ESPE Yearbook of Paediatric Endocrinology

Hormone Research in Paediatrics 2020;93:548–557https://bit.ly/2ToJvmv

The authors studied 2,657 German children aged 5-18 years to look for social patterning in the age at puberty timing and circulating gonadotrophin levels. Lower socio-economic status (SES) was associated with earlier thelarche, longer duration of puberty, and overweight in girls, but not age at menarche. In boys, lower SES showed a trend to earlier puberty onset. The paper also provides cut-off levels for serum LH (0.56 IU/L) and FSH (1.74 IU/L) as biochemical indicators of gonadarche in boys.

Puberty as a critical time of growth and development is influenced by a range of genetic, environmental, and lifestyle factors and may affect health risks. Early puberty might lead to adverse outcomes such as increased substance use, earlier sexual activity, and increased risk of breast cancer.There is clear evidence that there has been a decline in the age of pubertal onset and that, besides weight status, pubertal onset and duration are influenced by socioeconomic context.

Possible explanations for the link between lower SES and earlier puberty timing include social patterning in BMI, diet, physical activity and psychological stress (1). In addition, the authors argue that the findings are in agreement with John Bowlby’s theory of attachment and control of evolutionary strategy of puberty and fecundity. According to this theory, attachment in infants is primarily a process of proximity seeking to an identified attachment figure in situations of perceived distress or alarm for the purpose of survival. Infants become attached to adults who are sensitive and responsive in social interactions, and who remain as consistent caregivers for some months during the period from ages ^~6 months to 2 years. Parental responses lead to the development of patterns of attachment, which in turn lead to “internal working models”, which will guide the individual’s feelings, thoughts and expectations in later relationships.

Reference: 1. Ong KK. What triggers puberty? Arch Dis Child. 2017; 102(3): 209–210.