Abstract
Background
At the population level, there is a negative linear correlation between childhood body mass index (BMI) and pubertal height gain. However, in children with obesity, there are no studies showing whether the severity of obesity affects pubertal height gain. Moreover, how obesity in childhood affects pubertal timing is controversial, especially in boys. We aimed to investigate the impact of severe obesity in childhood on the pubertal growth spurt in both sexes.
Methods
The study group consisted of 68 patients (32 boys) with childhood onset obesity followed in a Spanish university hospital. The QEPS growth model was used to calculate pubertal growth function estimates for each individual. The highest individual prepubertal BMI SDS value was related to the age at onset of pubertal growth and pubertal height gain. Results were compared to analyses from individuals in a community-based setting (n = 1901) with different weight status.
Results
A higher peak BMI in childhood was associated with less specific pubertal height gain in children with moderate-to-extreme obesity. For boys, the higher the BMI, the earlier the onset of pubertal growth. For girls with obesity, this correlation was not linear.
Conclusions
Obesity in childhood impairs the pubertal growth spurt in a severity-related fashion.
Impact
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The higher the BMI in childhood, the lower the pubertal height gain in children with moderate-to-extreme obesity.
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For boys with obesity, the higher the BMI, the earlier the onset of pubertal growth.
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The results contribute to the research field of how weight status in childhood is related to pubertal timing and pubertal growth.
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The results have implications for understanding how childhood obesity is related to further growth.
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Acknowledgements
The authors are grateful for the contribution by Andreas F.M. Nierop in performing the estimations of the QEPS growth functions of the study groups and for careful editing and language revision by Dr. Julie A. Chowen. The authors acknowledge financial support from the governmental grants under the ALF agreement, ALFGBG-719041 and ALFGBG-812951 (to K.A.-W.), the Region Halland Grants (to A.H.), the Foundation Växthuset for children (to K.A.W.), grants from Fondo de Investigación Sanitaria (PI-16/00485 and PI-19/00166 to J.A.), Fondos FEDER, and Centro de Investigación Biomédica en Red Fisiopatología de Obesidad y Nutrición (CIBEROBN), Instituto de Salud Carlos III (to J.A.).
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All six authors developed the study concept and design. G.Á.M.-M. and J.M.-V. were responsible for data collection from the clinical obese study group. K.A.-W. and J.A. are principal investigators of the study populations used. A.N. made Figs. 2–4. A.H. performed the statistical analyses and made the tables and wrote the first draft. All six authors critically revised the paper for important intellectual content and approved the final manuscript to be submitted for publication.
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All patients/study subjects and their parents or guardians gave informed written consent to participate in research studies as required by the local ethics committees.
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Holmgren, A., Martos-Moreno, G.Á., Niklasson, A. et al. The pubertal growth spurt is diminished in children with severe obesity. Pediatr Res 90, 184–190 (2021). https://doi.org/10.1038/s41390-020-01234-3
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DOI: https://doi.org/10.1038/s41390-020-01234-3
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