Thelarche, pubarche, and menarche attainment in children with normal and elevated body mass index
Abstract
BACKGROUND: The early onset of puberty may be related to obesity, so there is a need to know the prevalence of early pubertal milestones in nonoverweight children. OBJECTIVE. We compared attainment of stage 2 breasts, stage 3 (sexual) pubic hair, and menarche in the Third National Health and Nutrition Examination Survey sample of children with normal BMI with those with excessive BMI (> or =85th percentile). DESIGN/METHODS: The ages at which 5%, 50%, and 95% of youth had attained key pubertal stages were estimated by probit models. Logit models were then fit to compare attainment of these milestones in children of excessive and normal BMI. RESULTS: Pubertal signs occurred before 8.0 years of age in <5% of the normal-BMI general and non-Hispanic white female population. However, pubertal milestones generally appeared earlier in normal-BMI non-Hispanic black and Mexican American girls; thelarche occurred before age 8.0 in 12% to 19% of these groups, and the 5th percentile for menarche was 0.8 years earlier for non-Hispanic black than non-Hispanic white subjects. Pubarche was found in < or =3% of 8.0-year-old girls with normal BMI of all of these ethnic groups but was significantly earlier in minority groups. Pubarche appeared before 10.0 years in <2% of normal-BMI boys. Girls with excessive BMI had a significantly higher prevalence of breast appearance from ages 8.0 through 9.6 years and pubarche from ages 8.0 through 10.2 years than those with normal BMI. Menarche was also significantly more likely to occur in preteen girls with an elevated BMI. CONCLUSIONS: Prevalence estimates are given for the key pubertal milestones in children with normal BMI. Breast and sexual pubic hair development are premature before 8 years of age in girls with normal BMI in the general population. Adiposity and non-Hispanic black and Mexican American ethnicity are independently associated with earlier pubertal development in girls.
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Puberty is deemed physiological when it begins between the ages of 8 and 12 years in girls and between 9 and 14 years in boys.
“Puberty is deemed physiological when it begins between the ages of 8 and 12 years in girls and between 9 and 14 years in boys.14”
From Pubertal development and regulation (2016) · cites this paper as [14]
Earlier puberty may be partly caused by increases in food intake and body mass index, but racial differences may also be independent of differences in body mass index.
“Earlier puberty may be partly caused by increases in food intake and body mass index, but racial differences may also be independent of differences in body mass index”
From Does puberty mark a transition in sensitive periods for plasticity in the associative neocortex? (2017) · cites this paper as Rosenfield et al., 2009
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“…testicular volume ≥ 4 mL [24]]; females ≥ 10 years [median age to observe Tanner stage II breast development in girls with BMI 10 – 84th percentile [25]]), longer diabetes duration ( ≥ 6 months), over-weight (BMI z-score ≥ 1.0, corresponding to the overweight de fi nition ≥ 85th percentile [5]) and…”
Influential
- Authors
- Rosenfield, R. L., Lipton, R. B., & Drum, M. L.
- Affiliations
- Departments of Pediatrics
- University of Chicago (US)
- Venue
- PEDIATRICS
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2009-01-01
- Volume
- 123
- Issue
- 1
- Pages
- 84-88
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- OpenAlex
- W2170243963
- Cited by
- 499
- References
- 22
- Citations by year
- 2026: 18 · 2025: 20 · 2024: 27 · 2023: 36 · 2022: 37 · 2021: 38 · 2020: 73 · 2019: 21 · 2018: 35 · 2017: 20 · 2016: 27 · 2015: 26 · 2014: 25 · 2013: 22 · 2012: 23
- FWCI
- 19.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- Funders
- U.S. Public Health Service (U54-041859)
- National Institute of Diabetes and Digestive and Kidney Diseases (R01DK044752, R01 DK44752)
- National Center for Research Resources (RR-00055)
- Eunice Kennedy Shriver National Institute of Child Health and Human Development
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Hypothalamic control of reproductive hormones
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Obesity, Physical Activity, Diet
- Health Sciences › Health Professions › General Health Professions › Adolescent Sexual and Reproductive Health
- Keywords
- thelarche, pubarche, menarche, pubertal timing, childhood obesity, body mass index, precocious puberty, breast development, pubic hair development, ethnic differences
- MeSH terms
- Adolescent, Body Composition, Body Weight, Child, Female, Humans, Male, Menarche, Nutrition Surveys, Obesity, Puberty, Puberty, Precocious, Body Mass Index, Overweight
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