Investigating the relationship between precocious puberty and obesity: a cross-sectional study in Shanghai, China

OBJECTIVES Obesity is reported to be closely relevant to early sexual development but the relationship between sexual precocity and obesity or central obesity is still inconsistent, especially in boys. We aimed to investigate the relationship between precocious puberty and obesity as well as central obesity. DESIGN A large population-based cross-sectional study using multistage, stratified cluster random sampling. SETTING Data from the Shanghai Children's Health, Education and Lifestyle Evaluation (SCHEDULE) study in June 2014. PARTICIPANTS 17 620 Chinese children aged 6-12 years. PRIMARY AND SECONDARY OUTCOME MEASURES Obesity was defined by WHO Child Growth Standards. Central obesity was defined by sex-specific waist-to-height ratio (WHtR) cut-offs (WHtR ≥0.48 for boys, WHtR ≥0.46 for girls). Precocious puberty was identified by Tanner stage of breast, pubic hair and testicle development. A χ2 test was performed to compare rates. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to assess the association between precocious puberty and general obesity and central obesity. Probit analysis was used for estimating the median age at entry into Tanner stage 2 or greater for breast, pubic hair and testicle development. Linear regression was utilised to compare the effects of WHtR and body mass index (BMI) on sex development indicators. RESULTS 25.98% and 38.58% of boys with precocious puberty were respectively accompanied by obesity (OR=2.15, 95% CI=1.31 to 3.50) or central obesity (OR=2.10, 95% CI=1.46 to 3.03); meanwhile, 13.86% and 29.42% of girls with precocious puberty were respectively accompanied by obesity (OR=9.00, 95% CI=5.60 to 14.46) or central obesity (OR=5.40, 95% CI=4.10 to 7.12). The median ages of breast, pubic hair and testicle development decreased with BMI increase and median ages of thelarche and testicular development rather than pubarche were earlier in children with central obesity. CONCLUSIONS Earlier pubertal development was positively associated with obesity and central obesity in Chinese children.