MON-243 - Association Between Increased BMI and Ethnicity with Onset of Early/Precocious Puberty in Male Children.

Introduction:
Over the last decade, the age of onset of puberty has been declining in both boys and girls globally, with a higher prevalence in girls. Few studies have been conducted in boys, the majority of which were done in China. Our research aims to investigate early puberty in boys in the US. The primary objective of this study is to assess increased BMI as a possible risk factor for the onset of early puberty in boys. The secondary objective is to evaluate if an ethnic predilection exists for boys who experience clinically significant early puberty.

Methods:
This is a retrospective, case-control study. Data collection was conducted through querying the outpatient Electronic Health Record (EHR) system. A matching group of controls was also selected from EHR for patients who were evaluated in clinic for issues not related to and not interfering with puberty.
For the purpose of this study, precocious puberty was defined as testicular enlargement ( Gonadarche) before the age of 9 years in boys, and breast enlargement (Thelarche) before the age of 8 years in girls. Early puberty was defined as testicular enlargement between 9-11 years in boys or breast development between 8-10 years in girls.

Pubertal timing in our study population was determined using a physician-assessed sexual maturity rating (SMR) system. The transition from testicular Tanner 1 stage (pre-pubertal) to Tanner 2 stage or more (pubertal) was used as the primary indicator of gonadarche in boys and thus the onset of puberty.

Results:
Statistical analysis was performed using IBM SPSS. A Chi-square test was conducted to determine whether a correlation exists between BMI percentile and Early Puberty and precocious Puberty. For ethnicity, a one-way ANOVA test was performed to assess predilection for developing early or precocious puberty.

The difference in BMI percentile across groups was not statistically significant (ANOVA P= 0.13). Ethnic distribution differed significantly across groups (Chi-square P< 0.001). Notably, Chinese ethnicity was overrepresented in the early puberty group (55.6%vs 22.7% vs 19.8% early puberty, precocious puberty and normal puberty respectively). Chinese boys had a significantly higher incidence of early puberty when compared to other ethnic groups. For precocious puberty, no significant difference among ethnic groups was observed.

Conclusion:
In this retrospective, case-control study, increased BMI was not found to have a statistically significant role in the onset of early puberty, However, boys of Chinese ethnicity were more likely to develop early puberty compared with other ethnic groups.
These findings may suggest that the process of precocious/early puberty is under the influence of many factors: genetic, environmental and other factors which need to be further investigated.

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