Prevalence of overweight and abdominal obesity according to anthropometric parameters and the association with sexual maturation in adolescent schoolchildren

The objective of the present study was to estimate the prevalence of overweight and abdominal obesity in schoolchildren according to anthropometric parameters and sexual maturation. A cross-sectional study was performed in 1,405 children of both genders aged 10-14 years, living in Recife, Pernambuco State, Brazil, in 2007. Body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) were assessed. Sexual maturation was self-assessed. Early sexual maturation was defined as the chronological age below the median age for the referred stage. Prevalence of overweight was 20.4% (95%CI: 18.3-22.6), and abdominal obesity was 14.9% (95%CI: 13.1-16.9) and 12.6% (95%CI: 10.9-14.4) according to WC and WHtR, respectively. There was a strong positive correlation among BMI, WC, and WHtR (rho ? 0.8; p < 0.001). In both genders, the prevalence of overweight and abdominal obesity was higher in the final stages of sexual maturation (p < 0.05). The high prevalence of overweight requires urgent preventive measures and control. Therefore, the inclusion of sexual maturation for the assessment of nutritional status is recommended.     

Dietary patterns are associated with sexual maturation in Korean children

The purpose of this study was to investigate the association between dietary patterns and sexual maturation among Korean children. A cross-sectional study was conducted in 422 boys and 365 girls aged 9-12 years living in Seoul, Korea. Three-day food records were obtained, and pubertal stages were determined with a questionnaire using Tanner stages. Body fat was measured by bioelectrical impedance analysis, and bone mass content at the right calcaneus was measured by portable dual-emission X-ray absorptiometry. Exploratory factor analysis with a Varimax rotation was applied to identify dietary patterns using twenty-four food groups. Four distinct dietary patterns--"rice and Kimchi", "shellfish and processed meat", "pizza and drinks" and "milk and cereal"--were obtained. Twenty-six per cent (24 % stage 2, 2 % stage 3) of boys had genital development, and 79 % (63 % stage 2, 16 % stage 3) of girls showed breast development. In boys, genital development was weakly positively associated with "shellfish and processed meat" dietary factor scores (odds ratio 1.65, CI 0.95, 2.89, P for trend 0.07) after adjusting for confounders. In girls, breast development was significantly positively associated with the factor score of "shellfish and processed meat" (odds ratio 1.88, CI 1.08, 3.26, P for trend 0.05). These results suggest that dietary patterns were related to body composition and sexual maturation among the Korean children. Further investigations are needed to identify components of the foods consumed in high amounts in these patterns and how they are related to sexual maturation.     

Sexuelle Reifung von Kindern und Jugendlichen in Deutschland

Following the standstill in maturity acceleration in the eighties of the twentieth century, now a further shift in maturity development towards younger ages is the issue of an international and also German discussion. The collection of sexual maturity data in boys and girls as part of the nationwide German Health Interview and Examination Survey for Children and Adolescents (KiGGS) is intended to pro vide population-representative information on sexual maturation and to evaluate associations between maturity status and selected health and social data. Girls were interviewed regarding their first menstrual period (menarche) and boys regarding voice change (status-quo method). Pubic hair was self-assessed by children and adolescents from 10 to 17 years of age, based on drawings of Tanner's defined developmental stages. The median age for menarche, for voice change and pubic hair stages were calculated using a logit model. At an age of 10 years, 42.4 % of girls and 35.7 % of boys report the development of pubic hair. At 17 years of age, the majority of girls and boys have reached the stages PH5 (girls 57.5 %, boys 47.8 %) and PH6 (girls 23.6 %, boys 46.5 %) according to Tanner. The average age for each pubic hair stage is lower in girls (PH2 10.8; PH3 11.7; PH4 12.3; PH5 13.4 years) than in boys (PH2 10.9; PH3 12.6; PH4 13.4; PH5 14.1). The median age at menarche is 12.8 years, the median for voice change (voice low) 15.1 years. Significant differences in age at menarche are found in girls depending on socioeconomic status (12.7/12.9/13.0 years for low/middle/high status) and between girls with and without migration background (12.5/12.9 years). No differences in age at menarche can be seen between East and West Germany or cities and rural areas. The association between maturity status and BMI is more pronounced in girls than in boys. Overall, the onset of maturity development in German children and adolescents is not significantly earlier than in other European studies.     

Osteocalcin. A biochemical marker of bone turnover during puberty

During bone remodelling, osteocalcin is produced by osteoblasts and its level increases during the events characterized by rapid bone turnover. Osteocalcin is a bone matrix protein, which is specific for bone metabolism and it is not influenced by metabolic bone disorders. Osteocalcin is an important marker of bone turnover in physiological and pathological conditions. Physiologically, serum osteocalcin was increased in children, particularly during the first year of life and during puberty, when evolution of the concentration was related to rapidity of physical growth. Evidence of a correlation with growth rates comes from the observation that serum osteocalcin levels parallel the height velocity curve, with higher values in childhood and during adolescence, that later fall to adult values. There are previous studies reporting that there is age- and sex-dependent change in serum osteocalcin levels in children and adolescents with a pattern resembling height velocity curves for children and serum osteocalcin elevation coincides with the pubertal growth spurt. These findings demonstrate that pubertal development and sex should be taken into account rather than chronological age when serum levels of osteocalcin are evaluated. In most of the studies relationships among osteocalcin and chronological age and bone age, but not pubertal developmental stage (sexual maturation stage) were investigated. The aim of our study was to determine whether osteocalcin is a useful marker for the pubertal growth spurt period. In this study, osteocalcin levels in male adolescents were examined in relation to their sexual maturation stage and age. According to our findings, the follow up of osteocalcin levels in relation to sexual maturation stages could be a new method to determine the phase of the pubertal growth spurt. An increase or decrease in osteocalcin levels on consecutive measurements may indicate the child's entering accelerated or decelerated stages of the growth spurt, respectively. We emphasize that the follow up of adolescent growth is made by determination of the sexual maturation stage, and not by age. Osteocalcin is a highly specific, reliable and useful marker for evaluation of the growth spurt and is not influenced by nonosseous disorders.     

义乌市城区学龄儿童性发育现状分析

目的 了解义乌市城区学龄儿童性发育现状,比较义乌地区与全国水平的差异。方法 于2016年9-10月分层整群抽取义乌市城区2所小学学龄儿童共1 026名(男578名,女448名),按照统一标准测量其身高、体重、腰围和臀围等。青春期发育指标为女童乳房发育和男童睾丸发育Tanner分期。结果 1)女童9岁组乳房发育到达B2期占18%,B3期及以上达11.5%;男童10岁组睾丸开始发育达8.9%,G3期及以上达1.1%;2)男童超重及肥胖分别占16.1%和13.0%,女童超重及肥胖分别占7.2%和12.6%;3)男童睾丸容积与年龄、身高、体重、BMI、腰围均呈正相关,与年龄相关性最强;4)男童和女童各年龄段超重组及肥胖组开始青春发育比例均高于正常组。结论 义乌市城区学龄儿童性发育水平高于全国平均水平,应引起重视。     

Cholesterol, high density lipoprotein cholesterol and triglycerides during puberty: the Oslo Youth Study

The relationships of serum total cholesterol, high density lipoprotein (HDL) cholesterol and fasting triglycerides (adjusted for body mass index, wt/ht2) with stages of pubertal development were examined in a Norwegian population of 920 adolescents, aged 10 to 16 years. For 13- and 14-year-olds, all five stages of Tanner's maturity index were represented. For the whole population, total serum cholesterol showed a larger decrease when related to sexual maturity stage than to chronologic age. For females, HDL cholesterol and triglycerides increased significantly when related to age in years; this was not found when related to the maturity index. Triglycerides showed a larger increase when related to chronologic age in males as compared with sexual maturity stage. Both among 13- and 14-year-old males, the most mature had significantly lower values for total cholesterol than the least mature. For 12-year-old males, HDL cholesterol decreased significantly with increasing sexual maturation. Among females, the more mature 12-year-olds had significantly lower values for total cholesterol compared with the less mature. Early maturing 13-, 14- and 15-16-year-olds had lower levels of HDL cholesterol compared with late maturers. These findings suggest that age in years may be a poor index of development in adolescents and that a measure of physiologic developmental age should be included in epidemiologic studies of serum lipids among adolescents.     

Self-assessment of sexual maturation in adolescent females with anorexia nervosa.

PURPOSE: To evaluate the accuracy of self-assessment of pubertal maturation and to determine the desired stage of pubertal maturity in adolescent females with anorexia nervosa. METHODS: Standardized figure drawings depicting Tanner's sexual maturation stages were given to a consecutive sample of 40 adolescent females with anorexia nervosa who were instructed to assess current and desired pubertal development. Pubertal development was assessed independently by two investigators. The percent agreement between physician and subject ratings was determined. RESULTS: Percent agreement between physician and subject ratings was 30% for developmental stage for breasts and 50% for pubic hair. Subjects underestimated breast development 3.4 times as often as they overestimated it and overestimated pubic hair development 1.5 times as often as they underestimated it. Multivariate probit analysis showed that inaccuracy in breast self-assessment was inversely related to a desire for sexual maturity (p < 0.05). Ninety percent of subjects stated that their desired stage of breast development was equal to or more mature than their present stage. Eighty percent stated that their desired stage of pubic hair development was equal to or more mature than their present stage. CONCLUSIONS: Self-assessment of sexual maturity by adolescents with anorexia nervosa using standardized figure drawings depicting Tanner's stages is not accurate. Patients desiring a sexually immature body were most likely to be inaccurate in their self-assessment of their pubertal stage.     

Validity of self-report of pubertal maturation in early adolescents.

Self-report measures of sexual maturation continue to be used to classify pubertal development even though their reliability remains in question. This study examined the accuracy of self-report measures by early adolescents in two settings. Standardized figured drawings depicting Tanner's sexual maturation scale (SMS) were shown to early adolescents at school (S1) and again in a clinical sitting (S2), and subjects were asked to rate their own pubertal development. Physical examination by a physician at S2 was used to corroborate sexual maturation. Participating in the study were 46 males, age 11-14 years (mean, 12.4, SD, 1.9), and 37 females, age 11-14 years (mean, 12.7, SD, 0.7). Concordance rate between physical examination and self-report of pubic hair development (males) at S1 was 58% (kappa = 0.35, p less than 0.0001) and 78% (kappa = .66, p less than 0.0001) at S2. Concordance rate of self-report of genital development at S1 and S2 was 27% (kappa = -0.06, p less than 0.49) and 44% (kappa = 0.18, p less than 0.04), respectively. Self-report of breast development demonstrated a concordance rate of 59% (kappa = 0.43, p less than 0.0001) at S1 and 72% (kappa = 0.59, p less than 0.0001) at S2. Concordance rate for self-report of pubic hair development in females was 58% at S1 (kappa = 0.42, p less than 0.0001) and 75% at S2 (kappa = 0.64, p less than 0.0001). There was a tendency for subjects to overestimate their development at early stages of maturation and underestimate development at later stages.(ABSTRACT TRUNCATED AT 250 WORDS)     

联合应用促性腺激素释放激素类似物和生长激素治疗女童特发性中枢性性早熟的疗效观察

【目的】 评价促性腺激素释放激素类似物(GnRHa)联合生长激素(GH)治疗女童特发性中枢性性早熟(ICPP)的疗效。 【方法】 对生长速率(GV)减慢至可能损害预测成年身高(PAH)的60例ICPP女童采用GnRHa和GH联合治疗6个月。行LH释放激素(LHRH)激发试验和GH激发试验,所有患者均不缺乏GH。观察治疗前后第二性征和GV的变化,观测子宫大小、卵巢容积、骨龄与年龄比值(BA/CA)的变化,并评估预测成人身高。 【结果】 经治疗后第二性征的发育明显受到抑制,表现为乳房回缩、子宫、卵巢容积减小。LHRH激发试验显示LH、FSH峰值显著降低,骨龄成熟延缓。按BA的身高标准差分值(HtSDSBA)从治疗前1.91±0.33升至1.44±0.27(P<0.001)。按CA的身高标准差分值(HtSDSCA)从0.31±0.12 下降至0.38±0.15。PAH由(153.4±1.1)cm升高到(156.0±1.0)cm(P<0.001)。GV由(3.81±1.3)cm增加至(8.63±3.5)cm。 【结论】 联合应用GnRHa和GH治疗ICPP,尤其是PAH明显落后的ICPP患者,能够有效抑制性腺轴及性腺发育,延缓骨龄成熟,改善预测成人终身高。     

阶段恢复训练对孤独症谱系障碍儿童的影响

目的 探讨阶段恢复训练对孤独症谱系障碍儿童的影响,为科学合理制定康复恢复训练计划提供参考。方法 筛选泸州市儿童医院59名孤独症谱系障碍儿童为研究对象,并随机分为对照组、干预Ⅰ组、干预Ⅱ组进行T1-T4 4个阶段恢复训练,干预Ⅰ组和干预Ⅱ组分别侧重运动类及补交类训练。训练前后,利用自闭症行为量表(ABC)筛查患儿的感觉、语言、动作、交往以及生活自理能力。结果 3组儿童(ABC)总体评分在T1和T2阶段差异均无统计学意义(P值均>0.05),在T3和T4阶段差异均有统计学意义(F值分别为3.98,5.09,P值均<0.05),且表现为干预Ⅰ组、Ⅱ组低于对照组。分维度来看,3组儿童除语言评分差异无统计学意义外(P值均>0.05),感觉、交往、动作、生活自理评分差异均有统计学意义(P值均<0.05)。相较于对照组,干预Ⅰ组和Ⅱ组儿童总体评分在T3和T4阶段差异均有统计学意义(P值均<0.05)。相较于T1阶段,对照组儿童总体评分在T2、T3和T4阶段的差异均无统计学意义(P值均>0.05),而干预Ⅰ组和Ⅱ组总体评分在T2～T4阶段的差异均有统计学意义(P值均...     

Tanner分期看图自评法在城市青少年中的适用性研究

目的 探讨青春期性发育水平Tanner分期看图自评法在中国城市青少年人群中的适用性,为开展现场调查提供方法学依据.方法 采用分层整群抽样方法,选取上海市中心城区和外围城区各1个,整群抽取小学四年级至高三学生2 569名,采用体格检查和问卷调查的方法评价被调查对象性器官和第二性征的Tanner发育分期,以专业人员检查为金标准,分析看图自评法的真实性和可靠性及影响自评准确性的相关因素.结果 男生外生殖器、阴毛的Tanner分期体检与自评间Kappa值分别为0.173和0.296,Kendall's等级相关系数分别为0.559和0.700；女生乳房、阴毛的Tanner分期体检与自评间的Kappa值分别为0.152和0.415,Kendall's等级相关系数分别为0.614和0.711.年龄越高、相对发育水平越高的个体越倾向于低估自身发育水平；而男生比女生、超重或肥胖者比体重正常者更倾向于高估,自感家庭经济状况越好,自评准确性越高.结论 Tanner分期看图自评法能够较为便捷地获取个体青春期性发育水平的必要信息,但在现阶段的人群流行病学调查中要综合考虑被调查对象的年龄、性别、相对发育水平、BMI和家庭经济状况等因素.     

Timing of maturation and predictors of menarche in girls enrolled in a contemporary British cohort

This study describes the timing of puberty in 8‐ to 13‐year‐old girls enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) and identifies factors associated with earlier achievement of menarche. Women were enrolled during pregnancy and their offspring were followed prospectively. We analysed self‐reported Tanner staging and menstrual status information collected annually from daughters up to age 13. We used survival models to estimate median age of attainment of stage >1 and stage >2 of breast and pubic hair development and of menarche. We also constructed multivariable logistic regression models to identify factors associated with earlier achievement of menarche. About 12% of girls reported Tanner breast stage >1 at age 8; 98% of girls were above stage 1 by age 13. For pubic hair, 5% and 95% of girls had attained a stage >1 by 8 and 13 years, respectively. The estimated median age of entry into stage >1 of breast development was 10.14 years (95% confidence interval [CI], 10.08, 10.19), and for pubic hair development the median age was 10.92 years [95% CI, 10.87, 10.97]. One girl (out of 2953) had attained menarche by age 8; 60% had attained menarche by age 13. The estimated median age at menarche was 12.93 years [95% CI, 12.89, 12.98]. Prenatal predictors of menarche by age 11 (12% of girls) included earlier maternal age at menarche, high maternal pre‐pregnancy body mass index, smoking during the third trimester, and non‐white race; the single postnatal predictor was the girl's body size at 8 years. Age at attainment of breast and pubic hair Tanner stage and age at menarche in the ALSPAC cohort are similar to ages reported in other European studies that were conducted during overlapping time periods. The results also give added support to the strong influence of maternal maturation, pre‐adolescent body size and race on the timing of a girl's menarche. This cohort will continue to be followed for maturational information until age 17.     

A continuous-scale measure of child development for population-based epidemiological surveys: a preliminary study using Item Response Theory for the Denver Test

A method for translating research data from the Denver Test into individual scores of developmental status measured in a continuous scale is presented. It was devised using the Denver Developmental Screening Test (DDST) but can be used for Denver II. The DDST was applied in a community-based survey of 3389 under-5-year-olds in Porto Alegre, Brazil. The items of success were standardised by logistic regression on log chronological age. Each child's ability age was then estimated by maximum likelihood as the age in this reference population corresponding to the child's success and failures in the test. The score of developmental status is the natural logarithm of this ability age divided by chronological age and thus measures the delay or advance in the child's ability age compared with chronological age. This method estimates development status using both difficulty and discriminating power of each item in the reference population, an advantage over scores based on total number of items correctly performed or failed, which depend on difficulty only. The score corresponds with maternal opinion of child developmental status and with the 3-category scale of the DDST. It shows good construct validity, indicated by symmetrical and homogeneous variability from 3 months upwards, and reasonable results in describing gender differences in development by age, the mean score increasing with socio-economic conditions and diminishing among low-birthweight children. If a standardised measure of development status (z-scores) is required, this can be obtained by dividing the score by its standard deviation. Concurrent and discriminant validity of the score must be examined in further studies.     

童年期情绪性多食与多基因遗传风险对青春期发育的交互效应研究

  目的  探讨童年期情绪性多食与多基因遗传风险对男女童青春期发育的交互效应，为进一步开展儿童青春期发育研究提供参考。  方法  通过整群抽样的方法，于2016年3月(T0)从安徽省蚌埠市2所小学招募896名一至三年级学生，建立青春期发育队列，之后2017—2019年每年开展1次随访调查(T1、T2、T3)。评估儿童情绪性多食与年度青春期发育状况(男童睾丸容积和女童乳房发育)，借助非线性生长模型拟合男女童的青春期发育时相与速度，基于17个与青春期发育提前相关的SNPs计算多基因遗传风险评分。采用分层线性回归分别检验情绪性多食与多基因遗传风险对男女童青春期发育的交互效应。  结果  896名儿童T1时情绪性多食行为报告率为22.7%。控制分娩方式、出生体重等协变量后，在青春期发育提前高遗传风险女童中，情绪性多食仅与青春期发育速度加快存在相关性(B=0.19，95%CI=0.07~0.32, P < 0.01)，与青春期发育时相无相关性(B=0.14，95%CI=- 0.12~0.41, P=0.28)。在低遗传风险女童以及不同遗传风险的男童中，情绪性多食与青春期发育时相和速度间差异无统计学意义(P值均>0.05)。  结论  青春期发育提前高遗传风险女童中情绪性多食与青春期发育速度加快有关。需要开展更多纵向研究检验多基因遗传风险与童年期饮食行为对男女童青春期发育的交互影响。     

Accuracy of the Stages of Change Algorithm: Sexual Risk Reported in the Maintenance Stage of Change

The Transtheoretical Model (TTM), which asserts that health behavior change progresses in stages, is often used to explore health risk behaviors and to target and evaluate health promotion interventions. A four-question staging algorithm is often used to measure an individual’s health behavior stage of change (SOC), but its accuracy or appropriateness for tailoring interventions or evaluating outcomes has not been established. The current study utilized data from three studies on HIV sexual risk behavior to compare SOC to reports of sexual risk on more detailed risk assessments, measured concurrently. Within each data set, detailed behavioral risk assessments were compared with SOC, with specific emphasis on maintenance staging, to evaluate the correspondence between SOC and reported behavior. Those classified in the maintenance SOC for condom use should, by definition, report no sexual risk events over the matched time period. Across all three studies, 18% of those classified in the maintenance SOC for condom use reported one or more sexual risk behaviors during the matched time period. Because the SOC algorithm is frequently used in intervention design, targeting, and evaluation, the potential for mis-categorization in the most advanced stage of maintenance raises concerns. Results suggest that intervention inclusion or evaluation strategies that use the maintenance stage as a primary outcome should be further qualified by behavioral data. Special thanks to William Barta, Gerald Friedland, and Steve Misovich in their contributions to the studies included in this review.     

Are child sexual experiences related to eating-disordered attitudes and behaviors in a college sample?

Clinicians and theorists have suggested a link between child sexual abuse (CSA) and the later development of eating disorders. Finkelhor and Browne (1986) argue that this link is mediated by abuse characteristics, personality variables, and levels of family support. The present study investigated child sexual experiences and family support as predictors of disordered attitudes and behaviors in a well-functioning female college sample. Abused respondents had higher total scores on the Eating Disorders Inventory (EDI) than nonabused respondents, but a MANOVA revealed no between-group differences on the EDI subscales. Further, abuse characteristics were either unrelated (e.g., severity) or weakly related (e.g., reaction to abuse) to EDI scores. Family support, especially parental reliability, did predict EDI scores. This was more true for CSA victims. Thus, there appeared to be an interactive relationship between abuse status and family variables in influencing EDI scores.     

孤独症患儿父母压力和情绪变化及相关因素

【目的】 探讨孤独症患儿父母压力和情绪变化及其相关因素。 【方法】 采用父母压力指数量表(PSI)、孤独症行为量表(ABC)、孤独症评定量表(CARS)、抑郁自评量表(SDS)和焦虑自评量表(SAS)对孤独症患儿父母进行评定;采用PSI、SDS和SAS量表对正常儿童父母进行评定。 【结果】 1)孤独症患儿父母PSI总分及各分量表分均显著高于正常儿童父母(P=0.000);2)患儿父、母亲SDS和SAS分均显著高于正常儿童父母(P= 0.000)。患儿母亲SDS和SAS分均高于患儿父亲得分(P=0.000),患儿母亲抑郁发生率高于父亲(P=0.000);3)患儿父母的压力与患儿症状严重度正相关(P<0.01);4)多元回归结果表明孤独症患儿ABC量表分、孤独症患儿母亲的焦虑以及患儿年龄影响孤独症儿童父母压力,解释了总变异的54.9%。 【结论】 孤独症患儿父母承受着较高的压力、焦虑和抑郁水平,孤独症患儿母亲比患儿父亲及正常儿童父母更易发生抑郁,患儿行为问题是父母压力的主要影响因素。     

特发性中枢性性早熟女童血浆kisspeptin、神经激肽B及强啡肽浓度的变化研究

目的 研究特发性中枢性性早熟(ICPP)女童血浆kisspeptin,神经激肽B(NKB)及强啡肽浓度的变化,探索其在ICPP发病中的作用。方法 选取2016年1月-2017年1月在山东大学齐鲁医院确诊为ICPP并未经治疗的女童50例,观察并比较ICPP女童与正常健康女童以及ICPP女童治疗前后性发育状况和血浆kisspeptin、神经激肽B、强啡肽浓度的变化。结果 未行治疗的ICPP女童的骨龄、骨龄/年龄、身高标准差单位(SDS)、黄体生成素基础值(B-LH)、卵泡刺激素基础值(B-FSH)、雌二醇(E2)、kisspeptin、NKB与健康对照组相比差异均有统计学意义(P<0.01),治疗6个月后,其B-LH、黄体生成素峰值(P-LH)、B-FSH、卵泡刺激素峰值(P-FSH)、P-LH/P-FSH、E2、kisspeptin、NKB较治疗之前均显著下降(P<0.01),治疗12个月后上述指标与治疗6个月时差异无统计学意义(P>0.05),强啡肽在各组之间差异无统计学意义(P>0.05)。ICPP女童接受促性腺激素释放激素类似物(GnRHa)治疗后,其性发育在3个月之内均得到明显控制,持续观察至12月,性发育均未再明显进展。Kisspeptin和NKB、P-LH、P-LH/P-FSH、E2均存在明显正相关关系(P<0.05),NKB和kisspeptin、P-LH、P-LH/P-FSH、E2也存在明显正相关关系(P<0.05)。结论 Kisspeptin和NKB在ICPP的发病过程中起重要作用,其有可能成为监测儿童性发育及评价ICPP治疗效果的有效指标。     

Timing of maturation and predictors of Tanner stage transitions in boys enrolled in a contemporary British cohort

This study describes the timing of puberty in 8- to 14-year-old boys enrolled in the Avon Longitudinal Study of Parents and Children (ALSPAC) and identifies factors associated with earlier achievement of advanced pubic hair stages. Women were enrolled during pregnancy and their offspring were followed prospectively. We analysed self-reported pubic hair Tanner staging collected annually. We used survival models to estimate median age of attainment of pubic hair stage >1, stage >2 and stage >3 of pubic hair development. We also constructed multivariable logistic regression models to identify factors associated with earlier achievement of pubic hair stages. Approximately 5% of the boys reported Tanner pubic hair stage >1 at age 8; 99% of boys were at stage >1 by age 14. The estimated median ages of entry into stages of pubic hair development were 11.4 years [95% confidence interval (CI) 11.3, 11.4] for stage >1, 12.7 years [95% CI 12.7, 12.8] for stage >2 and 13.5 years [95% CI 13.5, 13.6] for stage >3. Predictors of younger age at Tanner stage >1 included low birthweight, younger maternal age at delivery and being taller at age 8. Associations were found between younger age at attainment of stage >2 and gestational diabetes and taller or heavier body size at age 8. Being taller or heavier at age 8 also predicted younger age at Tanner stage >3. The results give added support to the strong influence of pre-adolescent body size on male pubertal development; the tallest and heaviest boys at 8 years achieved each stage earlier and the shortest boys later. Age at attainment of pubic hair Tanner stages in the ALSPAC cohort are similar to ages reported in other European studies that were conducted during overlapping time periods. This cohort will continue to be followed for maturational information until age 17.     

Feasibility of an Audio Computer-Assisted Self-Interview Method to Self-Assess Sexual Maturation

PurposeSexual maturation assessment using physical examination may no longer be feasible in some large epidemiologic surveys, such as National Health and Nutrition Examination Survey, because of the sensitivity of the examination and privacy concerns. This study tested the feasibility of a new automated audio computer-assisted self-interview (ACASI) module for children and adolescents for self-assessment of sexual maturation.MethodsA cross-sectional feasibility study was conducted at a large urban children/adolescent clinic in Washington D.C. Self-assessed sexual maturation (Tanner stages) was reported by 234 youths (119 boys and 115 girls) aged 8–18 years by using the ACASI module. Girls assessed their breast and pubic hair development, and boys assessed their genital and pubic hair development. Self-assessments were compared with Tanner stages recorded by clinical examiners during routine well-child physical examinations conducted on the same day.ResultsThere was good/excellent agreement between boy's self-assessment and the examiner's assessment of their genital stage (weighted κ: .65, 95% confidence interval [CI]: .55–.75) and pubic hair stage (weighted κ: .78, CI: .70–.86). There was excellent agreement between girl's self-assessment and the examiner's assessment of their breast stage (weighted κ: .81, CI: .74–.87) and pubic hair stage (weighted κ: .78, CI: .71–.86).ConclusionThe ACASI method is a feasible method of pubertal self-assessment for participants as young as 8 years in large epidemiologic surveys. However, additional testing is needed to determine the validity of this ACASI module.