Original Articles
Impact of timing of pubertal maturation on growth in black and white female adolescents: The National Heart, Lung, and Blood Institute Growth and Health Study,☆☆

https://doi.org/10.1067/mpd.2001.114476Get rights and content

Abstract

Objectives: To evaluate the impact of early, mid-onset, and late maturation, as assessed by timing of menarche, on height, height velocity, weight, body mass index, and sum of skinfolds in a group of white and black girls. Study design: The Growth and Health Study recruited 9- and 10-year-old girls from Richmond, California, Cincinnati, Ohio, and Washington, DC. There were 616 white and 539 black participants recruited at age 9 and 550 white and 674 black participants recruited at age 10. Participants were seen annually for 10 visits. Longitudinal regression models were used to test for differences in each growth measure by timing of menarche across all ages and to determine whether these differences change with age. Results: Mean age at menarche among white participants was 12.7 years, and among black participants, 12.0 years. According to race-specific 20th and 80th percentiles, early maturers were tallest at early ages and shortest after adult stature had been attained. Peak height velocity and post-menarche increment in stature were greatest in early maturers and least in late maturers. Weight was greatest in early and least in late maturers, as was body mass index. Sum of skinfolds was also greatest in early and least in late maturers. There was no impact of timing of maturation on two common measures of regional fat distribution. Conclusions: Girls who matured early were shorter in early adulthood, despite having greater peak height velocity and post-menarchal increment in height. Throughout puberty, early maturers had greater ponderosity and adiposity, although there was no association with regional distribution of fat. (J Pediatr 2001;138:636-43)

Section snippets

Methods

The National Heart, Lung, and Blood Institute Growth and Health Study was a cohort study designed to follow the development of obesity and related cardiovascular disease risk factors.2 Briefly, 9- and 10-year-old girls were recruited in 1987 at 3 clinical centers: University of California at Berkeley, through the public and private school systems in Richmond, California; University of Cincinnati, through selected public and parochial schools in the Cincinnati metropolitan area; and Westat, Inc,

Results

At baseline, there were 616 white and 539 black participants who were 9 years old and 550 white and 674 black participants who were 10 years old. The distribution of age at menarche by race is presented in Table I.

. Distribution of age at menarche in NGHS participants, by race

Empty CellEmpty CellEmpty CellEmpty CellPercentiles
RaceNo.Mean (y)SD (y)Minimum5102050809095Maximum
White109212.71.29.010.911.211.712.613.514.214.716.8
Black116412.01.28.110.110.611.112.012.913.614.016.2
Mean age at menarche in white participants was 12.7 years, and

Discussion

This study, performed with participants recruited from diverse socioeconomic backgrounds in 3 metropolitan regions, assessed the relationship between timing of maturation and anthropometric measures and used age at menarche as a measure of race-specific timing of pubertal maturation because age at menarche can be ascertained more reliably than onset of maturation8 and because a high correlation between onset of puberty and age at menarche (0.39-0.86) has been reported by other investigators.9,

Acknowledgements

We thank Carol Muir for her assistance in preparation of the manuscript.

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    Supported by the National Heart, Lung, and Blood Institute contracts N01-HL-55023 to 26 and U01-HL-48941.

    ☆☆

    Reprint requests: Frank M. Biro, MD, Children’s Hospital Medical Center, Division of Adolescent Medicine, 3333 Burnet Ave, Cincinnati, OH 45229-3039.

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