Abstract
Background: Height and adiposity track over childhood, but few studies, to our knowledge, have longitudinally examined the mediating relation of the timing and progression of puberty.Objective: We assessed interrelations between prepubertal height and body mass index, the progression through puberty, and young adult height and adiposity.Methods: We analyzed data from the Birth to Twenty Plus study (females, n = 823; males, n = 765). Serial measures of anthropometry and pubertal development were obtained between ages 9 and 16 y. We used latent class growth analysis to categorize pubertal development with respect to pubic hair (females and males), breasts (females), and genitalia (males) development. Adult height and weight were obtained at ages 18 to 20 y.Results: Among females, higher latent class (earlier initiation and faster progression through puberty) was associated with an increased risk of obesity [pubic hair class 3 compared with class 1: RR, 3.41 (95% CI: 1.57, 7.44)] and inconsistent associations with height. Among males, higher latent class was associated with increased adult height [pubic hair development class 3 compared with class 1: 2.43 cm (95% CI: 0.88, 4.00)] and increased risk of overweight/obesity [pubic hair development class 3 compared with class 1: OR, 3.44 (95% CI: 1.44, 8.20)]. In females, the association with adult height became inverse after adjusting for prepubertal height [pubic hair development class 3 compared with class 1: females, −1.31 cm (95% CI: −2.32, −0.31)]; in males, the association with height was attenuated with this adjustment [−0.56 cm (95% CI: −1.63, 0.52)]. Associations with adiposity were attenuated after adjusting for prepubertal adiposity.Conclusions: Progression through puberty modifies the relation between prepubertal and adult anthropometry. Screening for early or rapid progression of puberty might identify children at an increased risk of becoming overweight or obese adults.
Highlights
Puberty is a period of rapid change in stature and body composition, with both males and females experiencing acceleration in linear growth velocity [1]
At age 12 y, 30.0% and 26.2% of females were in Tanner stage 1 or 2 for pubic hair and breasts, respectively, whereas 16.8% and 15.7% of males were in Tanner stage 1 for pubic hair and genitalia, respectively
Age at menarche was inversely associated with adult overweight and obesity; the estimates were attenuated after adjusting for prepubertal height and BMI. In this prospectively followed contemporary South African cohort, we explored the relation between several indicators of pubertal development and young adult height and adiposity as measured by BMI
Summary
Puberty is a period of rapid change in stature and body composition, with both males and females experiencing acceleration in linear growth velocity [1]. The age of pubertal onset has been associated with adult anthropometric outcomes—girls who experience menarche at younger ages have reduced adult height, greater BMI, and an increased risk of obesity during adulthood [2,3,4,5,6,7,8]. The association between the age of pubertal onset and adult BMI may be explained by higher adiposity during childhood and early adolescence. Results: Among females, higher latent class (earlier initiation and faster progression through puberty) was associated with an increased risk of obesity [pubic hair class 3 compared with class 1: RR, 3.41 (95% CI: 1.57, 7.44)] and inconsistent associations with height.
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