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Prevalence of precocious puberty among Chinese children: a school population-based study

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Abstract

Purpose

To investigate the prevalence of precocious puberty in school-based population in Zhongshan, Guangdong, China.

Methods

We recruited a total of 4058 students in grades 1–3 using a multistage stratified cluster random sampling method in a population-based cross-sectional study. We evaluated height, weight, and development of breast and pubic hair in girls, breast development was evaluated by inspection and palpation combined with ultrasound detection for overweight and obese girls, and testicular volume and development of pubic hair in boys. We estimated overall, sex-, age, and district-specific prevalence of precocious puberty and examined the association between prevalence of precocious puberty and body mass index (BMI).

Results

The unadjusted and adjusted prevalence of precocious puberty by Tanner stage was 4.74% (girls:8.78%, boys:2.58%) and 6.19% (girls:11.47%, boys:3.26%), respectively. In both urban and suburban areas, the prevalence of precocious puberty was higher in the overweight and obese group than in the normal-weight group (p < 0.05). The prevalence of precocious puberty among overweight (27.94%) and obese (48.00%) girls was higher than that of normal-weight girls (8.73%) (p value for trend < 0.05). In boys, the prevalence of precocious puberty in the obese (6.78%) group was higher than that in the normal-weight (2.86%) group (p < 0.05).

Conclusions

The prevalence of precocious puberty was high in China. Overweight and obesity was related to precocious puberty, but this correlation had gender differences and may be affected by other environmental factors.

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Acknowledgements

We thank teachers for their cooperation and all subjects for their participation in the research. This study was supported by National Science Foundation of China [81872637,81903341], Shanghai Municipal Commission of Health and Family Planning[201840324], and Shanghai Professional and Technical Services Platform [18DZ2294100], Program of Shanghai Science and Technology Committee [19441904400], the Foundation of National Facility for Translational Medicine, Shanghai[TMSK-2020-124], the Key Subject Program for Clinical Nutrition from Shanghai Municipal Health Commission [2019ZB0103], National Key Research Program of China [2016YFC1305204], Key discipline construction project of the 3-year action Plan of Shanghai Public Health System [GWV-10.1-XK07].

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Author notes

  1. These authors contributed equally: Yifan Liu, Tingting Yu

Authors and Affiliations

  1. The Second School of Clinical Medicine, Southern Medical University, Guangzhou City, Guangdong Province, China

    Yifan Liu, Dongxue Pan & Xin Lai

  2. Department of Clinical Epidemiology and Biostatistics, Children Health Advocacy Institute, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Tingting Yu, Xiaoqing Li & Shijian Liu

  3. School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Tingting Yu, Xiaoqing Li & Shijian Liu

  4. Department of Endocrine and Genetic Metabolic Diseases, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Yao Chen & Xiumin Wang

  5. Department of Developmental and Behavioral Pediatrics, Shanghai Children’s Medical Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Xiaodan Yu

  6. Zhongshan Hospital of Sun-Yat-Sen University, Zhongshan City, Guangdong Province, China

    Simao Fu

  7. Health Care Center for Primary and Secondary Schools, Zhongshan City, Guangdong province, China

    Sizhe Huang

  8. Bo Ai Hospital of Zhongshan Affiliated to The Second School of Clinical Medicine, Southern Medical University, Zhongshan City, Guangdong Province, China

    Cuilan Lin

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  1. Yifan Liu
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Contributions

Conceived and designed the experiments: S.L., X.Y., S.F. and C.L.; collected clinical data: T.Y., X.L., D.P., X.L., S.H.; analyzed data: T.Y., Y.C., Y.L.; write the paper: Y.L., S.L.; revise the paper: S.L., C.L., X.W. All authors have approved the final draft of the paper.

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Correspondence to Cuilan Lin or Shijian Liu.

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Liu, Y., Yu, T., Li, X. et al. Prevalence of precocious puberty among Chinese children: a school population-based study. Endocrine 72, 573–581 (2021). https://doi.org/10.1007/s12020-021-02630-3

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