Steroids, stress, and body mass index interact to accelerate female pubertal development
Authors' conclusion
Elevated metabolites of glucocorticoids, androgens, and progesterone are associated with accelerated pubertal onset, and BMI and stress modify this association.
Study context
- Population
- Girls aged 5 to 13 years at baseline from the LEGACY Girls Study, followed for 6 years; 36 urinary steroid metabolites measured before and during puberty
- Participants
- 327 participants
- Exposure
- Higher vs lower prepubertal urinary steroid metabolites
- Outcome
- Age at thelarche (parent-reported onset of breast development); also pubarche and menarche
Methodological detailslongitudinal, Weibull survival models, interactions with stress and body mass index (BMI) z-scores
- Longitudinal
- Weibull survival models
- Interactions with stress and BMI z-scores
Main finding
As reported in the abstract
Accelerated thelarche (HR per doubling of prepubertal urinary metabolites)
Hazard ratio (95% CI)
Higher prepubertal urinary metabolites of glucocorticoids
1.9(1.5–2.5)
Higher prepubertal urinary metabolites of androgens
3.9(2.7–5.6)
Higher prepubertal urinary metabolites of progesterone
6.7(4.1–10.9)
Per doubling of prepubertal urinary metabolites, as printed
Observational data: associations, not effects.
Further findings
Age at thelarche: high glucocorticoid metabolites combined with high BMI and stress vs low measures
- Thelarche reached earlier with high glucocorticoid metabolites, high BMI and high stress vs counterparts with low measures
- 7 months
Original publication
Steroids, stress, and body mass index interact to accelerate female pubertal development. J Clin Endocrinol Metab. Published 7 April 2026. doi:10.
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