Sexual Dimorphisms in the Associations of BMI and Body Fat with Indices of Pubertal Development in Girls and Boys

作者：Melissa K. Crocker, Elizabeth Stern, Nicole M. Sedaka, Lauren B. Shomaker, Sheila M. Brady, Asem H. Ali, Thomas H. Shawker, Van S. Hubbard, Jack A. Yanovski · 发表于：The Journal of Clinical Endocrinology & Metabolism · 年份：2014 · DOI：10.1210/jc.2014-1384 · 被引用次数：105 · 研究领域：Hypothalamic control of reproductive hormones、Ovarian function and disorders、Sexual Differentiation and Disorders

CONTEXT: The effect of obesity and concomitant insulin resistance on pubertal development is incompletely elucidated. OBJECTIVE: To determine how measures of adiposity and insulin resistance are associated with pubertal maturation in boys and girls. SETTING AND DESIGN: Breast and pubic hair Tanner stage and testicular volume by orchidometry were determined by physical examination in 1066 children. Ovarian volume was estimated by trans-abdominal ultrasound. Fat mass, skeletal age, and fasting serum for insulin and glucose, total T, estradiol, estrone, dehydroepiandrosterone-sulfate, and androstenedione were measured at the National Institutes of Health Clinical Research Center. Convenience sample; 52% obese, 59% female. RESULTS: Logistic regression identified a significant interaction between sex and obesity for prediction of pubertal development (P ≤ .01). There was a negative association between boys' testicular volume and body mass index (BMI)/fat mass but a positive association between girls' breast stage and BMI/fat mass. Ovarian volume in girls was positively associated with insulin resistance but not with BMI/fat mass. There was a positive association between obesity and measures of estrogen exposure (breast development and skeletal age) in both sexes. Positive correlations were seen for girls between BMI and pubic hair development and between insulin resistance and T production, whereas adiposity was negatively associated with pubic hair in boys. CONCLUSIONS: Significa...