Prepubertal Growth Trajectory and Pubertal Onset
Authors' conclusion
In this cohort study, high-level or increasing prepubertal growth trajectories and greater CEA were associated with earlier and higher risk of pubertal onset. These findings highlight the importance of considering CEA in relation to early pubertal onset and suggest that ages 3 to 4 years may be an important intervention period for earlier pubertal onset monitoring.
Study context
- Population
- Children followed from birth to puberty in Australia and China with repeated anthropometric measures and completed pubertal onset measures2 birth cohorts
- Participants
- 3,354 vs 1,105
- Exposure
- Prepubertal body mass index (BMI) trajectories, cumulative exposure to adiposity (CEA) and rates of BMI increase at each age
- Longitudinal Study of Australian Children (LSAC)n = 3,354
- Tianjin Birth Cohort Study (TBCS)n = 1,105
- Outcome
- Pubertal status and timing (age and risk of pubertal onset) by parent-reported Pubertal Development Scale
Methodological details2 birth cohorts (LSAC, TBCS), latent class growth mixed model, interval regression and Cox proportional hazards regression, Data analysis April 2023 to November 2025, LSAC March 2004 to September 2021; TBCS May 2021 to April 2024
- 2 birth cohorts (LSAC, TBCS)
- Latent class growth mixed model
- Interval regression and Cox proportional hazards regression
- Data analysis April 2023 to November 2025
- LSAC March 2004 to September 2021; TBCS May 2021 to April 2024
Main finding
As reported in the abstract
Girls in high-level or increasing BMI trajectory groups: age at pubertal onset, β (years)
from −0.36 (95% CI, −0.66 to −0.07) to −1.51 (95% CI, −2.68 to −0.35)
Girls in high-level or increasing BMI trajectory groups: risk of pubertal initiation, HR
from 1.35 (95% CI, 1.04 to 1.74) to 2.80 (95% CI, 1.69 to 4.63)
Higher CEA and average CEA (both >2): age at pubertal onset, β (years); greater effect after averaging
from −0.04 (95% CI, −0.05 to −0.03) to −0.85 (95% CI, −1.48 to −0.23)
Observational data: associations, not effects.
Further findings
Mean (SD) age at last round
Sensitive ages 3 to 4 years: BMI increase and pubertal timing
- Pubertal timing, β (years)
- from −1.35 (95% CI, −2.00 to −0.71) to −3.41 (95% CI, −4.13 to −2.68)
- Risk of pubertal onset, HR
- from 1.85 (95% CI, 1.29 to 2.67) to 5.59 (95% CI, 3.73 to 8.37)
- Effect sizes of CEA within this period greater than outside it
Original publication
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