Abstract

Background. In recent years worldwide, there has been an increase in childhood obesity together with an advance in the age at which puberty begins in girls; however, in boys the evidence has been controversial (i.e. Crocker MK JCEM 2014, Lee JM pediatrics 2016). Objective. To determine whether total and central body obesity in pre-pubertal children evaluated since age 4 is associated with precocious puberty through the measurement of testicular volume. Methods. We included 527 boys for the Growth and Obesity Cohort Study longitudinal cohort. The anthropometric measures (weight, height, waist circumference) were registered and Body Mass index SDS calculated. Trained personnel valuated the onset of puberty through a Prader Orchidometer and precocious puberty was defined as reaching a testicular volume greater than 3 cc before 9 years of age in any of the testicles. The association between obesity (total body adiposity and central body adiposity) and precocious puberty, were analyzed through logistic regression models and the Odds Ratio (OR) and 95% confidence interval (CI) were estimated. Results. There was an increase in BMI SDS and prevalence of total obesity and central obesity through the years :at 6 - 7 yr, 0.99±1.32 SDS and 22.0% & 11.8 % respectively, and at Tanner 2 ,age 11.4±1.4 yr (n = 494) , 1.15±1.22 SDS and 28.6 % & 17.4% respectively. Forty ive boys initiated puberty before 9 yrs (9.1%). A positive and statistically significant association was found between total body obesity and precocious puberty from 4 to 7 years of age (i.e. between 5 and 6 years of age, OR: 2.68 95% CI: 1.09 - 6.57) and at the time of pubertal onset OR: 3.59 95% CI: 1.92 - 6.70. When analyzing BMI SDS as a continuous variable, the association remained positive and significant at birth and from 4 to 8 years of age and at the time of pubertal onset. Likewise, a positive and significant association was found between central obesity and precocious puberty from 4 to 7 years of age (example between 5 and 6 years, OR: 6.36 95% CI: 2.03-19.92). Conclusions. Total and central body obesity in boys aged 4 to 7 years is associated with earlier puberty. Our observation supports the association of adiposity and earlier pubertal events in Chilean boys. Early puberty might increase the risk of behavior problems. In addition, it has been postulated that precocious puberty in boys, could be related to higher incidence of testicular cancer in adulthood. Our results suggest that controlling the obesity epidemic could be useful in decreasing these risks. Additional studies are needed to understand the possible relationships among race/ethnicity, gender, BMI, and the timing of pubertal development

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