Abstract
Objective:
We aimed to evaluate the current status of sexual maturation of Chinese children, to examine the association between obesity and early sexual maturation in boys and compare it with girls and to test the hypothesis that the associations differ by gender.
Study Design:
Cross-sectional study.
Subjects:
A representative sample involving 9812 boys and 8895 girls aged 6–18 years who participated in the Chinese Children and Adolescent Metabolic Syndrome Epidemiologic Study (July 2009– July 2010) were surveyed.
Methods:
All subjects had complete anthropometry and sexual maturation data. Subjects who reached Tanner stage 2 or more (5601 boys and 6538 girls) were divided into tertiles based on the timing of sexual maturation. The subjects in the earliest tertile were included into the early-maturing group, and the middle tertile and the latest tertile into the not early-maturing group. Overweight was defined as a body mass index (BMI) ⩾85th percentile and obesity ⩾95th percentile. Logistic regression analysis was used to test how early maturation affected the risk of overweight. Multiple linear regression was used to examine the association between fatness (BMI Z-score) and sexual maturation.
Results:
Slightly more boys were obese than girls (P<0.01). The median age for girls of the Tanner stage 2 was 9.69 years, and for boys of Tanner stage 2 was 11.25 years. BMI Z-score were higher (P<0.01) in both early-maturing girls and boys, compared with the non-early maturers, respectively. Early sexual maturation was positively associated with obesity in both girls and boys. With covariates adjusted and using non-early maturing as the reference group, odds ratios for combined overweight were 1.48 for boys and 2.64 for girls, and for obesities were 1.61 for boys and 3.49 for girls, respectively.
Conclusion:
Obesity is positively associated with sexual maturation in both boys and girls, and the association does not differ by gender, but the association is stronger in girls than in boys.
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References
Field AE, Coakley EH, Must A, Spadano JL, Laird N, Dietz WH et al. Impact of overweight on the risk of developing chronic diseases during a 10 year period. Arch Intern Med 2001; 161: 1581–1586.
Pischon T, Lahmann PH, Boeing H, Friedenreich C, Norat T, Tjønneland A et al. Body size and risk of colonand rectal cancer in the European prospective investigation intocancer and nutrition (EPIC). J Natl Cancer Inst 2006; 98: 920–931.
Frisch RE, McArthur JW . Menstrual cycles: fatness as a determinant of minimum weight for height necessary for their maintenance or onset. Science 1974; 185: 949–951.
Wang Y . Is obesity associated with early sexual maturation? A comparison of the association in American boys versus girls. Pediatrics 2002; 110: 903–910.
Sørensen K, Aksglaede L, Petersen JH, Juul A . Recent changes in pubertal timing in healthy Danish boys: associations with body mass index. J Clin Endocrinol Metab 2010; 95: 263–270.
Marshall WA, Tanner JM . Variations in the pattern of pubertal changes in boys. Arch Dis Child 1970; 45 13–23.
Zachmann M, Prader A, Kind HP, Ha¨ fliger H, Budliger H . Testicular volume during adolescence. Cross-sectional and longitudinal studies. Helv Paediatr Acta 1974; 29: 61–72.
Group of China Obesity Tasldoree. Body mass index reference nOITU for screening overweight and obesity in Chinese children and adolescents. Chin J Epidemiol 2004; 25: 97–102.
World Health Organization. Expert Committee. Physical Status, the Use and Interpretation of Anthropometry. Geneva, Switzerland: World Health Organization, 1995, pp 263–311.
Euling SY, Herman-Giddens ME, Lee PA, Selevan SG, Juul A, Sorensen TI et al. Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics 2008; 121 (Suppl 3): S172–S191.
The Pubertal Study Group of the Subspecialty Group of Endocrinologic, Hereditary and Metabolic Diseases. Society of Pediatrics, Chinese Medical Association. Testis volume, pubic hair development and spermarcheal age in urban Chinese boys. Chin J Pediatr 2010; 48: 418–424.
The Pubertal Study Group of the Subspecialty Group of Endocrinologic, Hereditary and Metabolic Diseases. Society of Pediatrics, Chinese Medical Association. Secondary sexual characteristics and menses in urban Chinese girls. Chin J Endocrinol Metab 2010; 26: 669–675.
Garn SM, Lavelle M, Rosenberg KR, Hawthorne VM . Maturational timing as a factor in female fatness and obesity. Am J Clin Nutr 1986; 43: 879–883.
Katon JG, Flores YN, Salmerón J . Sexual maturation and metabolic profile among adolescents and children of the Health Worker Cohort Study in Mexico. Salud Publ Mex 2009; 51: 219–226.
Carlsen E, Andersen AG, Buchreitz L, Jørgensen N, Magnus O, Matulevicuus V et al. Inter-observer variation in the results of the clinical andrological examination including estimation of testicular size. Int J Androl 2000; 23: 248–253.
Karaman MI, Kaya C, Caskurlu T, Guney S, Ergenekon E . Measurement of pediatric testicular volume with Praderorchidometer: comparison of different hands. Pediatr Surg Int 2005; 21: 517–520.
Sakamoto H, Saito K, Oohta M, Inoue K, Ogawa Y, Yoshida H . Testicular volume measurement: comparison of ultrasonography,orchidometry, and water displacement. Urology 2007; 69: 152–157.
Jin L, Burguera BG, Couce ME, Scheithauer BW, Lamsan J, Eberhardt NL et al. Leptin and leptin receptor expression in normal and neoplastic human pituitary: evidence of a regulatory role for leptin on pituitary cell proliferation. J Clin Endocrinol Metab 1999; 84: 2903–2911.
Lebrethon MC, Vandersmissen E, Gerard A, Parent AS, Junien JL, Bourguignon JP . In vitro stimulation of the prepubertal rat gonadotropin-releasing-hormone pulse generator by leptin and neuropeptide Y through distinct mechanisms. Endocrinology 2000; 141: 1464–1469.
Yu WH, Kimura M, Walczewska A, Karanth S, McCann SM . Role of leptin in hypothalamic-pituitary function. Proc Natl Acad Sci USA 1997; 94: 1023–1028.
Karlsson C, Lindell K, Svensson E, Bergh C, Lind P, Billig H et al. Expression of functional leptin receptors in the human ovary. J Clin Endocrinol Metab 1997; 82: 4144–4148.
Gortmaker SL, Dietz WH Jr, Sobol AM, Wehler CA . Increasing pediatric obesity in the United States. Am J Dis Child 1987; 141: 535–540.
Clayton PE, Gill MS, Hall CM, Tillmann V, Whatmore AJ, Price DA . Serum leptin through childhood and adolescence. Clin Endocrinol (Oxf ) 1997; 46: 727–733.
Blum WF, Englaro P, Hanitsch S, Juul A, Hertel NT, Müller J et al. Plasma leptin levels in healthy children and adolescents: dependence on body mass index, body fat mass, gender, pubertal stage, and testosterone. J Clin Endocrinol Metab 1997; 82: 2904–2910.
Mantzoros CS, Flier JS, Rogol AD . A longitudinal assessment of hormonal and physical alterations during normal puberty in boys, V: rising leptin levels may signal the onset of puberty. J Clin Endocrinol Metab 1997; 82: 1066–1070.
Klein KO, Larmore KA, de Lancey E, Brown JM, Considine RV, Hassink SG . Effect of obesity on estradiol level, and its relationship to leptin, bone maturation, and bone mineral density in children. J Clin Endocrinol Metab 1998; 83: 3469–3475.
Hassink SG, Sheslow DV, de Lancey E, Opentanova I, Considine RV, Caro JF . Serum leptin in children with obesity: relationship to gender and development. Pediatrics, 1996; 98 (Part 1): 201–203.
Ribeiro J, Santos P, Duarte J, Mota J . Association between overweight and early sexual maturation in Portuguese boys and girls. Ann Hum Biol 2006; 33: 55–63.
Schneider G, Kirschner MA, Berkowitz R, Ertel NH . Increased estrogen production in obese men. J Clin Endocrinol Metab 1979; 48: 633–638.
Jensen TK, Andersson AM, Jorgensen N, Andersen AG, Carlsen E, Petersen JH et al. Body mass index in relation to semen quality and reproductive hormones among 1558 Danish men. Fertil Steril 2004; 82: 863–870.
Bagatell CJ, Dahl KD, Bremner WJ . The direct pituitary effect of testosterone to inhibit gonadotropin secretion in men is partially mediated by aromatization to estradiol. J Androl 1994; 15: 15–21.
Hayes FJ, Seminara SB, Decruz S, Boepple PA, Crowley WF Jr . Aromatase inhibition in the human male reveals a hypothalamic site of estrogen feedback. J Clin Endocrinol Metab 2000; 85: 3027–3035.
Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R et al. CDC Growth Charts: United States. Adv Data 2000; 8: 1–27.
Cole TJ, Bellizzi MC, Flegal KM, Dietz WH . Establishing a standard definition for child overweight and obesity worldwide: international survey. BMJ 2000; 320: 1240–1243.
Bray GA, Bouchard C, James WPT . Handbook of Obesity. New York, NY: Marcel Dekker, 1998, pp 143–152, 243–266, 457–469.
Acknowledgements
This work was supported by a grant from National Key Technology R&D Program of China (2012BAI02B03, 2009BAI80B01), National Natural Science Fund (81270938), Zhejiang Provincial Key Disciplines of Medicine (Innovation discipline, 11-CX24), Zhejiang Province Key Scientific and Technological Innovation Team (2010R50050) and Sea-Related International Exchanges and Cooperation (S20120001534). We all agree that the manager of each unit is the co-first author of the paper.
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Dai, Y., Fu, J., Liang, L. et al. Association between obesity and sexual maturation in Chinese children: a muticenter study. Int J Obes 38, 1312–1316 (2014). https://doi.org/10.1038/ijo.2014.116
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DOI: https://doi.org/10.1038/ijo.2014.116
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