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. 2020 Jun 1;49(3):834-844.
doi: 10.1093/ije/dyaa056.

Childhood overweight and obesity and timing of puberty in boys and girls: cohort and sibling-matched analyses

Nis Brix  1 , Andreas Ernst  1 , Lea Lykke Braskhøj Lauridsen  1 , Erik Thorlund Parner  1 , Onyebuchi A Arah  2   3 , Jørn Olsen  2   4 , Tine Brink Henriksen  5 , Cecilia Høst Ramlau-Hansena  1
Affiliations

Childhood overweight and obesity and timing of puberty in boys and girls: cohort and sibling-matched analyses

Nis Brix et al. Int J Epidemiol. .

Erratum in

Abstract

Background: Early puberty is a risk indicator for adult diseases. Identification of modifiable causes of earlier puberty is, therefore, warranted. We estimate the association between childhood body mass index (BMI) and pubertal timing in a cohort study and in a sibling-matched study to adjust for unobserved time-stable confounders shared within families.

Methods: For the cohort study, 11 046 of 22 439 (49%) invited children, born 2000-203, from the Danish National Birth Cohort (DNBC) had information on childhood BMI at 7 years and self-reported, half-yearly puberty information from 11 years on Tanner stages, menarche, voice break, first ejaculation, acne, and axillary hair. For the sibling-matched study, 1700 brothers and sisters were included among 86 820 live-born singletons from the DNBC.

Results: Childhood overweight (85th ≤ BMI < 95th percentile) and obesity (BMI ≥ 95th percentile) were associated with earlier age attaining the pubertal milestones in a dose-dependent manner in boys and girls. When modelling all pubertal milestones simultaneously, the pubertal milestones were attained earlier in: overweight boys: -3.1 [95% confidence interval (CI): -4.5, -1.7] months, overweight girls: -5.5 (95% CI: -7.1, -3.9) months, obese boys: -3.5 (95% CI: -5.1, -2.0) months, obese girls: -5.2 (95% CI: -7.1, -3.4) months compared with normal weight (BMI < 85th percentile) children. In the sibling-matched study, higher BMI was associated with earlier age at attaining most pubertal milestones in girls, but only a tendency toward earlier pubertal timing was observed in boys.

Conclusions: Childhood overweight and obesity were associated with earlier pubertal timing even after adjustment for unobserved time-stable confounders shared within families.

Keywords: Obesity; adiposity; body mass index; menarche; paediatric obesity; puberty.

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Figures

Figure 1
Figure 1
Flow chart of children included in the cohort analysis and the sibling-matched analysis. BMI, body mass index; DNBC, Danish National Birth Cohort; FU, follow-up.
Figure 2
Figure 2
Adjusted mean age at attaining the pubertal milestones as spline functions of childhood BMI (body mass index). Tanner stage 2 (dashed line), Tanner stage 5 (solid line), voice break (dashed line), first ejaculation (solid line) and menarche (solid line). Estimates presented for a reference child who was the first-born child with a birthweight of 3500 g, who had average diet, physical activity and sedentary behaviour in childhood, and whose mother was a high-grade professional, had pre-pregnant normal weight, did not smoke during first trimester and had menarche at same time as her peers. NSP-value >0.05; *P-value <0.01; **P-value <0.001; ***P-value <0.0001.
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