Background: In a population of a community-based setting (BMISDS range −3.5 to +4.1), there is a negative linear correlation between childhood BMISDS and pubertal height gain, together with earlier onset of pubertal growth with higher BMISDS for both sexes (1).
Objective: To investigate the impact of BMI in childhood on the pubertal pattern of growth for obese children in a clinical setting.
Method: Pubertal growth in obese children in a clinical setting (University hospital, Madrid) were analyzed and compared with the longitudinally followed population, the GrowUp1990Gothenburg cohort (community-based setting). The obese study-group included 47 children (26 females) with BMISDS at diagnosis of +2.0 to +7.4. Analyses were done with the QEPS growth model (2). Individual BMISDS (3) values were related to individual growth functions from QEPS-model; Pmax (specific pubertal gain, cm) and AgeP5 (age in years at 5% of the specific pubertal growth, representing onset of pubertal growth). The results of the obese children were compared to the population study.
Results: In obese children, as well as in the population study, BMISDS showed a negative dose-response effect of specific pubertal gain. Pmax was 10.19 cm0.630×BMISDS. in females, 15.61 cm1.049×BMISDS in males, meaning that every increase in BMISDS by 1 is equal to 0.63 cm less pubertal height gain for females and 1 cm for males. There were significant differences when compared to the population study; however, the patterns were similar (Pmax =13.661.35−BMISDS, in girls, Pmax=18.051.61×BMISDS in boys, population study). There was also a linear correlation of obesity degree (BMISDS) and onset of pubertal growth (AgeP5): 9.60 years 0.101×BMISDS in girls, 11.59 years 0.1145×BMISDS in boys. The regression formula was similar to the results from the population study (with AgeP5 9.82 years 0.137×BMISDS in girls, 11.81 years 0.1267×BMISDS in boys, where every increase in BMISDS by 1 SD-score gave an earlier onset-of-pubertal growth by 1.21.6 month.
Conclusion: The higher BMISDS in childhood, the less the specific pubertal gain in obese boys and girls, and the earlier the onset of pubertal growth. Weight status is an important modifier of pubertal growth in both normal-weight and obese children. References: (1) Holmgren A., et al. Ped. Res 2017:81,448454. (2) Nierop A., et al. J. of Theor. Biol. 2016;406:143165. (3) Cole T.J., Lobstein T. Ped. obesity. 2012;7(4):284294.
27 - 29 Sep 2018
European Society for Paediatric Endocrinology