ESPE Yearbook of Paediatric Endocrinology

Program Collaborators for Environmental Influences on Child Health OutcomesJAMA Netw Open. 2022 Feb 1;5(2):e2146873. doi: 10.1001/jamanetworkopen.2021.46873. PMID: 35119461https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2788643/

Brief Summary: This study describes the correlation between growth patterns during the first 5 years of life and onset of puberty. A sex-specific association was found between rapid weight and height gains and early onset of puberty.

A secular trend in timing of pubertal onset has been reported world-wide [1]. The mechanism is likely multifactorial. Some studies have hypothesized a role for altered growth patterns in childhood caused by environmental exposure or nutritional excess [2]–[5]. This prospective multi-cohort study evaluated the correlation between growth patterns during the first 5 years of life and the onset of puberty. 7495 children were included (3772 girls and 3712 boys) and examined during early infancy (first 5 months of life), late infancy (5 month – 2 years) and early childhood (2-5 years). The primary outcome was age at peak height velocity (APHV), while the secondary outcome was self-reported or parent-reported age at pubertal onset and age at menarche. Anamnestic data about pregnancy, maternal data, socioeconomic level, ethnicity and environmental exposure were collected. Girls had an earlier APHV than boys (10.8 vs 12.9 years). Boys with faster gain in weight, length or height or BMI exhibited earlier pubertal onset evidenced by earlier APHV. Girls with faster gains in weight and length or height in early childhood had earlier APHV, while girls with faster gains in weight and BMI in late infancy and early childhood exhibited earlier time at menarche and pubarche, respectively. In all cases, data were normalized for available anamnestic parameters. Comorbidities were not evaluated.

Although puberty was indirectly evaluated, this large multi-cohort study identifies rapid growth patterns during the first years of life as a potential risk factor for earlier pubertal onset.

References: 1. Eckert-Lind C, Busch AS, Petersen JH, Biro FM, Butler G, Bräuner EV, Juul A. (2020) “Worldwide Secular Trends in Age at Pubertal Onset Assessed by Breast Development Among Girls: A Systematic Review and Meta-analysis.” JAMA Pediatr; 1; 174(4):e195881. 2. Villamor E, Jansen EC. (2016) “Nutritional Determinants of the Timing of Puberty,” Annu Rev Public Health; 37:33–46. 3. Euling SY, Selevan SG, Pescovitz OH, Skakkebaek NE. (2008) “Role of environmental factors in the timing of puberty,” Pediatrics; 121 Suppl 3:S167–71. 4. Dunger DB, Ahmed ML, Ong KK. (2006) “Early and late weight gain and the timing of puberty,” Mol Cell Endocrinol; 254–255:140–5. 5. Aydin BK, Devecioglu E, Kadioglu A, Cakmak AE, Kisabacak S, Gokcay G, Bas F, Poyrazoglu S, Bundak R, Darendeliler F. (2017) “The relationship between infancy growth rate and the onset of puberty in both genders.” Pediatr Res; 82(6):940–946.