New insights into precocious puberty and ADHD: a nationwide cohort study

Li-Fan Pai; Der-Shiun Wang; Wan-Fu Hsu; Shao-Wei Huang; Chi-Hsiang Chung; Shyi-Jou Chen; Wu-Chien Chien; Der-Ming Chu

doi:10.1038/s41390-022-02028-5

New insights into precocious puberty and ADHD: a nationwide cohort study

Pediatr Res. 2022 Dec;92(6):1787-1794. doi: 10.1038/s41390-022-02028-5. Epub 2022 Mar 26.

Authors

Li-Fan Pai^{1

2}, Der-Shiun Wang^{1

2

3}, Wan-Fu Hsu^{1

2}, Shao-Wei Huang^{1

2}, Chi-Hsiang Chung^{4

5}, Shyi-Jou Chen^{1

2}, Wu-Chien Chien^{6

7

8

9}, Der-Ming Chu^{10

11}

Affiliations

¹ Department of Pediatrics, Tri-service General Hospital, Taipei, Taiwan.
² School of Medicine, National Defense Medical Center, Taipei, Taiwan.
³ Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
⁴ School of Public Health, National Defense Medical Center, Taipei, Taiwan.
⁵ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
⁶ School of Public Health, National Defense Medical Center, Taipei, Taiwan. chienwu@mail.ndmctsgh.edu.tw.
⁷ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan. chienwu@mail.ndmctsgh.edu.tw.
⁸ Graduate Institute of Life Sciences, National Defense Medical Center, Taipei, Taiwan. chienwu@mail.ndmctsgh.edu.tw.
⁹ Taiwanese Injury Prevention and Safety Promotion Association, Taipei, Taiwan. chienwu@mail.ndmctsgh.edu.tw.
¹⁰ Department of Pediatrics, Tri-service General Hospital, Taipei, Taiwan. dermingchu618@gmail.com.
¹¹ School of Medicine, National Defense Medical Center, Taipei, Taiwan. dermingchu618@gmail.com.

PMID: 35347278
DOI: 10.1038/s41390-022-02028-5

Abstract

Background: Attention deficit-hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders in children; however, studies delineating the association between ADHD and central precocious puberty are limited. This study aimed to understand whether children with ADHD are at a higher risk of central precocious puberty.

Methods: This population-based retrospective cohort study was conducted using the National Health Insurance Research Database of Taiwan to investigate the association between ADHD and the incidence of central precocious puberty between 2000-2015. We identified ADHD individuals treated with methylphenidate, atomoxetine or not. The control cohort consisted of individuals without ADHD. The outcome measure was central precocious puberty diagnosis.

Results: Among 290,148 children (mean age: 5.83 years), central precocious puberty incidence was 4.24 and 1.95 per 10⁵ person-years in the ADHD and control groups, respectively. Children with ADHD treated with medication had a higher risk than those without ADHD. However, medication use did not affect the incidence of central precocious puberty among children with ADHD.

Conclusion: This study showed an association between ADHD and a higher risk of central precocious puberty. Early referral of children with ADHD to a pediatric endocrinologist for evaluation may facilitate correct diagnoses and early interventions.

Impact: ADHD is associated with a higher risk of central precocious puberty. This study provides relevant findings, as it is the first nationwide, population-based cohort study to investigate the association between ADHD and the risk of central precocious puberty with a 15-year follow-up. Early referral of children with ADHD to a pediatric endocrinologist for the evaluation of suspected precocious puberty could facilitate correct diagnosis. Early intervention treatment with gonadotropin-releasing hormone agonist might improve final height in children with central precocious puberty.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Attention Deficit Disorder with Hyperactivity* / complications
Attention Deficit Disorder with Hyperactivity* / diagnosis
Attention Deficit Disorder with Hyperactivity* / drug therapy
Child
Child, Preschool
Cohort Studies
Gonadotropin-Releasing Hormone / therapeutic use
Humans
Puberty, Precocious* / complications
Puberty, Precocious* / diagnosis
Puberty, Precocious* / drug therapy
Retrospective Studies

Substances

Gonadotropin-Releasing Hormone