Comparing adolescent self staging of pubertal development with hormone biomarkers

Nana-Hawa Yayah Jones; Jane C. Khoury; Yingying Xu; Nicholas Newman; Heidi J. Kalkwarf; Joseph M. Braun; Bruce Lanphear; Aimin Chen; Kim M. Cecil; Susan R. Rose; Kimberly Yolton

doi:10.1515/jpem-2021-0366

Article

Comparing adolescent self staging of pubertal development with hormone biomarkers

Nana-Hawa Yayah Jones , Jane C. Khoury , Yingying Xu , Nicholas Newman , Heidi J. Kalkwarf , Joseph M. Braun , Bruce Lanphear , Aimin Chen , Kim M. Cecil , Susan R. Rose and Kimberly Yolton

Published/Copyright: August 24, 2021

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From the journal Journal of Pediatric Endocrinology and Metabolism Volume 34 Issue 12

Abstract

Objectives

Physical examinations to characterize pubertal maturation may be unacceptable for children enrolled in research studies. Studies confirm the utility of pubertal self staging for research, but there has been limited comparison of self examination with hormone biomarkers. Our objective was to assess concordance of pubertal self staging with hormone biomarkers of puberty.

Methods

Participants were enrolled in the Health Outcomes and Measures of the Environment Study, a longitudinal pregnancy and birth cohort study. At age 12 years, 139 females and 112 males completed pubertal self staging including breast and pubic hair development in females and pubic hair development in males. No clinical physical examination was performed. Hormone concentrations were measured in 102 females and 96 males including serum dehydroepiandrosterone sulfate, luteinizing hormone, and follicle-stimulating hormone in all; estradiol in females; and testosterone in males.

Results

Estradiol was significantly associated with female breast stage, even when adjusted for BMI, with geometric least squares means (95%CI) of 13.2 (8.7, 20.2), 38.3 (29.9, 49.1), 59.4 (39.8, 88.6), and 81.2 (45.6, 144) pg/mL for breast stage 1–2, 3, 4, and 5, respectively. Testosterone was significantly associated with male pubic hair stage, with adjusted geometric least squares means (95%CI) of 37.6 (19.9, 71.1), 43.4 (27.7, 68.3), 126 (78.4, 203), 275 (146, 521), and 559 (237, 1319) ng/dL for pubic hair stage 1, 2, 3, 4, and 5, respectively.

Conclusions

Self assessed pubertal development was positively associated with hormonal biomarkers of puberty.

Keywords: hormones; puberty; self-staging

Corresponding author: Kimberly Yolton, PhD, Cincinnati Children’s Hospital Medical Center, 3333 Burnet Avenue, MLC 7035 Cincinnati, OH 45229-3039, USA, Phone: +15136362815, E-mail: kimberly.yolton@cchmc.org

Susan R. Rose and Kimberly Yolton Dual senior authors contributed equally.

Funding source: National Institute of Environmental Health Sciences doi.org/10.13039/100000066

Funding source: Environmental Protection Agency

Award Identifier / Grant number: P01ES011261

Award Identifier / Grant number: R01ES025214

Award Identifier / Grant number: R01ES027224

Acknowledgments

We are grateful to our participants for the time they have given to our study. All who have contributed significantly to this work have been acknowledged.

Research funding: This work was supported by grants from the National Institute of Environmental Health Sciences and Environmental Protection Agency, P01ES011261, R01ES027224, R01ES025214.
Author contributions: All authors have accepted responsibility for the entire content of this manuscript and approved its submission.
Competing interests: Dr. Braun’s institution was financially compensated for his services as an expert witness for plaintiffs in litigation related to PFAS-contaminated drinking water; these funds were not paid to JMB directly. Dr. Braun received an honorarium for serving on an advisory board to Quest Diagnostics. All other authors declare no conflicts of interest.
Informed consent: Informed consent was obtained from all individuals included in this study.
Ethical approval: The local Institutional Review Board approved all study activities.

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Supplementary Material

The online version of this article offers supplementary material (https://doi.org/10.1515/jpem-2021-0366).

Received: 2021-05-25

Accepted: 2021-08-06

Published Online: 2021-08-24

Published in Print: 2021-12-20

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Articles in the same Issue

https://doi.org/10.1515/jpem-2021-0366

Keywords for this article

hormones; puberty; self-staging