ESPE Abstracts (2023) 97 RFC6.4

1Centre for Paediatric Endocrinology/ Diabetology & Obesity, Children`s Hospital AUF DER BULT, Hannover, Germany. 2Pediatric Endocrinology and Diabetology Division, Children's Hospital, University of Bonn, Bonn, Germany. 3Institute of Epidemiology and Medical Biometry, ZIBMT, University of Ulm, Ulm, Germany. 4German Center for Diabetes Research (DZD), Munich, Germany. 5Division of Pediatric Endocrinology, Diabetology and Metabolism, Department of Pediatrics, Bern University Hospital, University of Bern, Bern, Switzerland. 6Paediatric Endocrinology, University Hospital, Technical University of Dresden, Dresden, Germany. 7Pediatric Endocrinology and Diabetology, Children`s Hospital St. Louise, Paderborn, Germany. 8Department of Pediatric Endocrinology, University Hospital Augsburg, Augsburg, Germany. 9Division of Pediatrics/Pediatric Diabetology, DRK Hospital, Kirchen, Germany. 10Department of Pediatrics, University Hospital Erlangen, Erlangen, Germany

Introduction: Pubertal onset is signaled by thelarche (in girls) and gonadarche (in boys) and indicates the beginning of the hypothalamic-pituitary-gonadal axis activity. Thus, the onset of pubic hair development usually coincides with adrenarche. Girls worldwide are experiencing earlier puberty, but it is uncertain if this trend affects boys, or if it applies to children with type 1 diabetes (T1D).

Aim: The aim of this study is to analyze puberty onset and pubertal hair development in adolescents with T1D from a large, multicenter (German/Austrian/Swiss/Luxemburg) diabetes registry spanning 2000 to 2021.

Methods: The mean age of thelarche (♀), gonadarche (♂), and pubarche (all sexes) among adolescents with T1D was analyzed. Linear regression models were used and adjusted for diabetes duration, BMI, HbA1C, and migratory background. The results are presented in 5-year intervals (mean) for the periods ≤2005 and >2015.

Results: The onset of puberty has shifted forward over the last two decades in both girls and boys, according to the analyzed data from 20,064 children. The mean age for the onset of puberty in girls decreased from 11.46 years to 11.06 years, and in boys from 12.41 years to 12.19 years. Additionally, an annual advance of thelarche by 0.26 years or 3.17 months per decade in girls and an annual advance of gonadarche by 0.15 years or 1.78 months per decade in boys was observed. The study also found that children with overweight (BMI SDS ≥ 90th percentile) had a significantly earlier onset of puberty than those with normal weight or underweight. An HbA1C value of ≤ 7.5% was associated with a significantly earlier onset of puberty in both sexes than a value of >7.5% to <8.5% or ≥ 8.5%. The mean age at documentation of Tanner P2 for girls decreased from 11.47 years in 2000 to 10.97 years in 2021, with a change of -0.0227/ year or a decrease of 2.72 months/ decade. For boys, the mean age at documentation of Tanner P2 decreased from 12.06 years in 2000 to 11.57 years in 2021, with a change of -0.0222/ year or a decrease of 2.67 months/ decade.

Discussion/ Conclusion: In summary, this study provides the first evidence of a decline in pubertal age in young male adolescents, consistent with the known and demonstrated age regression of pubertal onset in girls. Moreover, the development of pubertal hair shows a similar pattern in both sexes. These results highlight pubertal complexity and indicate further research needed

Volume 97

61st Annual ESPE (ESPE 2023)

The Hague, Netherlands
21 Sep 2023 - 23 Sep 2023

European Society for Paediatric Endocrinology 

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