Abstract
ObjectivesThe purpose of this study was to examine the association of prepubertal body mass index (BMI) and weight status with pubertal development in boys and girls in Chongqing, China.MethodsIn a longitudinal study, 1237 students (695 boys and 542 girls) were recruited from Chongqing, China, and examined at baseline, then followed every 6 months for three and a half years. Height, weight, testicular volume, and breast development were measured at every examination. Age of first spermatorrhea and menarche were obtained from self‐report. Subjects were divided into normal weight, overweight, and obese groups according to baseline BMI. Multivariable Cox regression analysis was used to examine the association of BMI and weight status with pubertal development.ResultsIn girls, higher prepubertal BMI increased the chance of earlier menarche (hazards ratio (HR): 1.205, 95% confidence interval (95% CI): 1.151‐2.261) and breast development (HR: 1.092, 95% CI: 1.045‐1.142). Girls in the overweight (HR: 2.605, 95% CI: 1.716‐3.956) and obese (HR: 2.565, 95% CI: 1.603‐4.103) groups had an increased risk of early menarche compared with those in the normal weight group, while only overweight was associated with an increased risk for earlier breast development (HR: 1.469, 95% CI: 1.024‐2.108). In boys, higher prepubertal BMI was significantly associated with the timing of first spermatorrhea (HR: 1.054, 95% CI: 1.004‐1.106) and testicular development (HR: 1.098, 95% CI: 1.063‐1.135). Overweight (HR: 1.672, 95% CI: 1.204‐2.322) and obesity (HR: 1.598, 95% CI: 1.135‐2.249) increased the hazard of earlier testicular development compared with the normal weight group, while no significant differences were detected among the three weight groups in terms of time to first spermatorrhea.ConclusionsHigher prepubertal BMI was associated with earlier puberty in both Chinese boys and girls.
Highlights
In 1993, after the analysis of the long-term follow-up data of 181 normal children, Frisch (1993) proposed the concept of “critical weight,” that is, a certain percentage of body fat is necessary for the initiation of menarche, and a certain percentage of body fat is necessary for the maintenance of fertility
In analyses stratified by baseline body mass index (BMI) categories, compared to the normal weight group, overweight girls had a significantly higher risk of experiencing menarche with HR = 2.605, as had obese girls with HR = 2.565
This is the first longitudinal study of a relatively large number of both Chinese girls and boys to examine the association between prepubertal BMI and pubertal development
Summary
In 1993, after the analysis of the long-term follow-up data of 181 normal children, Frisch (1993) proposed the concept of “critical weight,” that is, a certain percentage of body fat is necessary for the initiation of menarche, and a certain percentage of body fat is necessary for the maintenance of fertility. Undernutrition can cause male reproductive dysfunction, Am J Hum Biol. A certain level of fat is a key factor in the initiation of puberty and pubertal development, but it is unclear whether obesity caused by overnutrition alters the association between fat and puberty development. Puberty is a period during which sexual maturation occurs and reproductive capacity is attained (Golub et al, 2008; Patton & Viner, 2007). It is a milestone in the growth and development of adolescents. From the beginning of the 19th century to present, a trend toward earlier puberty has been observed globally both in girls and boys (de Muinich Keizer & Mul, 2001; Herman-Giddens, Wang, & Koch, 2001; Ong, Ahmed, & Dunger, 2006; Parent et al, 2003; Tinggaard et al, 2012)
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