To define anthropometric and hormonal differences in a group of black and white girls
who began puberty with breast development alone ("thelarche" pathway) compared to
those who began with pubic hair development alone ("pubarche" pathway), and test the
hypothesis that pubarche may represent true pubertal development.
Longitudinal cohort seen annually for ten years.
Recruited through elementary schools in Cincinnati, OH, and Richmond, CA; through
HMO in Washington, DC.
9 years old, either Black or White, in the National Heart, Lung, and Blood Institute
Growth and Health Study.
None; observational study.
Initial secondary sexual characteristic at onset of puberty; anthropometric measures;
hormone measures.
478 of 1155 girls matured through a defined pathway. Age at onset of secondary sexual
characteristics was similar between pathways, although girls in the thelarche pathway
had puberty at a somewhat younger age, and black participants entered at a significantly
younger age. Height velocity was the same in both pathways, and in the pubertal range.
DHEA-S levels at onset of puberty were significantly greater in girls in the pubarche
pathway, but levels of estradiol and testosterone were not different. Age of menarche
was different by race (younger in blacks) and pathway (younger in thelarche pathway).
Given similar age and height velocities at onset of secondary sexual characteristics,
these results suggest that pubarche, the development of pubic hair without breast
development, may represent true pubertal maturation.