ESPE Abstracts

Background: In a population of a community-based setting (BMI_SDS range −3.5 to +4.1), there is a negative linear correlation between childhood BMI_SDS and pubertal height gain, together with earlier onset of pubertal growth with higher BMI_SDS 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 BMI_SDS at diagnosis of +2.0 to +7.4. Analyses were done with the QEPS growth model (2). Individual BMI_SDS (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, BMI_SDS showed a negative dose-response effect of specific pubertal gain. Pmax was 10.19 cm–0.630×BMI_SDS. in females, 15.61 cm–1.049×BMI_SDS in males, meaning that every increase in BMI_SDS 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 =13.66–1.35−BMI_SDS, in girls, Pmax=18.05–1.61×BMI_SDS in boys, population study). There was also a linear correlation of obesity degree (BMI_SDS) and onset of pubertal growth (AgeP5): 9.60 years – 0.101×BMI_SDS in girls, 11.59 years – 0.1145×BMI_SDS in boys. The regression formula was similar to the results from the population study (with AgeP5 9.82 years – 0.137×BMI_SDS in girls, 11.81 years – 0.1267×BMI_SDS in boys, where every increase in BMI_SDS by 1 SD-score gave an earlier onset-of-pubertal growth by 1.2–1.6 month.

Conclusion: The higher BMI_SDS 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 2017:81,448–454. (2) Nierop A., et al. J. of Theor. Biol. 2016;406:143–165. (3) Cole T.J., Lobstein T. Ped. obesity. 2012;7(4):284–294.