Clinical and laboratory characteristics of children referred for early puberty: preponderance in 7-8 years of age

J Clin Res Pediatr Endocrinol. 2012 Dec;4(4):208-12. doi: 10.4274/jcrpe.736.


Objective: The aim of this study was to evaluate the girls referred to the pediatric outpatient clinic with a presumptive diagnosis of early puberty due to early onset of breast development or pubarche.

Methods: Within the study period, we evaluated 289 subjects referred for concerns about early onset of puberty. History, anthropometric data, bone age (BA), hormones including luteinizing hormone (LH), follicle-stimulating hormone (FSH), estradiol, and dehydroepiandrosterone sulfate, as well as pelvic ultrasonography (USG)-derived ovarian and uterine volumes were analyzed.

Results: Of the 289 girls referred for early onset of pubertal development, 64 (22.1%) had false alarms for puberty. Of the remaining 225 girls, 41 (18.2%) were diagnosed as premature pubarche, 56 (24.9%) as premature thelarche (PT), and 128 (56.9%) as precocious puberty (PP). Girls with early-onset puberty had more advanced BA, greater uterine and ovarian volumes, and also higher LH values than subjects with PP and PT. Nearly half of these girls were 7-8 years of age. Body mass index (BMI) standard deviation score was significantly higher in the PP cases.

Conclusions: There is a need for primary care physicians to be more knowledgeable on puberty and on puberty problems. There seems to be a preponderance of PP in 7-8-year-old children . Increased BMI may have a role in the trend towards earlier onset of puberty.

MeSH terms

  • Age Determination by Skeleton
  • Body Mass Index
  • Bone and Bones / pathology*
  • Child
  • Dehydroepiandrosterone Sulfate / blood
  • Estradiol / blood
  • Female
  • Follicle Stimulating Hormone, Human / blood
  • Follow-Up Studies
  • Hospitals, University
  • Humans
  • Luteinizing Hormone / blood
  • Obesity / complications
  • Obesity / physiopathology
  • Outpatient Clinics, Hospital
  • Ovary / diagnostic imaging
  • Ovary / pathology*
  • Puberty, Precocious / blood
  • Puberty, Precocious / epidemiology
  • Puberty, Precocious / pathology
  • Puberty, Precocious / physiopathology*
  • Severity of Illness Index
  • Turkey / epidemiology
  • Ultrasonography
  • Uterus / diagnostic imaging
  • Uterus / pathology*


  • Follicle Stimulating Hormone, Human
  • Estradiol
  • Dehydroepiandrosterone Sulfate
  • Luteinizing Hormone