Abstract
This systematic review and meta-analysis examined the associations between obesity and puberty timing based on scientific evidence. Eight electronic databases were searched up to February 2017 for eligible studies, and two reviewers screened the articles and extracted the data independently. A total of 11 cohort studies with 4841 subjects met the inclusion criteria. Compared with the group of normal-weight girls, the obese group had more girls with menarche (RR: 1.87, 95% CI: 1.59–2.19, 2 studies). The number of girls with early puberty was significantly higher in the obese group than the normal weight group (RR: 2.44, 95% CI: 1.32–4.52, 5 studies). However, no differences were detected between girls who were obese or normal weight at age of menarche (WMD: −0.53 years, 95% CI: −1.24–0.19, 2 studies). There is no consistent result in the relationship between obesity and timing of pubertal onset in boys. Obesity may contribute to early onset of puberty in girls, while in boys, there is insufficient data. Given the limited number of cohort studies included in this meta-analysis, high-quality studies with strong markers of puberty onset, as well as standardized criteria for defining obesity are needed.
Highlights
Puberty is initiated in late childhood through a cascade of endocrine changes that lead to sexual maturation and reproductive capability [1]
The results demonstrated that the obese group had more girls with earlier puberty than early breast development stage II (RR: 2.03, 95% confidence intervals (CIs): 1.65–2.50, 382 girls) in obese group was significantly higher than the number of girls in the normal weight control group, Another study by
The results demonstrated that the obese normal weight group
Summary
Puberty is initiated in late childhood through a cascade of endocrine changes that lead to sexual maturation and reproductive capability [1]. The onset of puberty is reflected by the appearance of breast buds (B2) in girls [2] and genital changes (G2) in boys [3] as described by Tanner definitions [4]. There has been a secular trend of early puberty timing since the late 19th century, reflected by a lower mean age of menarche in most developed countries, and in recent years, in developing countries [6]. Previous studies showed that early puberty may lead to a number of adverse outcomes such as adolescent risk-taking behaviors, short adult stature, higher adult body mass index (BMI), waist circumference and adiposity, increased risk of adult-onset diabetes and pre-menopausal breast cancer [7,8]. Multiple studies have shown that the secular trend of puberty timing in girls is related with the increasing trend of childhood obesity. Several cross-sectional studies have shown a significant correlation between feminine obesity and earlier menarcheal age [15,16,17,18], pubertal growth spurt, earlier development
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