Relationship between body mass index and sexual development in Chinese children.

Xiao Qin XU; Jian Wei Zhang; Rui Min Chen; Jing Si Luo; Shao Ke Chen; Rong Xiu Zheng; Di WU; Min Zhu; Chun Lin Wang; Yan Liang; Hui Yao; Hai Yan Wei; Zhe SU; Mireguli Maimaiti; Hong Wei DU; Fei Hong Luo; Pin LI; Shu Ting SI; Wei WU; Ke Huang; Guan Ping Dong; Yun Xian YU; Jun Fen FU

Return

Relationship between body mass index and sexual development in Chinese children.

Author: Xiao Qin XU ¹ ; Jian Wei ZHANG ² ; Rui Min CHEN ³ ; Jing Si LUO ⁴ ; Shao Ke CHEN ⁴ ; Rong Xiu ZHENG ⁵ ; Di WU ⁶ ; Min ZHU ⁷ ; Chun Lin WANG ⁸ ; Yan LIANG ⁹ ; Hui YAO ¹⁰ ; Hai Yan WEI ¹¹ ; Zhe SU ¹² ; Mireguli MAIMAITI ¹³ ; Hong Wei DU ¹⁴ ; Fei Hong LUO ¹⁵ ; Pin LI ¹⁶ ; Shu Ting SI ¹⁷ ; Wei WU ¹ ; Ke HUANG ¹ ; Guan Ping DONG ¹ ; Yun Xian YU ¹⁷ ; Jun Fen FU ¹
Author Information

1. Department of Endocrinology, the Children's Hospital, Zhejiang University School of Medicine, National Clinical Research Center for Child Health, Hangzhou 310052, China.
2. Department of Pediatrics, Shaoxing Maternity and Child Health Care Hospital, Shaoxing 312000, China.
3. Department of Endocrinology, Fuzhou Children's Hospital of Fujian Province, Fuzhou 350000, China.
4. Department of Endocrinology and Genetic Diseases, Maternal and Child Health Hospital of Guangxi Zhuang Autonomous Region, Nanning 530003, China.
5. Department of Pediatrics, Tianjin Medical University General Hospital, Tianjin 350002, China.
6. Department of Endocrinology Genetics and Metabolism, Beijing Children's Hospital, Capital Medical University, Beijing 100045, China.
7. Department of Endocrinology, Children's Hospital of Chongqing Medical University, Chongqing 400014, China.
8. Department of Pediatrics, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310053, China.
9. Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.
10. Department of Genetic Metabolism and Endocrinology, Wuhan Children's Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430016, China.
11. Department of Endocrinology and Metabolism, Genetics, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450000, China.
12. Department of Endocrinology, Shenzhen Children's Hospital, Shenzhen 518028, China.
13. Department of Pediatrics, the First Affiliated Hospital of Xinjiang Medical University, Urumchi 830054, China.
14. Department of Pediatrics, the First Bethune Hospital of Jilin University, Changchun 130021, China.
15. Department of Endocrinology, Children's Hospital of Fudan University, Shanghai 201102, China.
16. Department of Endocrinology, Children's Hospital of Shanghai, Shanghai 200062, China.
17. School of Public Health, Zhejiang University, Hangzhou 310014, China.
Publication Type:Multicenter Study
MeSH: Adolescent; Body Mass Index; Child; Child, Preschool; China/epidemiology*; Cross-Sectional Studies; Female; Humans; Male; Obesity/epidemiology*; Overweight/epidemiology*; Puberty; Puberty, Precocious; Sexual Development
From: Chinese Journal of Pediatrics 2022;60(4):311-316
CountryChina
Language:Chinese
Abstract: Objective: To investigate the relationship between body mass index (BMI) and sexual development in Chinese children. Methods: A nationwide multicenter and population-based large cross-sectional study was conducted in 13 provinces, autonomous regions and municipalities of China from January 2017 to December 2018. Data on sex, age, height, weight were collected, BMI was calculated and sexual characteristics were analyzed. The subjects were divided into four groups based on age, including ages 3-<6 years, 6-<10 years, 10-<15 years and 15-<18 years. Multiple Logistic regression models were used for evaluating the associations of BMI with sexual development in children. Dichotomous Logistic regression was used to compare the differences in the distribution of early and non-early puberty among normal weight, overweight and obese groups. Curves were drawn to analyze the relationship between the percentage of early puberty and BMI distribution in girls and boys at different Tanner stages. Results: A total of 208 179 healthy children (96 471 girls and 111 708 boys) were enrolled in this study. The OR values of B2, B3 and B4+ in overweight girls were 1.72 (95%CI: 1.56-1.89), 3.19 (95%CI: 2.86-3.57), 7.14 (95%CI: 6.33-8.05) and in obese girls were 2.05 (95%CI: 1.88-2.24), 4.98 (95%CI: 4.49-5.53), 11.21 (95%CI: 9.98-12.59), respectively; while the OR values of G2, G3, G4+ in overweight boys were 1.27 (95%CI: 1.17-1.38), 1.52 (95%CI: 1.36-1.70), 1.88 (95%CI: 1.66-2.14) and in obese boys were 1.27 (95%CI: 1.17-1.37), 1.59 (95%CI: 1.43-1.78), and 1.93 (95%CI: 1.70-2.18) (compared with normal weight Tanner 1 group,all P<0.01). Analysis in different age groups found that OR values of obese girls at B2 stage and boys at G2 stage were 2.02 (95%CI: 1.06-3.86) and 2.32 (95%CI:1.05-5.12) in preschool children aged 3-<6 years, respectively (both P<0.05). And in the age group of 6-10 years, overweight girls had a 5.45-fold risk and obese girls had a 12.54-fold risk of B3 stage compared to girls with normal BMI. Compared with normal weight children, the risk of early puberty was 2.67 times higher in overweight girls, 3.63 times higher in obese girls, and 1.22 times higher in overweight boys, 1.35 times higher in obese boys (all P<0.01). Among the children at each Tanner stages, the percentage of early puberty increased with the increase of BMI, from 5.7% (80/1 397), 16.1% (48/299), 13.8% (27/195) to 25.7% (198/769), 65.1% (209/321), 65.4% (157/240) in girls aged 8-<9, 10-<11 and 11-<12 years, and 6.6% (34/513), 18.7% (51/273), 21.6% (57/264) to 13.3% (96/722), 46.4% (140/302), 47.5% (105/221) in boys aged 9-<10, 12-<13 and 13-<14 years, respectively. Conclusions: BMI is positively correlated with sexual development in both Chinese boys and girls, and the correlation is stronger in girls. Obesity is a risk factor for precocious puberty in preschool children aged 3-<6 years, and 6-<10 years of age is a high risk period for early development in obese girls.