Associations between early onset of puberty and obesity types in children: Based on both the cross-sectional study and cohort study

  • Tao MA ,
  • Yan-hui LI ,
  • Man-man CHEN ,
  • Ying MA ,
  • Di GAO ,
  • Li CHEN ,
  • Qi MA ,
  • Yi ZHANG ,
  • Jie-yu LIU ,
  • Xin-xin WANG ,
  • Yan-hui DONG ,
  • Jun MA
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  • 1. Institute of Child and Adolescent Health, Peking University School of Public Health, Beijing 100191, China
    2. School of Public Health and Management, Ningxia Medical University, Yinchuan 750004, China

Received date: 2022-06-13

  Online published: 2022-10-14

Supported by

the National Natural Science Foundation of China(81673192);the Research Special Fund for Public Welfare Industry of Health of the Ministry of Health of China(201202010)

Abstract

Objective: To explore and analyze the relationship between early onset of puberty and different types of obesity in children, by combining large sample cross-sectional survey data with long-term longitudinal cohort data, so as to provide clues for further clarifying the health hazards of early onset of puberty and obesity prevention and control. Methods: The research data were from the cross-sectional survey data of seven provinces(autonomous regions, municipalities) in China and the cohort data of adolescent development in Xiamen. The study first found the association between early onset of puberty and obesity by Logistic regression on the cross-sectional data, and then used Poisson regression to analyze the association between early puberty initiation and various types of obesity risk. Results: In the study, 43 137 and 1 266 children were included in the cross-sectional survey and cohort survey respectively. The cross-sectional study found that among the girls aged 10-13 years, compared with the girls of the same age who did not start puberty, the body mass index (BMI)-Z score of the girls in the puberty start group was 0.5-0.8 higher, and the waist circumference Z score was 0.4-0.7 higher, and the risk of various types of obesity was higher. At the same time, the early onset of puberty was positively correlated with simple obesity, central obesity and compound obesity, the OR (95%CI) were 1.86 (1.42-2.44), 1.95 (1.65-2.32) and 1.86 (1.41-2.45), respectively. No significant association was found in boys. According to the cohort data, in girls, the risk of simple obesity was 6.00 times [RR (95%CI): 6.00 (1.07-33.60)], the risk of central obesity was 3.30 times [RR (95%CI): 3.30 (1.22-8.92)], and the risk of compound obesity was 5.76 times [RR (95%CI): 5.76 (1.03-32.30)], compared with the group without early puberty initiation, while no association between early puberty initiation and obesity was found in boys. Conclusion: Based on the cross-sectional survey and longitudinal cohort survey, it is confirmed that the early onset of puberty in girls may increase the risk of simple obesity, central obesity and compound obesity, while there is no significant correlation between puberty onset and obesity in boys.

Cite this article

Tao MA , Yan-hui LI , Man-man CHEN , Ying MA , Di GAO , Li CHEN , Qi MA , Yi ZHANG , Jie-yu LIU , Xin-xin WANG , Yan-hui DONG , Jun MA . Associations between early onset of puberty and obesity types in children: Based on both the cross-sectional study and cohort study[J]. Journal of Peking University(Health Sciences), 2022 , 54(5) : 961 -970 . DOI: 10.19723/j.issn.1671-167X.2022.05.025

References

1 Patton GC , Viner R . Pubertal transitions in health[J]. Lancet, 2007, 369 (9567): 1130- 1139.
2 Veldhuis JD , Roemmich JN , Richmond EJ , et al. Endocrine control of body composition in infancy, childhood, and puberty[J]. Endocr Rev, 2005, 26 (1): 114- 146.
3 Vijayakumar N , Op de Macks Z , Shirtcliff EA , et al. Puberty and the human brain: Insights into adolescent development[J]. Neurosci Biobehav Rev, 2018, 92, 417- 436.
4 Day FR , Elks CE , Murray A , et al. Puberty timing associated with diabetes, cardiovascular disease and also diverse health outcomes in men and women: The UK Biobank study[J]. Sci Rep, 2015, 5, 11208.
5 Day FR , Thompson DJ , Helgason H , et al. Genomic analyses identify hundreds of variants associated with age at menarche and support a role for puberty timing in cancer risk[J]. Nat Genet, 2017, 49 (6): 834- 841.
6 Kennedy D , Norman C . What don't we know?[J]. Science, 2005, 309 (5731): 75.
7 Biro FM , Greenspan LC , Galvez MP , et al. Onset of breast deve-lopment in a longitudinal cohort[J]. Pediatrics, 2013, 132 (6): 1019- 1027.
8 Kaplowitz PB , Slora EJ , Wasserman RC , et al. Earlier onset of puberty in girls: Relation to increased body mass index and race[J]. Pediatrics, 2001, 108 (2): 347- 353.
9 Rosenfield RL , Lipton RB , Drum ML . Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index[J]. Pediatrics, 2009, 123 (1): 84- 88.
10 Mamun AA , Hayatbakhsh MR , O'Callaghan M , et al. Early overweight and pubertal maturation: Pathways of association with young adults' overweight: A longitudinal study[J]. Int J Obes (Lond), 2009, 33 (1): 14- 20.
11 Wang Y . Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls[J]. Pediatrics, 2002, 110 (5): 903- 910.
12 Crocker MK , Stern EA , Sedaka NM , et al. Sexual dimorphisms in the associations of BMI and body fat with indices of pubertal development in girls and boys[J]. J Clin Endocrinol Metab, 2014, 99 (8): E1519- E1529.
13 孙莹. 中国儿童青春发动时相评定标准的建立及应用研究[D]. 合肥: 安徽医科大学, 2013.
14 Ribeiro J , Santos P , Duarte J , et al. Association between overweight and early sexual maturation in Portuguese boys and girls[J]. Ann Hum Biol, 2006, 33 (1): 55- 63.
15 Tomova A , Robeva R , Kumanov P . Influence of the body weight on the onset and progression of puberty in boys[J]. J Pediatr Endocrinol Metab, 2015, 28 (7/8): 859- 865.
16 S?rensen K , Aksglaede L , Petersen JH , et al. Recent changes in pubertal timing in healthy Danish boys: Associations with body mass index[J]. J Clin Endocrinol Metab, 2010, 95 (1): 263- 270.
17 Cole TJ , Bellizzi MC , Flegal KM , et al. Establishing a standard definition for child overweight and obesity worldwide: International survey[J]. BMJ, 2000, 320 (7244): 1240- 1243.
18 Freedman DS , Wang J , Maynard LM , et al. Relation of BMI to fat and fat-free mass among children and adolescents[J]. Int J Obes (Lond), 2005, 29 (1): 1- 8.
19 van Dijk SB , Takken T , Prinsen EC , et al. Different anthropometric adiposity measures and their association with cardiovascular disease risk factors: A meta-analysis[J]. Neth Heart J, 2012, 20 (5): 208- 218.
20 Lee CM , Huxley RR , Wildman RP , et al. Indices of abdominal obesity are better discriminators of cardiovascular risk factors than BMI: A meta-analysis[J]. J Clin Epidemiol, 2008, 61 (7): 646- 653.
21 Xi B , Zong X , Kelishadi R , et al. International waist circumfe-rence percentile cutoffs for central obesity in children and adolescents aged 6 to 18 years[J]. J Clin Endocrinol Metab, 2020, 105 (4): e1569- e1583.
22 马传伟, 羊柳, 赵敏, 等. 儿童腹型肥胖及其肥胖类型与颈动脉内中膜厚度的关系[J]. 中华流行病学杂志, 2020, 41 (9): 1450- 1454.
23 中国学生体质与健康研究组. 2010年中国学生体质与健康调研报告[M]. 北京: 高等教育出版社, 2012: 31- 86.
24 Lian Q , Mao Y , Luo S , et al. Puberty timing associated with obesity and central obesity in Chinese Han girls[J]. BMC Pediatr, 2019, 19 (1): 1.
25 Guo X , Ji C . Earlier menarche can be an indicator of more body fat: study of sexual development and waist circumference in Chinese girls[J]. Biomed Environ Sci, 2011, 24 (5): 451- 458.
26 田璐, 郑涵, 李岩志, 等. 女性月经初潮年龄与肥胖关系的研究[J]. 中华流行病学杂志, 2021, 42 (7): 1231- 1234.
27 韦晓淋, 华钰洁, 陆艳, 等. 月经初潮年龄对女性成年后近期和远期肥胖的影响[J]. 中华流行病学杂志, 2019, 40 (2): 142- 146.
28 Gill D , Brewer CF , Del Greco MF , et al. Age at menarche and adult body mass index: A Mendelian randomization study[J]. Int J Obes (Lond), 2018, 42 (9): 1574- 1581.
29 Mendle J , Turkheimer E , Emery RE . Detrimental psychological outcomes associated with early pubertal timing in adolescent girls[J]. Dev Rev, 2007, 27 (2): 151- 171.
30 Blaine B . Does depression cause obesity? A meta-analysis of longitudinal studies of depression and weight control[J]. J Health Psychol, 2008, 13 (8): 1190- 1197.
31 Marshall WA , Tanner JM . Variations in pattern of pubertal changes in girls[J]. Arch Dis Child, 1969, 44 (235): 291- 303.
32 Marshall WA , Tanner JM . Variations in the pattern of pubertal changes in boys[J]. Arch Dis Child, 1970, 45 (239): 13- 23.
33 史慧静. 青少年健康研究应关注青春发动时相[J]. 中国学校卫生, 2008, 29 (4): 289- 291.
34 Reinehr T , Bosse C , Lass N , et al. Effect of weight loss on puberty onset in overweight children[J]. J Pediatr, 2017, 184, 143- 150.e1.
35 Marcovecchio ML , Chiarelli F . Obesity and growth during childhood and puberty[J]. World Rev Nutr Diet, 2013, 106, 135- 141.
36 李科琼, 王宏, 郭靖, 等. 重庆市中小学生首次遗精与月经初潮现状及相关因素研究[J]. 中华流行病学杂志, 2016, 37 (2): 169- 173.
37 S?rensen K , Juul A . BMI percentile-for-age overestimates adiposity in early compared with late maturing pubertal children[J]. Eur J Endocrinol, 2015, 173 (2): 227- 235.
38 Scacchi M , Pincelli AI , Cavagnini F . Growth hormone in obesity[J]. Int J Obes Relat Metab Disord, 1999, 23 (3): 260- 271.
39 Malik IA , Durairajanayagam D , Singh HJ . Leptin and its actions on reproduction in males[J]. Asian J Androl, 2019, 21 (3): 296- 299.
40 付连国, 阳益德, 马军, 等. 中国青春期女生月经初潮较早与身体素质的关系[J]. 中华预防医学杂志, 2013, 47 (8): 707- 711.
41 Cheng TO . Central obesity is a more sensitive predictor of cardiovascular disease than body mass index in the Chinese population[J]. Int J Cardiol, 2009, 135 (3): 385.
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