Meanwhile, since some subgroup categories contained only one or very few studies, the statistical power is weakened. Next, they compared brain samples from the ventral premammillary and arcuate nuclei in normal pre-pubescent and adult mice to the obese leptin-deficient mice. A time trend toward earlier puberty in girls has been observed in many countries, but a time trend is less established in boys.17 This is a concern, as early puberty has been related to adult diseases such as depression, obesity, type 2 diabetes, cardiovascular disease, and cancers.811 Some authors have suggested the time trend to be partly attributable to the increase in childhood obesity.7,1215 Childhood obesity is associated with hyperandrogenism, insulin resistance and compensatory hyperinsulinism,16 which may initiate earlier puberty either by modulation of the hypothalamus-pituitary-gonadal axis17 or by increasing the bioavailability of sex hormones through insulins effect on the liver, adrenals, ovaries and adipose tissue.15 Several epidemiological studies have found obese girls to have earlier age at menarche and onset of breast development than normal-weight girls,14,15,1821 but studies on boys have found conflicting results.5,2233 Genetic factors and socioeconomic factors may, however, have confounded the reported association between childhood obesity and pubertal timing.34,35 Siblings raised together share a number of potential confounding factors, including socioeconomic factors and half of their genes. A number of limitations merit attention. Putative Effects of Obesity on Linear Growth and Puberty. In our study, the key exposure variable was overweight/obesity in childhood, and the key outcome variable was early puberty. FOIA A number of studies controlled for one or more confounding factors (13, 19, 20, 25, 26, 29, 31), such as parental education, race, height, whether the only child, family income, birth weight, breastfeeding, gestational age, and in-utero smoking. Pubertal overweight/obese girls have lower frequency and amplitude of LH pulses during sleep, while their responses to GnRH analog are similar to those of non overweight girls. Investigating the relationship between precocious puberty and obesity: a cross-sectional study in Shanghai, China. Peak LH responses correlate with LH peak concentrations. Obesity may trigger early puberty or a common genetic or environmental factor may underlie both phenomena (23, 27). Exp Clin Endocrinol Diabetes. "But nobody has a handle on prevention of obesity because it is such a complex . An American Cancer Society study of 404,576 men demonstrated the link: being overweight increases a man's risk by 8%, being obese boosts risk by 20%, and being severely obese increases risk by 34%. When including childhood BMI as a restricted cubic spline, the associations were reasonably linear (Figure2; Supplementary Figure 2, available as Supplementary data at IJE online). Trajectories of growth among children who have coronary events as adults. We conducted three sensitivity analyses. Most studies used BMI as the basis for defining childhood overweight/obesity, a few studies used body fat and skinfold thickness. We conducted the present meta-analysis according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Statement (21). For girls, puberty can begin as early as eight years old, with most instances of early puberty linked to childhood obesity. In vitro stimulation of the prepubertal rat gonadotropin-releasing hormone pulse generator by leptin and neuropeptide Y through distinct mechanisms, Height and weight at menarche and a hypothesis of critical body weights and adolescent events. In the sibling-matched study, higher BMI was associated with earlier age at attaining most pubertal milestones in girls, but only a tendency toward earlier pubertal timing was observed in boys. Adjusted mean age at attaining the pubertal milestones as spline functions of childhood BMI (body mass index). Buyken AE, Karaolis-Danckert N, Remer T.. Association of prepubertal body composition in healthy girls and boys with the timing of early and late pubertal markers. Cohort analysis: monthly difference in timing of puberty across childhood weight groups and per 5kg/m2 BMI. With the increase in childhood obesity worldwide, there has been an advance in the age at which puberty begins in girls, said the lead investigator, Maria Veronica Mericq, M.D., a professor at the university. By giving leptin to mice lacking it, the researchers were able to control when puberty starts. Lpez-Peralta S, Romero-Velarde E, Vsquez-Garibay EM, Gonzlez-Hita M, Robles-Robles LC, Ruiz-Gonzlez FJ, Prez-Romero MA. In boys, excess adiposity has been associated with advanced puberty in some studies, whereas others have reported a delay in pubertal onset. For example, when case-control studies are used to explore the relationship between smoking and lung cancer, lung cancer patients are likely to have recall bias on their past smoking dose and frequency due to the long incubation period of lung cancer. 2022. NSP-value >0.05; *P-value <0.01; **P-value <0.001; ***P-value <0.0001. See Int J Epidemiol. The https:// ensures that you are connecting to the Add the Michigan Medicine News Break oniTunes or anywhere you listen to podcasts. The sibling-matched analysis in boys showed a tendency toward earlier puberty given higher childhood BMI, although the estimates had wide confidence intervals. In conclusion, based on the available evidence, our systematic review and meta-analysis showed that for girls the associate between overweight/obesity and early puberty is definite or strong whereas for males, such an association is possible, prompting that future studies need to further explore the possible relationship between overweight/obesity and early puberty in boys. And puberty may be starting earlier in boys as well. Subgroup and sensitivity analyses were performed to explore possible sources of heterogeneity and to assess the robustness of the results. The site is secure. Puberty looks different, in terms of both reproductive hormones and breast maturation, in girls with excess total body fat, according to a new study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism. Future research is needed to confirm the association between childhood overweight/obesity and early puberty in boys based on larger sample size. Xu YY, Sun L, Guo X, Zhang J, Lou XM, Wang H, et al.. Girls had a significantly higher precocious puberty rate than boys (5.93% vs. 0.87%), particularly in those aged 7 years old (9.20%). et al. A European study also reported a positive relationship between preadolescent BMI and early puberty in boys, where voice breaking was defined as puberty occurring (13). The following data were extracted: first author, year of publication, study period, geographic region, gender, study design, length of follow-up, and age of enrolment (for cohort studies only), sample size, definition of overweight/obesity, definition of early puberty, and adjustments and matches made. Fourth, both case-control and cohort studies were included in our study, case-control studies may appear reverse causality. Would you like email updates of new search results? Childhood overweight and obesity were associated with earlier pubertal timing even after adjustment for unobserved time-stable confounders shared within families. The strength of this meta-analysis is the large sample size which involving 13,338 girls and 12,796 boys, and thereby can enhance statistical power, providing more precise and reliable risk estimates. To determine the relationship between childhood overweight/obesity and early puberty in both boys and girls. Begg's test did not show a potential publication bias (z = 0.49, p = 0.624). Data were compatible with these assumptions (data not shown). As the puberty information was provided half-yearly, the pubertal milestones were right-, left- or interval-censored. Birthweight and parity were obtained from the Danish Medical Birth Registry.44 Highest educational class of the parents was obtained from Statistics Denmark and classified according to the International Standard Class of Occupation and Education codes (ISCO-88 and ISCED). Its possible that leptin is speeding up the development of these structures in the base of the brain.. Generating an ePub file may take a long time, please be patient. Aksglaede L, Juul A, Olsen LW, Sorensen TI.. Age at puberty and the emerging obesity epidemic. In the cohort analysis, childhood overweight and obesity were associated with earlier pubertal timing in both boys and girls in a dose-dependent manner. Sandhu J, Ben-Shlomo Y, Cole TJ, Holly J, Davey Smith G.. Neurons that respond to leptin in this area have a fundamental role in pubertal development. The Committee for Biomedical Research Ethics in Denmark approved the collection of data in the DNBC ((KF)01471/94). Thus, the non-shared confounders were birth date (for adjustment of calendar time) and the same potential confounders as in the cohort analysis, except maternal age at menarche and highest educational class of parents, which were both shared by the sibling-pairs. It should be noted that overweight/obese children were at greater risk of early puberty when the study sample size was greater than 2000 or the follow-up duration was longer than 8 years. A combination of an increasingly sedentary lifestyle and unfavorable diet in the western world has resulted in increasing numbers of overweight and obese children and adults. already built in. A total of 10 studies involving 13,338 girls and 12,796 boys were included. Several studies have shown that during prepubertal years obese children have higher height velocity and accelerated bone age compared to lean subjects. Childhood overweight and obesity were associated with earlier puberty in a dose-dependent manner in boys and girls in the cohort analysis. Total obesity and central obesity from ages 4 to 7 raised the odds of early puberty compared with having a healthy weight. It follows the beginning of puberty, typically starting around age 14 or 15 and ends around age 17 or 18. All studies included here were of medium or high quality. To increase the statistical power, these children were sampled according to 12 different prenatal exposures, hypothesized to be causes of earlier pubertal timing, as well as a random sample of 8000 children.38 From August 2012, these 22439 children were invited half-yearly to provide information on pubertal development through web-based questionnaires, from the age of 11.5years until 18years or full maturity (defined as Tanner stage 5 for pubic hair and genital development in boys and Tanner stage 5 for pubic hair and breast development in girls). Although subgroup analysis revealed several important sources of heterogeneity, such as study design, sample size, follow-up duration, definition of early puberty and confounders controlled, we still cannot ignore the existence of heterogeneity. In a recent validation study within the Puberty Cohort, we found moderate agreement between self-reported Tanner stages when compared with Tanner staging assessed by clinicians.54 This may be problematic for breast assessment in obese girls, who may mistake adipose tissue for breast tissue.55 This might explain the stronger associations for breast stages, but it is probably less problematic for other pubertal milestones, where this measurement error most likely causes bias towards the null.56 In the cohort analysis, a relatively high proportion of children had already attained the earliest pubertal milestones, leaving their puberty information left-censored; in the sibling-matched analysis, a relatively high proportion of children had not attained the later pubertal milestones, as some only provided puberty information at 11years, leaving their puberty information right-censored (Supplementary Tables 7 and 8, available as Supplementary data at IJE online). Karpati AM, Rubin CH, Kieszak SM, Marcus M, Troiano RP. Growth of testicles and scrotal sac. "Prevention of obesity would prevent a slight delay in timing of puberty," Kaplowitz says. Secondly, substantial heterogeneity was found in this meta-analysis. The .gov means its official. As reported, up to 19.2% individuals aged 718 years old were overweight or obese in China (3). 1 Design A large population-based cross-sectional study using multistage, stratified . car clothes hanger bar near berlin; lambswool feather duster; healthcare assistant jobs in usa with visa sponsorship; nordstrom fitflop sale; clearsight 1 day discontinued Shamseer L, Moher D, Clarke M, Ghersi D, Liberati A, Petticrew M, et al.. suggested obesity in preadolescent children may lead to the improvement of aromatase activity, which can accelerate the conversion of androgens to estrogen (33). [emailprotected]. Previous studies found that obesity may alter hormone secretion and sensitivity, including leptin and insulin. (NHANES, 2021) From 1999 -2000 through 2017 -March 2020, US obesity prevalence increased from 30.5% to 41.9%. Meta-analytic pooling of these risk estimates yielded a summary OR of 2.22 (95% CI 1.652.99), with substantial heterogeneity (I2 = 94%, p < 0.001). According to results from studies reported in Table 1, girls with obesity enter puberty earlier compared with girls with normal weight. The genes that were expressed during pubertal transition were, in part, related to growing axons and dendrites, i.e. Then, a set of more rigorous selection criteria was used in the screening of the selected studies. Based on the underlying mechanisms between the childhood overweight/obesity and early puberty, we ventured to speculate that there might be a link between childhood overweight/obesity and early puberty in boys. Our goal was to identify the genes that were differentially expressed in these two brain areas that could provide some clues about the molecular mechanisms associated with pubertal onset and obesity-induced early puberty, Elias says. One remedy is the Mendelian randomization study design that exploits the random allocation of genes at conception to estimate causal effects by using randomized genetic variants as instruments for the exposure of interest.29 Findings from Mendelian randomization studies support a causal relation between childhood obesity and early menarche in girls.62,63 The sibling-matched design is another option for confounding control. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher. Compared with previous the meta-analysis, our study is more comprehensive since we assessed the association between childhood overweight/obesity and risk of early puberty in both girls and boys. Sensitivity analysis were performed by repeating the meta-analysis after the exclusion of each included study; results showed that exclusion of any single study did not materially alter the risk estimate of early puberty in boys (ORs ranged between 1.09 and 1.47; see Table 5). Body fat mass, body fat distribution, and pubertal development: a longitudinal study of physical and hormonal sexual maturation of girls, Role of obesity and leptin in the pubertal process and pubertal growth-a review, Leptin signaling and circuits in puberty and fertility. Jochum F, Abdellatif M, Adel A, Alhammadi A, Alnemri A, Alohali E, AlSarraf K, Al Said K, Elzalabany M, Isa HMA, Kalyanasundaram S, Reheim NA, Saadah O. Pediatr Gastroenterol Hepatol Nutr. Supplementary data are available at IJE online. 8600 Rockville Pike The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. If there was more than one study from the same population, only the most comprehensive or most recent published one was included. An official website of the United States government. Department of Pediatrics, Aarhus University Hospital, Aarhus, Denmark. precocious puberty and childhood overweight and obesity are important public health problems that both had adverse effects, which including psychological symptom in childhood, short final height or reproductive dysfunction in adulthood, on children's physical and psychological development.the prevalence of precocious puberty and childhood For girls, increased adiposity and earlier onset of puberty are linked in many studies. 2021 Dec 20;22(24):13662. doi: 10.3390/ijms222413662. Further research should focus not only on the relation of environmental factors and early puberty but also on genetic factors, and gene-environment interactions. and transmitted securely. Department of Clinical Epidemiology, Aarhus University Hospital, Aarhus, Denmark, 5 Heterogeneity in the risk estimates of early puberty was partially explained by study design, sample size, follow-up duration, definitions of early puberty and confounders controlled. On the basis of a large sample size, we received a more convincing result. Relation of age at menarche to race, time period, and anthropometric dimensions: the Bogalusa Heart Study, https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42021264649, Obesity: BMI of 95 percentile Overweight: 85th BMI to 94th percentile, Early menarche was defined as age at menarche earlier than 12 years. Corresponding author. Sensitivity analysis for the association of childhood overweight/obesity and early puberty in boys. The most important difference between cohort studies and case-control studies is the ability to demonstrate causation. There is clear evidence indicating that obesity leads to early appearance of pubertal signs in girls. Senior Communications Manager, Public Relations We aimed to investigate the relationship between precocious puberty and obesity as well as central obesity. [Associations between early onset of puberty and obesity types in children: Based on both the cross-sectional study and cohort study]. Adjusted mean age at attaining the pubertal milestones as spline functions of childhood BMI (body mass index).
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