design, length of follow-up, and age of enrolment (for cohort studies only), sample size, definition of overweight/obesity, definition of early puberty, and adjustments and matches made. Further, the main strength of the sibling-matched analysis was that it, by design, controls for all time-stable confounders that were shared within the siblings family. To increase the statistical power, these children were sampled according to 12 different prenatal exposures, hypothesized to be causes of earlier pubertal timing, as well as a random sample of 8000 children.38 From August 2012, these 22439 children were invited half-yearly to provide information on pubertal development through web-based questionnaires, from the age of 11.5years until 18years or full maturity (defined as Tanner stage 5 for pubic hair and genital development in boys and Tanner stage 5 for pubic hair and breast development in girls). For people assigned male at birth, puberty begins at age 11 on average, although starting as early as age 9 or as late as age 14 is still considered normal. Ogden CL, Yanovski SZ, Carroll MD, Flegal KM.. Robust standard errors were employed to account for the use of weights and the clustering of siblings. Among the studies, five were conducted in Asia, four in North America, and one was conducted in Europe. Some boys begin the growth spurt earlier and others later. Evidence points to the hormone leptin, which is produced by fat cells, as one of the likely culprits, says Carol Elias, Ph.D., a professor of molecular & integrative physiology and obstetrics & gynecology at the U-M Medical School. 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). the display of certain parts of an article in other eReaders. These factors may include place of residence, socioeconomic status and genetic factors, which may be difficult to adjust for in a usual cohort study. LC and TW: study concept and design and study supervision. In this study, we estimate the association between childhood body mass index (BMI) and timing of puberty, using a cohort design and a sibling-matched design. 2022. Most studies used BMI as the basis for defining childhood overweight/obesity, a few studies used body fat and skinfold thickness. LC, TW, XZ, and YH: critical revision of the manuscript for important intellectual content. The younger siblings BMI at 7years was comparable to the older siblings BMI: mean difference 0.0 (standard deviation: 1.9) kg/m2. In addition, the common view is that early puberty is a complex phenomenon caused by many environmental and genetic factors, as well as interactions among these (39). It's an intensive three years! Leito RB, Rodrigues LP, Neves L, Carvalho GS. Flehmig G, Scholz M, Klting N, Fasshauer M, Tnjes A, Stumvoll M, et al.. Furthermore, a birth cohort study with 18 years of follow-up found a positive association between obesity and earlier puberty in boys (10) and a cohort and sibling-matched analysis found that higher BMI was associated with earlier age at attaining most pubertal milestones in girls, but only a tendency toward earlier pubertal timing was observed in boys (32). To prevent the omission of relevant literature, a comprehensive and specific search strategy was used at the beginning of this study. Lee JM, Kaciroti N, Appugliese D, Corwyn RF, Bradley RH, Lumeng JC. Borenstein M, Hedges LV, Higgins JP, Rothstein HR. 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. [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]. A number of studies controlled for one or more confounding factors (13, 19, 20, 25, 26, 29, 31), such as parental education, race, height, whether the only child, family income, birth weight, breastfeeding, gestational age, and in-utero smoking. Previous studies found that obesity may alter hormone secretion and sensitivity, including leptin and insulin. 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). 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). Bethesda, MD 20894, Web Policies Careers. 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. . However, in boys the evidence has been controversial.. 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