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      Forty Years Trends in Timing of Pubertal Growth Spurt in 157,000 Danish School Children

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          Abstract

          Background

          Entering puberty is an important milestone in reproductive life and secular changes in the timing of puberty may be an important indicator of the general reproductive health in a population. Too early puberty is associated with several psychosocial and health problems. The aim of our study was to determine if the age at onset of pubertal growth spurt (OGS) and at peak height velocity (PHV) during puberty show secular trends during four decades in a large cohort of school children.

          Methods and Findings

          Annual measurements of height were available in all children born from 1930 to 1969 who attended primary school in the Copenhagen Municipality. 135,223 girls and 21,612 boys fulfilled the criteria for determining age at OGS and age at PHV. These physiological events were used as markers of pubertal development in our computerized method in order to evaluate any secular trends in pubertal maturation during the study period (year of birth 1930 to 1969). In this period, age at OGS declined statistically significantly by 0.2 and 0.4 years in girls and boys, respectively, whereas age at PHV declined statistically significantly by 0.5 and 0.3 years in girls and boys, respectively. The decline was non-linear with a levelling off in the children born between 1940 and 1955. The duration of puberty, as defined by the difference between age at OGS and age at PHV, increased slightly in boys, whereas it decreased in girls.

          Conclusion

          Our finding of declining age at OGS and at PHV indicates a secular trend towards earlier sexual maturation of Danish children born between 1930 and 1969. Only minor changes were observed in duration of puberty assessed by the difference in ages at OGS and PHV.

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          Most cited references43

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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.
          Article 0 comments Cited 166 times – based on 0 reviews     Review now
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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.
            Article 0 comments Cited 145 times – based on 0 reviews     Review now
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              Standards from birth to maturity for height, weight, height velocity, and weight velocity: British children, 1965. II.

              J M Tanner, R H Whitehouse, M Takaishi (1966)
              Article 0 comments Cited 121 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                : Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, USA )
                ISSN (Electronic): 1932-6203
                Publication date Collection: 2008
                Publication date (Electronic): 16 July 2008
                Volume: 3
                Issue: 7
                Electronic Location Identifier: e2728
                Affiliations
                [1 ]University Department of Growth and Reproduction, Rigshospitalet, Copenhagen, Denmark
                [2 ]Institute of Preventive Medicine, Copenhagen University Hospital, Centre for Health and Society, Copenhagen, Denmark
                Center for Research for Mothers & Children (CRMC), United States of America
                Author notes

                Conceived and designed the experiments: TIS AJ. Analyzed the data: LA LWO TIS AJ. Contributed reagents/materials/analysis tools: LA. Wrote the paper: LA. Responsible for initiating and building up of the School Health Record Register: AJ. Contributed to the conception of the present study: TIS AJ. Responsible for all the statistical analyses: LWO. Contributed to the development of the definitions and criteria for determining OGS and PHV, and to the validation of the method: LA LWO AJ. Revised the manuscript: LWO TIS AJ.

                Article
                Publisher ID: 08-PONE-RA-03734R2
                DOI: 10.1371/journal.pone.0002728
                PMC ID: 2443288
                PubMed ID: 18628945
                SO-VID: 94c28154-9cef-4b03-8a30-66f225383fb7
                Copyright © Aksglaede et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
                History
                Date received : 25 February 2008
                Date accepted : 24 June 2008
                Page count
                Pages: 8
                Categories
                Subject: Research Article
                Subject: Diabetes and Endocrinology/Endocrinology
                Subject: Diabetes and Endocrinology/Reproductive Endocrinology
                Subject: Pediatrics and Child Health/Adolescent Medicine
                Subject: Pediatrics and Child Health/Child Development

                ScienceOpen disciplines: Uncategorized
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                ScienceOpen disciplines: Uncategorized

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