OJPed  Vol.2 No.2 , June 2012
Pubertal pathways and the relationship to anthropometric changes in childhood: The Fels longitudinal study
Abstract: Objective: To examine the relationship of the initial manifestation of pubertal development in children to anthropometric measurements recorded during the early childhood and adolescence. Methods: The Fels Longitudinal study is an observational study of growth and development of healthy white children. A total of 109 boys and 75 girls with serial self-assessments of Tanner stages of genital/breast and pubic hair developments provided data for a longitudinal analysis with a linear mixed model. Results: About 11.0% of boys and 22.7% of girls witnessed the appearance of pubic hair (adrenarche) prior to the onset of genital/breast growth (gonadarche/thelarche) and about 13.7% of boys and 22.7% of girls experienced the onset of gonadarche/thelarche prior to adrenarche. The remaining 75.3% of boys and 54.7% of girls were concordant for adrenarche and gonadarche/thelarche. During the first two years of life, boys and girls with earlier gonadarche and thelarche than adrenarche were found to have more rapid weight gain than those with earlier adrenarche than gonadarche/thelarche. During early childhood from age 2 - 7 years, those girls with early thelarche had higher body mass index (BMI) and waist circumference to height ratio (waist/ height) than those with early adrenarche. In children of ages 8 - 20, girls with early gonadarche had higher BMI z-scores than those with early adrenarche. Conclusion: Girls with early thelarche and later adrenarche, have more rapid mean weight gain during the first two years of life, higher BMI and waist/height during early childhood, and higher BMI z-scores during adolescence. Boys with early gonadarche and later adrenarche experienced more rapid weight gain during the first two years of life than boys with early adrenarche and later gonadarche. In other words, girls with early thelarche are more likely to be triggered by early accumulation of fat mass than those with early adrenarche.
Cite this paper: Wan, W. , Deng, X. , Archer, K. and Sun, S. (2012) Pubertal pathways and the relationship to anthropometric changes in childhood: The Fels longitudinal study. Open Journal of Pediatrics, 2, 118-126. doi: 10.4236/ojped.2012.22020.

[1]   Susman, E.J., Houts, R.M., Steinberg, L., et al. (2010) Longitudinal development of secondary sexual characteristics in girls and boys between ages 9.5 and 15.5 years. Archives of Pediatric and Adolescent Medicine, 164, 166-173. doi:10.1001/archpediatrics.2009.261

[2]   Biro, F.M., Lucky, A.W., Simbartl, L.A., et al. (2003) Pubertal maturation in girls and the relationship to anthropometric changes: Pathways through puberty. Journal of Pediatrics, 142, 643-646. doi:10.1067/mpd.2003.244

[3]   Biro, F.M., Huang, B., Daniels, S.R. and Lucky, A.W. (2008) Pubarche as well as thelarche may be a marker for the onset of puberty. Journal of Pediatric and Adolescent Gynecology, 21, 323-328. doi:10.1016/j.jpag.2007.09.008

[4]   Frisch, R. and Revelle, R. (1970) Height and weight at menarche a hypothesis of critical body weights and adolescent events. Science, 169, 397-399. doi:10.1126/science.169.3943.397

[5]   Lee, J.M., Appugliese, D., Kaciroti, N., Corwyn, R.F., Bradley, R.H. and Lumeng, J.C. (2007) Weight status in young girls and the onset of puberty. Pediatrics, 119, 624-630. doi:10.1542/peds.2006-2188

[6]   Dunger, D.B., Ahmed, M.L. and Ong, K.K. (2006) Early and late weight gain and the timing of puberty. Molecular and Cellular Endocrinology, 140-145, 254-255. doi:10.1016/j.mce.2006.04.003

[7]   Mills, J.L., Shiono, P.H., Shapiro, L.R., et al. (1986) Early growth predicts timing of puberty in boys: Results of a 14-year nutrition and growth study. Journal of Pediatrics, 109, 543-547. doi:10.1016/S0022-3476(86)80141-X

[8]   Shi, L.J., Wudy, S.A., Buyken, A.E., et al. (2009) Body fat and animal protein intakes are associated with adrenal androgen secretion in children. American Joural of Clinical Nutrition, 90, 1321-1328. doi:10.3945/ajcn.2009.27964

[9]   Remer, T., Shi, L.J., Buyken, A.E., Maser-Gluth, C., Hartmann, M.F. and Wudy, S.A. (2010) Prepubertal adrenarchal androgens and animal protein intake independently and differentially influence pubertal timing. Journal of Clinical Endocrinology and Metabolism, 95, 3002-3009. doi:10.1210/jc.2009-2583

[10]   Davison, K.K., Susman, E.J. and Birch, L.L. (2003) Percent body fat at age 5 predicts earlier pubertal development among girls at age 9. Pediatrics, 111, 815. doi:10.1542/peds.111.4.815

[11]   Roche, A.F. (1992) Growth, maturation and body composition: The Fels Longitudinal Study 1929-1991. Cambridge University Press, Cambridge. doi:10.1017/CBO9780511661655

[12]   Lohman, G.T., Roche, A.F. and Martorell, R. (1988) Anthropometric standardization reference manual. Human Kinetics, Champaign.

[13]   Kuczmarski, R.J., Ogden, C.L., Grummer-Strawn, L.M., Flegal, K.M., Guo, S.S., Wei, R., Mei, Z., Curtin, L.R., Roche, A.F. and Johnson, C.L. (2000) CDC growth charts: United States. National Center for Health Statistics, Hyattsville.

[14]   Roche, A.F. and Sun, S. (2003) Human growth: Assessment and interpretation. Cambridge University Press, Cambridge. doi:10.1017/CBO9780511525681

[15]   Ibanez, L., Dimartino-Nardi, J., Potau, N., et al. (2000) Premature adrenarche—Normal variant or forerunner of adult disease? Endocrine Review, 21, 671-696. doi:10.1210/er.21.6.671

[16]   Alwis, G., Rosengren, B., Stenevi-Lundgren, S., Düppe, H., Sernbo, I. and Karlsson, M.K. (2000) Normative dual energy X-ray absorptiometry data in Swedish children and adolescents. Acta P?diatrica, 99, 1091-1099. doi:10.1111/j.1651-2227.2010.01713.x

[17]   Remer, T. and Manz, F. (2001) The midgrowth spurt in healthy children is not caused by adrenarche. The Journal of Clinical Endocrinology & Metabolism, 86, 4183-4186. doi:10.1210/jc.86.9.4183

[18]   Molinari, L., Largo, R.H. and Prader, A. (1980) Analysis of the growth spurt at age seven (mid-growth spurt). Helvetica Paediatrica Acta, 35, 325-334.

[19]   Cutler, G.B. Jr. and Loriaux, D.L. (1980) Adrenarche and its relationship to the onset of puberty. Federation Proceedings, 39, 2384-2390.

[20]   Taylor, J., Whincup, P., Hindmarsh, P., et al. (2001) Performance of a new pubertal self-assessment questionairre: a preliminary study. Paediatric and Perinatal Epidemiology, 15, 88-94. doi:10.1046/j.1365-3016.2001.00317.x

[21]   Schmitz, K., Hovell, M., Nichols, J., et al. (2004) A validation study of early adolescents’ pubertal self-assessments. Journal of Early Adolescence, 24, 357-384. doi:10.1177/0272431604268531

[22]   Norris, S. and Richter, L. (2005) Usefulness and reliability of tanner pubertal self-rating to urban black adolescents in South Africa. Journal of Research on Adolescence, 15, 609-624. doi:10.1111/j.1532-7795.2005.00113.x

[23]   Leone, M. and Comtois, A.S. (2007) Validity and reliability of self-assessment of sexual maturity in elite adolescent athletes. Journal of Sports Medicine and Physical Fitness, 47, 61-65.

[24]   Schubert, C.M., Chumlea, W.C., Kulin, H.E., Lee, P.A., Himes, J.H. and Sun, S.S. (2005) Concordant and discordant sexual maturation among US children in relation to body weight and BMI. Journal of Adolescent Health, 37, 356-362. doi:10.1016/j.jadohealth.2005.03.009

[25]   Taranger, J., Engstrom, I., Lichtenstein, H. and Svennberg-Redegren, I. (1976) Somatic pubertal development. Acta Paediatrica Scandinavica Journal, 258S, 121-135. doi:10.1111/j.1651-2227.1976.tb14766.x

[26]   Dietz, W.H. (1998) Health consequences of obesity in youth: childhood predictors of adult disease. Pediatrics, 101, 518-525.

[27]   Magnusson, D., Stattin, H. and Allen, V. (1985) Biological maturation and social development: A longitudinal study of some adjustment processes from mid-adolescence to adulthood. Journal of Youth and Adolescence, 14, 267-283. doi:10.1007/BF02089234

[28]   Wilson, D.M., Killen, J.D., Hayward, C., et al. (1994) Timing and rate of sexual maturation and the onset of cigarette and alcohol use among teenage girls. Archives of Pediatric and Adolescent Medicine, 148,789-795. doi:10.1001/archpedi.1994.02170080019004

[29]   Deardorff, J., Gonzales, N.A., Christopher, F.S., Roosa, M.W. and Millsap, R.E. (2005) Early puberty and adolescent pregnancy: The influence of alcohol use. Pediatrics, 116, 1451-1456. doi:10.1542/peds.2005-0542

[30]   Stoll, B.A. (1998) Western diet, early puberty, and breast cancer risk. Breast Cancer Research Treatment, 49, 187-193. doi:10.1023/A:1006003110909

[31]   Garn, S.M., La Velle, M., Rosenberg, K.R. and Hawthorne, V.M. (1986) Maturational timing as a factor in female fatness and obesity. American Journal of Clinical Nutrition, 43, 879-883.