Thelarche, Pubarche, and Menarche Attainment in Children With Normal and Elevated Body Mass Index

Department of aPediatrics, University of Chicago, Chicago, IL, USA.
PEDIATRICS (Impact Factor: 5.47). 02/2009; 123(1):84-8. DOI: 10.1542/peds.2008-0146
Source: PubMed


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).
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.
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.
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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    • "Previous studies reporting comparisons between age at menarche among Maya and non-Maya girls or women from Yucatan are not available . However, at least we know that Mexican American girls attain puberty earlier than non-Hispanic Whites and later than African American girls, even when adjusting for BMI (Rosenfield, Lipton, and Drum 2009), giving an idea that ethnic or physical traits among girls of Mexican origin might be independently associated with EM (Mangweth-Matzek et al. 2007). In addition, children of mothers who had EM are more frequently overweight or obese (Ong et al. 2007). "
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    ABSTRACT: Early menarche (EM) (i.e., age at menarche [AAM] <12 years of age) is related to short height and higher body fatness. In a mixed-longitudinal study done in Merida, Yucatan, height, body mass index (BMI), and percentage of body fat (BF%) were recorded at a one-year interval among 258 postmenarcheal (EM = 94) girls. Anthropometric measurements were recorded of the age cohorts in 2008–09 when participants were 13–17 years of age (baseline), and in the one-year follow-up study (± 6 days) the girls were 14–18 years of age. The BF% was estimated through bioelectrical impedance analysis. Mean AAM was 10.59 years in EM girls and 12.54 years in not early menarche (NEM) girls. Height growth (cm/year) was greater in NEM girls. Mean values of BMI, BF%, and frequencies of stunting (low height-for-age) and excess weight (overweight + obesity) were higher in EM girls than in their NEM age peers.
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    • "In addition to diet, body weight affects puberty according to an inverted relation, with increased body weight associated with earlier pubertal onset (Rosenfield et al., 2009). Accordingly, we found such inverted relation in experimental groups exposed to CD. "
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    Full-text · Article · Aug 2014 · Frontiers in Behavioral Neuroscience
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    • "Marti-Henneberg et al. [24] showed a negative correlation between the age at the onset of puberty and the duration of puberty and between the age at the onset of puberty and the age at first menstruation. Rosenfield et al. [25] reported slightly early menarche (0.5 yr) despite thelarche that occurred 1.3 yr early. "
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    Full-text · Article · Jul 2014 · BMC Pediatrics
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