Endocrine Abstracts

Introduction: Obesity has become an international epidemic, with complex multifactorial aetiology. Both modifiable and unchangeable risk factors must be identified, to target public health interventions. Some studies have suggested that earlier pubertal maturation increases risk of adult obesity, although others have found no relationship. We aimed to meta-analyse existing data and hypothesised that any association is likely to be confounded by childhood adiposity.

Methods: We conducted a systematic review, carrying out a computerized search of the literature using the following databases: MEDLINE, EMBASE, Web of Knowledge and the TRIP database. Forty-one papers described the effect of pubertal timing on adult adiposity after the age of 25 years; 37 reported adult Body Mass Index (BMI). Both authors independently reviewed and extracted pre-defined data from all selected papers. Meta-analyses were conducted in RevMan 5.

Results: Only six studies reported no significant relationship between pubertal timing and adult BMI. Meta-analyses showed that early menarche (menarche <12 years vs ≥12 years) increased adult BMI: standardised mean difference (SMD) 0.34 kg/m² (95% CI: 0.33–0.34) while late menarche (menarche ≥15 years vs <15 years) decreased adult BMI (SMD −0.26 (−0.36, −0.21). Early menarche increased the risk of adult obesity: pooled odds ratio of 2.00 (95% CI: 1.79–2.24). Data in males was insufficient to report. Only eight papers included data on childhood BMI, the majority reporting that childhood BMI only partially attenuated the association between early menarche and later obesity.

Conclusions: Earlier pubertal maturation is predictive of higher adult BMI and greater risk of obesity. This effect appears to be partially independent of childhood BMI. Further work is needed to examine potential mechanisms and the level at which interventions may be targeted.