Endocrine Abstracts

The Relationship between Precocious/Early Puberty and Obesity with Metabolic Abnormalities: A Comprehensive Review

Introduction: The impact of pubertal timing on the development of obesity and metabolic abnormalities has been the subject of extensive research with variable outcomes.

Objective: We systematically reviewed studies (Medline, Pubmed, Google scholar, and Web of Science) 2000 until March 2023 evaluating the relation between early puberty and occurrence of obesity and metabolic abnormalities including T2DM.

Results: 12 studies were examined and analyzed. The Gothenburg Osteoporosis and Obesity Determinants study followed 579 subjects. Early pubertal onset predicted central fat mass distribution, while high prepubertal BMI strongly predicted subcutaneous obese phenotype. A twin cohort analysis revealed strong heritability estimates for age at onset of pubertal growth spurt, and adult height. These traits were associated with childhood BMI and early adulthood stature due to shared genetic factors. A Finnish cohorts supported strong genetic etiology in the correlation between early puberty and higher childhood BMI especially in girls. A meta-analysis (34 studies) demonstrated that early menarche correlated with increased adult BMI, while late menarche correlated with decreased BMI. Another meta-analysis (28 studies) found that earlier age at menarche was associated with a higher risk of T2DM even after adjusting for adiposity. A Swedish study of 30,697 men demonstrated that earlier pubertal onset was linked to a higher risk of early diabetes, and early need for insulin therapy even after BMI adjustments. Late puberty correlated with reduced diabetes risk. Analysis of the Nurses’ Health Study cohorts revealed that early menarche was associated with increased risk of type 2 diabetes. Adiposity partly mediated this association. A meta-analysis of 28 observational studies (n=1,228,306) identified that without adjustment for adult adiposity, T2DM/IGT risk was lower per year later onset of menarche and higher for early vs later menarche. In a UK Biobank study indicated that both in women and men separately, earlier puberty timing was associated with higher risks for angina, hypertension and T2D. A study in Brazil involving 8,075 women demonstrated that early menarche (<11 years) was linked to a higher risk of diabetes, even after controlling for socio-demographic factors and maternal diabetes.

Conclusion: Collectively, early puberty appears to contribute to an increased risk of obesity and T2DM in both men and women, often mediated by factors such as childhood BMI and genetic predisposition. Monitoring and early diagnosing these conditions are important for successful management.