Current Pubertal Development in Chinese Children and the Impact of Overnutrition, Lifestyle, and Perinatal Factors
Authors' conclusion
Over the past decade, pubertal development is occurring earlier in Chinese children. While the cause is multifactorial, overweight and obesity are associated with earlier puberty onset. The currently used normative pubertal data of precocious puberty may not be applicable to diagnose precocious puberty.
Study context
- Population
- Chinese children and adolescents, nationally representative sample, 2017–2019; growth and pubertal staging by physical examination
- Participants
- 231,575 children
- Exposure
- Boys vs Girls
- Boysn = 123,232
- Girlsn = 108,343
- Outcome
- Current status of sexual maturation
Methodological detailsnational, community-based health survey, multistage, stratified cluster random sampling, nationally representative sample
- National
- Community-based health survey
- Multistage, stratified cluster random sampling
- Nationally representative sample
Main finding
As reported in the abstract
Median age of Tanner 2 breast development (similar to 10 years previously)
9.65 years
Median age of menarche (similar to 10 years previously)
12.39 years
Median age of testicular volume ≥4 mL (male puberty earlier than 10 years previously)
10.65 years
Observational data: associations, not effects.
Secondary outcomes
Girls with breast development by age band
- 6.5-6.99 years old
- 3.3%
- 7.5-7.99 years old
- 5.8%
Boys with testicular volume ≥4 mL by age band
- 7.5-7.99 years
- 1.5%
- 8.5-8.99 years
- 3.5%
Weight status and earlier puberty
- Obesity and overweight increased risk of earlier puberty vs normal weight in boys and girls
Original publication
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