Scientific Programme & Abstracts from the International Meeting in Pediatric Endocrinology (IMPE)
IMPE Abstracts (2023) 96 P52

IMPE2023 Poster Presentations Fat, Metabolism and Obesity (15 abstracts)

Pubertal Development and Growth Spurt in Childhood Obesity: Real World Profiling in 1300 Patients

Gabriel Ángel Martos-Moreno 1,2,3 , Julián Martínez-Villanueva 1 & Jesús Argente 1,2,3,4


1Hospital Infantil Universitario Niño Jesús. Departments of Pediatrics & Pediatric Endocrinology. La Princesa Research Institute, Madrid, Spain. 2Universidad Autónoma de Madrid. Department of Pediatrics, Madrid, Spain. 3Centro de Investigación Biomédica en Red de Fisiopatologia de la Obesidad y Nutriciόn (CIBEROBN), Instituto de Salud Carlos III, Madrid, Spain. 4IMDEA Food Institute, Madrid, Spain


Background: Obesity onset at early ages influences skeletal maturation, growth and the onset of adrenarche and puberty. How this influence is exerted, the differences between sexes and the influence of obesity severity are insufficiently addressed.

Objectives: To explore the patterns and pace of pubertal development, including the pre- and pubertal growth spurt in children and adolescents affected with obesity.

Patients and methods: A prospective study of 1300 children and adolescents with obesity (mean age: 10.46±3.48 years; mean BMI: 4.01±0.49 SDS), 47.2% females, 53.3% prepubertal at enrollment was carried out. Caucasian (n=986, 75.8%) and Latino (n=247, 19.0%) were the predominant ethnicities. Bone age at enrollment, age at puberty onset and at menarche in girls (either explored or referred) and height, BMI and Tanner stage at each visit were registered up to 7 years (maximum follow up). Treatment consisted of lifestyle reorganization (dietary and exercise related behavioral counseling).

Results: Mean age at puberty onset [Tanner stage II (TS-II)] was 9.98±1.12 in females and 12.05±1.16 years in males with 14.4% and 3.4% of males entering TS-II after age 13 and 14, respectively. All females were TS-II before age 13 and the mean age at menarche (n=315) was 11.61±1.14 years, without inter-ethnic differences. At enrollment, bone age was accelerated over chronological age (+0.89±1.10 year; P<0.001), especially in hyperinsulinemic patients, and height was +1.32±1.18 SDS above target height (P<0.001). Mean follow-up duration was 1.59±1.60 years, with a high drop-out rate (7% completed 7-year follow-up). In 81 patients (45 females/36 males) follow-up encompassed their entire pubertal development. Mean duration of puberty was 3.23±1.16 years and time from puberty onset to menarche in girls was 1.65±0.91 years (no interethnic differences). Duration of puberty was negatively correlated with baseline BMI-SDS (r=−0.25; P<0.05). The pubertal growth spurt was 16.29±5.80 cm, with no differences between sexes and negatively correlating with the severity of obesity (BMI-SDS; r=−0.38; P<0.01). Adult height (n=308) was above predicted target height by +0.29±0.94 SDS (+1.6±5.4 cm; P<0.001).

Conclusions: 1). Obesity increases prepubertal growth and decreases the pubertal growth spurt according to the severity of obesity but does not impair target height attainment. 2) Obesity’s influence on pubertal onset has sex-dependant differences and its severity affects the pace of pubertal development.

Volume 96

IMPE 2023

Buenos Aires, Argentina
04 Mar 2023 - 07 Mar 2023

International Meeting in Pediatric Endocrinology 

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