Obesity May Affect Puberty Timing, and Breast Maturation In Young Girls
In view of the increasing incidence of overweight and obesity among children, the study of weight status and pubertal development has attracted attention. Recent research suggests, in mid-to-late puberty, girls with greater total body fat demonstrated higher levels of reproductive hormones, delayed breast maturation and early menarche. The study findings were published in The Journal of Clinical Endocrinology & Metabolism on February 25, 2021.
Previous epidemiologic studies demonstrated that overweight/obese girls (OW/OB) undergo thelarche and menarche earlier than normal-weight girls (NW). However, no longitudinal studies have specifically investigated how body weight/fat affects both clinical and biochemical pubertal markers in girls. For the same, researchers of the National Institutes of Health, Durham, USA, conducted a study to further investigate this transition in girls from the Triangle region of North Carolina.
It was a longitudinal study of 90 girls (36 OW/OB, 54 NW), aged 8.2–14.7 years, completed 2.8 ± 1.7 study visits over the course of four years. Researchers used the dual-energy x-ray absorptiometry to calculate total body fat (TBF), Tanner staging, breast ultrasound for morphological staging (BMORPH; A-E), pelvic ultrasound, hormone tests, and assessment of menarchal status. For analysis, associations between the aforementioned factors and total body fat were tested using mixed, multi-state, or Cox proportional hazards models adjusted for baseline BMOPRH.
Key findings of the study were:
• At baseline, researchers noted that the NW were older than OW/OB (11.3 vs. 10.2 yrs, p<0.01) and had more advanced BMORPH.
• Upon initial analysis, they found that the luteinizing hormone, estradiol, and ovarian and uterine volumes increased with time and total body fat appeared to have no effect on this.
• They noted an interaction time- total body fat interaction for follicle-stimulating hormone, inhibin B, estrone, total and free testosterone, and androstenedione.
• However, the levels were initially similar but increased in girls with higher TBF, plateaued in girls with mod-range TBF, and decreased in girls with lower TBF at 1 year.
• Additionally, they also found that girls with higher TBF progressed through BMORPH stage D more slowly but achieved menarche earlier than girls with lower TBF.
The authors concluded, "In late puberty, girls with higher TBF demonstrate differences in standard hormonal and clinical markers of puberty. Investigation of the underlying causes and clinical consequences of these differences in girls with higher TBF deserves further study."
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