The implications of this work are that pubertal development and its timing should be considered, and potentially targeted, in efforts to improve cardiometabolic health.
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Puberty could play a key role in transmitting early childhood risk factors into poorer cardiometabolic health many decades later, study findings suggest.

Girls who experienced breast development, pubic hair growth and periods earlier on in life had poorer cardiometabolic health in adulthood compared with others, according to research presented in the journal PLOS ONE.

The findings suggest that early exposure to adverse health and socioeconomic risk factors that advance puberty may impact cardiometabolic health throughout the course of life, at least in women.

“The clinical implications of the current finding that pubertal timing may play a larger role as a pathway linking early life exposures to cardiometabolic health in adulthood are far-reaching,” noted researcher Maria Bleil, PhD, from the University of Washington, and colleagues.

They believe that “understanding the role of pubertal development as a pathway raises novel opportunities for early surveillance and intervention.”

There is growing evidence for an association between exposure to adversity in childhood and poorer health as an adult. Earlier studies have found a link between earlier puberty and younger menarche with family hardship relating to parenting quality, parent-child relationships, stressful life events and socioeconomic disadvantage.

Furthermore, earlier initiation of puberty has been linked with poorer psychosocial functioning, for reasons that remain poorly understood.

To investigate the relationship between puberty and later health further, Bleil and co-workers studied 655 female participants in the prospective NICHD Study of Early Child Care and Youth Development and recent 30-year follow up in 374 participants.

Those taking part were followed from birth to adolescence between 1991 and 2009 to investigate trajectories of child health and development.

When they were aged between 26 and 31 years, between 2018 and 2022, they were then followed up for social, behavioral, and health measures.

The researchers found that later onset of puberty—consisting of later breast development, pubic hair onset, and first period—predicted lower adulthood cardiometabolic risk.

Each pubertal timing indicator significantly correlated with adulthood cardiometabolic risk (CMR), determined from a composite of waist circumference, systolic blood pressure, diastolic blood pressure, hemoglobin A1c, C-reactive protein, and high-density lipoprotein.

The pubertal factors also appeared to mediate the effects of factors like mother’s age when she had her first period, race, body mass index (BMI), and childhood socioeconomic status on cardiometabolic risk in adulthood.

Specifically, the timing of breast development onset and menarche significantly mediated the effects of maternal menarcheal age, Black versus White ethnicity, Asian/Pacific Islander versus White ethnicity, child BMI percentile, and child socioeconomic status on adulthood CMR.

The timing of pubic hair onset mediated the effects of maternal menarcheal age, Black versus White ethnicity, and child BMI percentile on adulthood CMR.

“This study suggests the timing of pubertal development in girls is an important pathway through which early life risk factors, such as prepubertal body mass index and socioeconomic position, influence cardiometabolic health in adulthood,” the researchers concluded.

“The implications of this work are that pubertal development and its timing should be considered, and potentially targeted, in efforts to improve cardiometabolic health.”

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