Determining the timing of pubertal onset via a multicohort analysis of growth

PLoS One. 2021 Nov 18;16(11):e0260137. doi: 10.1371/journal.pone.0260137. eCollection 2021.

Abstract

Objective: Growth-based determination of pubertal onset timing would be cheap and practical. We aimed to determine this timing based on pubertal growth markers. Secondary aims were to estimate the differences in growth between cohorts and identify the role of overweight in onset timing.

Design: This multicohort study includes data from three Finnish cohorts-the Type 1 Diabetes Prediction and Prevention (DIPP, N = 2,825) Study, the Special Turku Coronary Risk Factor Intervention Project (STRIP, N = 711), and the Boy cohort (N = 66). Children were monitored for growth and Tanner staging (except in DIPP).

Methods: The growth data were analyzed using a Super-Imposition by Translation And Rotation growth curve model, and pubertal onset analyses were run using a time-to-pubertal onset model.

Results: The time-to-pubertal onset model used age at peak height velocity (aPHV), peak height velocity (PHV), and overweight status as covariates, with interaction between aPHV and overweight status for girls, and succeeded in determining the onset timing. Cross-validation showed a good agreement (71.0% for girls, 77.0% for boys) between the observed and predicted onset timings. Children in STRIP were taller overall (girls: 1.7 [95% CI: 0.9, 2.5] cm, boys: 1.0 [0.3, 2.2] cm) and had higher PHV values (girls: 0.13 [0.02, 0.25] cm/year, boys: 0.35 [0.21, 0.49] cm/year) than those in DIPP. Boys in the Boy cohort were taller (2.3 [0.3, 4.2] cm) compared with DIPP. Overweight girls showed pubertal onset at 1.0 [0.7, 1.4] year earlier compared with other girls. In boys, there was no such difference.

Conclusions: The novel modeling approach provides an opportunity to evaluate the Tanner breast/genital stage-based pubertal onset timing in cohort studies including longitudinal data on growth but lacking pubertal follow-up.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Age of Onset
  • Biological Phenomena
  • Body Height
  • Breast / growth & development
  • Child
  • Cohort Studies
  • Female
  • Finland
  • Forecasting / methods*
  • Genitalia / growth & development
  • Growth / physiology
  • Humans
  • Male
  • Men
  • Models, Theoretical
  • Overweight
  • Puberty / metabolism*
  • Puberty / physiology*
  • Risk Factors
  • Women

Grants and funding

The DIPP Study was supported by the Academy of Finland (grants 63672, 68292, 79685, 79686, 80846, 114666, 126813, 129492, 139391, 201988, 210632, 276475, 308066, and Center of Excellence in Molecular Systems Immunology and Physiology Research 2012-2017, Decision No. 250114), URL: https://www.aka.fi/en/; European Foundation for the Study of Diabetes (EFSD) award supported by EFSD/JDRF/Lilly, URL: http://www.europeandiabetesfoundation.org/; the Finnish Diabetes Association, URL: https://www.diabetes.fi/en/finnish_diabetes_association; the Finnish Diabetes Research Foundation, URL: https://www.diabetestutkimus.fi/en; the Juho Vainio Foundation, URL: https://juhovainionsaatio.fi/en/juho-vainio-foundation/; the Juvenile Diabetes Research Foundation International (grants 4-1998-274, 4-1999-731, and 4-2001-435), URL: https://www.jdrf.org/; the Competitive State Research Financing of the Expert Responsibility area of Tampere University Hospital (grants 9E082, 9F089, 9G087, 9H092, 9J147, 9K149, 9L042, 9L117, 9M114, 9N086, 9P057, 9R055, 9S074, 9U065, and 9V072); Oulu University Hospital Research Funds; Turku University Hospital (state research funding ERVA); the European Comission (grant BMH4-CT98-3314), URL: https://ec.europa.eu/info/index_en; the Novo Nordisk Foundation, URL: https://novonordiskfonden.dk/en/; Special Research Funds for University Hospitals in Finland; and the Sigrid Jusélius Foundation, URL: https://www.sigridjuselius.fi/en/. The STRIP was supported by the Academy of Finland (grants 251360, 276861, 307996, and 322112), URL: https://www.aka.fi/en/; the Juho Vainio Foundation, URL: https://juhovainionsaatio.fi/en/juho-vainio-foundation/; the Finnish Foundation for Cardiovascular Research, URL: https://www.sydantutkimussaatio.fi/en/foundation; the Finnish Ministry of Education and Culture, URL: https://minedu.fi/en/frontpage; the Finnish Cultural Foundation, URL: https://skr.fi/en; the Sigrid Jusélius Foundation, URL: https://www.sigridjuselius.fi/en/; Special Governmental Grants for Health Sciences Research (Turku University Hospital); the Yrjö Jahnsson Foundation, URL: https://www.yjs.fi/en/; and the Turku University Foundation. The Boy cohort study was supported by Turku University Hospital (state research funding ERVA); the Sigrid Jusélius Foundation, URL: https://www.sigridjuselius.fi/en/; the Novo Nordisk Foundation (grant NNF16OC0021302), URL: https://novonordiskfonden.dk/en/; European Commission (grants BMH4-CT96-0314, QLK4-CT-1999-01422, QLK4-CT-2001-00269, QLK4-2002-00603, and FP7/2008-2012: DEER 212844), URL: https://ec.europa.eu/info/index_en; the Academy of Finland (grants 77320, 211480, 121880, 136850, 253341, 308065, and 128576), URL: https://www.aka.fi/en/; and the Foundation for Pediatric Research, URL: https://www.lastentautientutkimussaatio.fi/. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.