Breast buds
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2009 23:492–504.ĭe Ridder CM, Bruning PF, Zonderland ML, Thijssen JH, Bonfrer JM, Blankenstein MA, et al. Timing of maturation and predictors of menarche in girls enrolled in a contemporary British cohort. Rubin C, Maisonet M, Kieszak S, Monteilh C, Holmes A, Flanders D, et al. Percent body fat at age 5 predicts earlier pubertal development among girls at age 9. Weight status in young girls and the onset of puberty.
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Lee JM, Appugliese D, Kaciroti N, Corwyn RF, Bradley RH, Lumeng JC. Pubertal assessment method and baseline characteristics in a mixed longitudinal study of girls. 2014 370:403–11.īiro FM, Galvez MP, Greenspan LC, Succop PA, Vangeepuram N, Pinney SM, et al. Incidence of childhood obesity in the United States. Recent secular trends in pubertal timing: implications for evaluation and diagnosis of precocious puberty. Sorensen K, Mouritsen A, Aksglaede L, Hagen CP, Mogensen SS, Juul A. Association between obesity and puberty timing: a systematic review and meta-analysis. Li W, Liu Q, Deng X, Chen Y, Liu S, Story M.
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These studies do not support the hypothesis that estrogen derived from total body fat or local (mammary) fat contributes to breast development in OB girls. Tanner breast stage did not correlate with breast morphological stage and led to misclassification of chest fatty tissue as breast tissue in some OB. When controlling for breast morphological stage determined by ultrasound, %BF was not associated with serum estrogen or gonadotropin (LH and FSH) levels or with indices of systemic estrogen action (uterine volume, endometrial thickness, BA advancement, and VMI). MethodsĮighty premenarchal girls (26 OB, 54 NW), aged 8.2–14.7 years, underwent dual-energy x-ray absorptiometry to calculate percent body fat (%BF), Tanner staging of the breast, breast ultrasound for morphological staging, trans-abdominal pelvic ultrasound, hand x-ray (bone age, BA), a blood test for reproductive hormones, and urine collection to determine the vaginal maturation index (VMI), an index of estrogen exposure in urogenital epithelial cells. This hypothesis would predict that breast development would be more advanced than other estrogen-sensitive tissues as a function of obesity and body fat. We hypothesized that estrogen synthesized locally, in mammary fat, may contribute to breast development. It has been proposed that estrogen synthesized by adipose tissue may be contributory, yet OB do not have higher serum estrogen levels than NW matched on breast stage. Girls who are overweight/obese (OB) develop breast tissue but do not undergo menarche (the first menstrual period) significantly earlier than girls of normal weight (NW).