Recent pubertal timing trends in Northern Taiwanese children: Comparison with skeletal maturity

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Abstract

Background:

International studies have reported an early age of onset of puberty in girls and boys. However, the current situation of puberty onset in Taiwanese children is unknown. In this study, the timing of menarche and pubertal change in testicular volume (TV) in Taiwanese children was examined, and bone age (BA) was used as an internal somatic maturity scale and compared with the chronological age (CA) at pubertal timing.

Methods:

Clinical data from October 1, 2010, to March 31, 2018, were retrospectively collected from a general hospital in Taipei. The data of patients who were diagnosed with endocrine/genetic disorders were excluded. Clinical data included CA, timing of menarche, and X-ray images of TV and BA. BA was determined by a senior pediatrician and a senior pediatric radiologist. The reliability and validity of BA readings were tested. Collected data were analyzed statistically.

Results:

Overall, TV records of 241 boys and the menarche timing data of 98 girls were collected from 1823 children. CA for menarche was 11.35 ± 1.06 years (mean ± SD), and BA for menarche was 12.95 ± 0.80 years. CA and BA at TV = 15 mL in male puberty was 12.32 ± 1.22 and 13.46 ± 0.68 years, respectively. A stronger correlation was observed between TV and BA than between TV and CA during the pubertal period.

Conclusion:

The secular trend of earlier puberty timing continues. The decline rate of menarche timing was approximately 0.43 years per decade in the past 30 years. Among boys, an advance of more than 1 year in pubertal timing age was observed over the past 20 years. BA and TV showed high correlation during puberty.

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Most cited references 30

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Parent-of-origin specific allelic associations among 106 genomic loci for age at menarche

John RB Perry, Felix Day, Cathy E Elks … (2014)

Age at menarche is a marker of timing of puberty in females. It varies widely between individuals, is a heritable trait and is associated with risks for obesity, type 2 diabetes, cardiovascular disease, breast cancer and all-cause mortality 1 . Studies of rare human disorders of puberty and animal models point to a complex hypothalamic-pituitary-hormonal regulation 2,3 , but the mechanisms that determine pubertal timing and underlie its links to disease risk remain unclear. Here, using genome-wide and custom-genotyping arrays in up to 182,416 women of European descent from 57 studies, we found robust evidence (P<5×10−8) for 123 signals at 106 genomic loci associated with age at menarche. Many loci were associated with other pubertal traits in both sexes, and there was substantial overlap with genes implicated in body mass index and various diseases, including rare disorders of puberty. Menarche signals were enriched in imprinted regions, with three loci (DLK1/WDR25, MKRN3/MAGEL2 and KCNK9) demonstrating parent-of-origin specific associations concordant with known parental expression patterns. Pathway analyses implicated nuclear hormone receptors, particularly retinoic acid and gamma-aminobutyric acid-B2 receptor signaling, among novel mechanisms that regulate pubertal timing in humans. Our findings suggest a genetic architecture involving at least hundreds of common variants in the coordinated timing of the pubertal transition.

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Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings.

Michelle M. Giddens, P Lee, Shanna Swan … (2008)

Whether children, especially girls, are entering and progressing through puberty earlier today than in the mid-1900s has been debated. Secular trend analysis, based on available data, is limited by data comparability among studies in different populations, in different periods of time, and using different methods. As a result, conclusions from data comparisons have not been consistent. An expert panel was asked to evaluate the weight of evidence for whether the data, collected from 1940 to 1994, are sufficient to suggest or establish a secular trend in the timing of puberty markers in US boys or girls. A majority of the panelists agreed that data are sufficient to suggest a trend toward an earlier breast development onset and menarche in girls but not for other female pubertal markers. A minority of panelists concluded that the current data on girls' puberty timing for any marker are insufficient. Almost all panelists concluded, on the basis of few studies and reliability issues of some male puberty markers, that current data for boys are insufficient to evaluate secular trends in male pubertal development. The panel agreed that altered puberty timing should be considered an adverse effect, although the magnitude of change considered adverse was not assessed. The panel recommended (1) additional analyses of existing puberty-timing data to examine secular trends and trends in the temporal sequence of pubertal events; (2) the development of biomarkers for pubertal timing and methods to discriminate fat versus breast tissue, and (3) establishment of cohorts to examine pubertal markers longitudinally within the same individuals.

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Public health implications of altered puberty timing.

Ewa Rajpert-De Meyts, Richard Sharpe, Jorma Toppari … (2008)

Changes in puberty timing have implications for the treatment of individual children, for the risk of later adult disease, and for chemical testing and risk assessment for the population. Children with early puberty are at a risk for accelerated skeletal maturation and short adult height, early sexual debut, potential sexual abuse, and psychosocial difficulties. Altered puberty timing is also of concern for the development of reproductive tract cancers later in life. For example, an early age of menarche is a risk factor for breast cancer. A low age at male puberty is associated with an increased risk for testicular cancer according to several, but not all, epidemiologic studies. Girls and, possibly, boys who exhibit premature adrenarche are at a higher risk for developing features of metabolic syndrome, including obesity, type 2 diabetes, and cardiovascular disease later in adulthood. Altered timing of puberty also has implications for behavioral disorders. For example, an early maturation is associated with a greater incidence of conduct and behavior disorders during adolescence. Finally, altered puberty timing is considered an adverse effect in reproductive toxicity risk assessment for chemicals. Recent US legislation has mandated improved chemical testing approaches for protecting children's health and screening for endocrine-disrupting agents, which has led to changes in the US Environmental Protection Agency's risk assessment and toxicity testing guidelines to include puberty-related assessments and to the validation of pubertal male and female rat assays for endocrine screening.

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Author and article information

Journal

Journal ID (nlm-ta): J Chin Med Assoc

Journal ID (iso-abbrev): J Chin Med Assoc

Journal ID (publisher-id): CA9

Title: Journal of the Chinese Medical Association

Publisher: Lippincott Williams & Wilkins (Hagerstown, MD )

ISSN (Print): 1726-4901

ISSN (Electronic): 1728-7731

Publication date (Electronic): 29 May 2020

Publication date (Print): September 2020

Volume: 83

Issue: 9

Pages: 870-875

Affiliations

[a ]Department of Pediatrics, Cheng Hsin General Hospital, Taipei, Taiwan, ROC

[b ]Department of Radiology, Cardinal Tien Hospital, Taipei, Taiwan, ROC

[c ]Department of Medical Education, College of Medicine, Fu Jen Catholic University, Taipei, Taiwan, ROC

[d ]Department of Medical Education and Research, Cheng Hsin General Hospital, Taipei, Taiwan, ROC

[e ]Department of Pediatrics, National Defense Medical Center, Taipei, Taiwan, ROC

Author notes

[* ]Address correspondence. Dr. Yeong-Seng Yuh, Department of Pediatrics, Cheng Hsin General Hospital, 45, Zhenxing Street, Taipei 112, Taiwan, ROC. E-mail address: pubertaltiming@ 123456gmail.com (Y.-S. Yuh).

Article

Accession ID: 00018

DOI: 10.1097/JCMA.0000000000000360

PMC ID: 7478199

PubMed ID: 32902941

SO-VID: 4468d5ae-e51a-4bcd-94d9-91f36ee0b44b

License:

This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/)

History

Date received : 16 January 2020

Date accepted : 9 April 2020

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Keywords: bone age,chronological age,female,male,menarche,pubertal timing,testicular volume

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Keywords: bone age, chronological age, female, male, menarche, pubertal timing, testicular volume

Recent pubertal timing trends in Northern Taiwanese children: Comparison with skeletal maturity

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Most cited references 30

Parent-of-origin specific allelic associations among 106 genomic loci for age at menarche

Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings.

Public health implications of altered puberty timing.

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