ISSN 1662-4009 (online)

ESPE Yearbook of Paediatric Endocrinology (2021) 18 7.5 | DOI: 10.1530/ey.18.7.5

ESPEYB18 7. Puberty Clinical Guidance (7 abstracts)

7.5. Trends in the Incidence of central precocious puberty and normal variant puberty among children in denmark, 1998 to 2017

Bräuner EV , Busch AS , Eckert-Lind C , Koch T , Hickey M & Juul A

JAMA Netw Open. 2020;3(10):e2015665. 10.1001/jamanetworkopen.2020.15665..

In brief: This Danish population-based 20-year cohort study provides strong epidemiological data supporting substantial increases in central precocious puberty (CPP) and normal early variants of puberty.

Comment: The secular trend towards younger onset of puberty has been reported in the general population for the last 30 years (1–3). However, because of scarce epidemiological data, the question remains whether there are also parallel secular trends in the incidence of CPP, premature thelarche (PT) and adrenarche (PA), which are normal puberty variants (4).

The authors searched the Danish National Patient Registry and included 8596 children registered between 1998 and 2017 with a diagnosis of CPP, PT or PA. Incidences were stratified according to immigration group: Danish origin, second-generation immigrants or first-generation immigrants. Substantial upwards trends in the annual incidence of CPP, PT and PA were documented in girls of Danish origin. CPP showed a 6-fold increase during the 20-year period, PT 33-fold and PA 18-fold. A similar but slightly weaker trend was reported in boys of Danish origin. The annual incidence of CPP and PA was substantially higher in girls of non-Danish origin.

This study is the first to report specific data regarding national incidence of CPP, PA and PT in Denmark. It demonstrates substantial increases, not only in normal variants of puberty (PA and PT) but also in CPP during the last 20 years. These findings raise the question of a need to change the international reference for normal ages at puberty.

Reference: 1. Parent AS et al. “The timing of normal puberty and the age limits of sexual precocity: variations arount the world, secular trends, and changes after migration”; Endocr Rev. 2003:24(5):668–6932. Aksglaede L et al. “Recent decline in age at breast development: the Copenhagen Puberty Study”; Pediatrics. 2009;125(5):932–9393. Sorensen K et al. “Recent changes in pubertal timing in healthy Danish boys: associations with body mass index”; J Clin Endocrinol Metab. 2010;95(1):263–2704. Carel JC et al. “Clinical practice – precocious puberty”; N Engl J Med. 2008; 358(22):2366–2377

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