Abstract
BackgroundObesity is an important underlying cause of central precocious puberty (CPP), but previous large studies are flawed by using just age and breast examination to diagnose CPP. We aimed to determine whether overweight and obesity in childhood increases hormonally diagnosed CPP.MethodsOur retrospective, case-control study recruited 846 children diagnosed as having CPP and randomly sampled 1650 healthy control subjects in Xingtai Third Hospital in China between November 2018 and March 2021. Information was obtained from an electronic medical record and questionnaire investigated in the outpatient visit. Observations were made before the a priori hypothesis. Unconditional logistic regression for analysis was used to determine whether overweight and obesity status and duration of overweight/obesity were associated with CPP.ResultsOverweight and obesity were significantly associated with increased odds of CPP among girls, even after adjusting for birth weight, exclusive breastfeeding for 6 month, household income, maternal overweight, paternal overweight, and maternal menarche age (overweight: the adjusted odds ratio (aOR) (95%CI): 1.92 (1.16, 3.24), p = 0.02; obesity: aOR (95%CI): 1.78 (1.13, 3.48), p = 0.03). Furthermore, the effects of overweight and obesity were significant when ongoing for 1 to 2 years, 2 to 3 years, and greater than 3 years, but not at less than 1 year. For boys, association between obesity and increased odds of CPP was observed (aOR (95%CI): 1.68 (1.09, 3.75), p = 0.03). The effects of overweight and/or obesity were only significant when ongoing for greater than 2 years.ConclusionsProlonged overweight and obesity in early childhood may be risk factors for CPP, especially in girls. Weight loss might be an important approach for the prevention of precocious puberty in children.
Highlights
Obesity is an important underlying cause of central precocious puberty (CPP), but previous large studies are flawed by using just age and breast examination to diagnose CPP
Girls with CPP had lower rates of exclusive breastfeeding for 6 month, higher birth weight, higher overweight and obesity rates, and whose mother and father had higher overweight rates than those of control group (p < 0.03)
Children in case group had lower rates of exclusive breastfeeding for 6 month, higher overweight and obesity rates compared with boys in the control group (p < 0.03)
Summary
Obesity is an important underlying cause of central precocious puberty (CPP), but previous large studies are flawed by using just age and breast examination to diagnose CPP. Central precocious puberty (CPP) is a disease of abnormal growth and development, characterized as early onset of adolescent secondary sexual characteristics resulting from early commencement of pulsatile secretion of gonadotrophin releasing hormone (GnRH) [1]. It is worth noting that most epidemiological studies diagnosed puberty onset through clinical features only, breast development reached Tanner II stage before age 8 in girls and testicular volume was ≥4 mL before age 9 in boys [1, 16].
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