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Ann Pediatr Endocrinol Metab > Accepted Articles
DOI: https://doi.org/10.6065/apem.2244062.031    [Accepted] Published online June 30, 2022.
Slower progression to central puberty in overweight girls presenting with precocious breast development
Eun-Gyong Yoo  , Mi Ra Kim  , Mo Kyung Jung 
Department of Pediatrics, CHA Bundang Medical Center, CHA University, Seongnam, Korea
Address for correspondence:  Eun-Gyong Yoo
Email: pedyoo@cha.ac.kr
Received: February 26, 2022   Revised: April 29, 2022   Accepted: May 9, 2022
Abstract
Purpose
Overweight/obese girls tend to have an earlier pubertal onset. However, only few studies on the progression of puberty in these girls are reported. This study aimed to identify risk factors for rapid pubertal progression in overweight/obese girls presenting with precocious breast development.
Methods
This retrospective cohort study reviewed the medical records of 110 overweight (OW, BMI >85P for age and sex) and 213 non-overweight (NW, BMI <85P for age and sex) girls who presented with breast budding before 8 years of age. OW girls were divided into two subgroups: girls with central puberty progression before 9 years of age (OW-RP) and those without (OW-SP).
Results
Progression to central puberty before the age of 9 was more common in NW girls than in OW girls (83.8 % vs. 65.2 % in NW vs. OW group, P<0.001), and progression free survival for 1, 2, and 3 year were higher in the OW group (P<0.001). In subgroup analysis for OW girls, the OW-RP subgroup had more advanced bone age (BA) at first visit (P=0.047), and higher initial luteinizing hormone (LH, P=0.010) levels, compared to OW-SP subgroup. Being NW (P=0.001) as well as more advanced BA (P=0.023) at initial workup were the risk factors of pubertal progression before the age of 9.
Conclusion
Pubertal progression seems to be slower in OW girls presenting with precocious breast development than in those NW. However, it can progress rapidly in these girls with more pronounced BA advancement and higher LH levels at the initial workup.
Keywords: Puberty; precocious, Pediatric obesity, Overweight, Luteinizing hormone
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