Background: Over the past 20 years there is growing evidence that onset of puberty and changes in body proportions occur at an earlier age, especially in girls. Several studies have suggested this trend is linked to increasing rates of overweight and obese children. However, data on delayed pubertal trends are scant.
Objective and hypotheses: To characterize body proportions of children evaluated for pubertal disorders.
Method: Retrospective study of a large cohort of patients followed at a single tertiary center during a 17 year period (19962013). Clinical data including height, weight, the upper to lower segment (U/LS) ratio, body mass index (BMI) and clinical outcomes were reviewed and analysed.
Results: The cohort comprised 647 patients. In total, 304 were evaluated for precocious puberty (86% girls, of whom 72% were diagnosed with idiopathic central precocious puberty) and 347 presented with delayed puberty (67% boys, of whom 92% had constitutional delay of growth and puberty). There was a trend (not significant) towards earlier puberty in recent years with more referrals for early puberty and fewer related to delayed puberty. BMI z-score was significantly greater in the patients referred for early puberty compared to delayed puberty counterparts (girls mean +1.6 vs. -0.57 SDS, boys mean +2.2 vs. −0.78 SDS, P<0.001). Significant U/LS ratio differences (P<0.015) between these groups were equally found. Height, BMI, and basal LH values were associated with having initiated treatment in early puberty, but not in late puberty.
Conclusion: BMI z-scores and U/LS ratio differ significantly in children referred for precocious or delayed puberty. Lower height- and BMI z-scores and higher basal LH values were predictors of those children starting treatment for early puberty. Clinical follow-up over time seems mandatory.
01 - 03 Oct 2015
European Society for Paediatric Endocrinology