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- Title
Pubertal Timing Across Asian American, Native Hawaiian, and Pacific Islander Subgroups.
- Authors
Kubo, Ai; Acker, Julia; Aghaee, Sara; Kushi, Lawrence H.; Quesenberry Jr, Charles P.; Greenspan, Louise C.; Srinivasan, Shylaja; Kanaya, Alka M.; Deardorff, Julianna
- Abstract
This cohort study investigates whether there are differences in pubertal timing among Asian American, Native Hawaiian, and Pacific Islander individuals after disaggregating by ethnic subgroups. Key Points: Question: Does pubertal timing vary among Asian American, Native Hawaiian, and Pacific Islander youths when disaggregated by ethnic subgroups? Findings: In this cohort study of 107 325 US children and adolescents, substantial variations in pubertal timing across Asian American, Native Hawaiian, and Pacific Islander ethnic subgroups were identified. Asian Indian, Native Hawaiian and Pacific Islander, and Other South Asian youths typically had earlier ages at pubertal onset, while Chinese and Korean youths exhibited later onset. Meaning: These findings may provide insight into disparities in chronic diseases, such as type 2 diabetes and cardiovascular diseases, later in life. Importance: Earlier puberty is associated with adverse health outcomes, such as mental health issues in adolescence and cardiometabolic diseases in adulthood. Despite rapid growth of the Asian American, Native Hawaiian, and Pacific Islander populations in the US, limited research exists on their pubertal timing, potentially masking health disparities. Objective: To examine pubertal timing among Asian American, Native Hawaiian, and Pacific Islander children and adolescents by disaggregating ethnic subgroups. Design, Setting, and Participants: This retrospective cohort study included Asian American, Native Hawaiian, and Pacific Islander youths aged 5 to 18 years assessed for pubertal development at Kaiser Permanente Northern California, a large, integrated health care delivery system. Follow-up occurred from March 2005, through December 31, 2019. Data were analyzed in October 2023. Exposure: Race and ethnicity, categorized into 11 ethnic subgroups: Asian Indian, Chinese, Filipino, Japanese, Korean, Native Hawaiian and Pacific Islander, Other South Asian, Other Southeast Asian, Vietnamese, multiethnic, and multiracial. Main Outcomes and Measures: Pubertal timing was determined using physician-assessed sexual maturity ratings (SMRs). Outcomes included the median age at transition from SMR 1 (prepubertal) to SMR 2 or higher (pubertal) for onset of genital development (gonadarche) in boys, breast development (thelarche) in girls, and pubic hair development (pubarche) in both boys and girls. Results: In this cohort of 107 325 Asian American, Native Hawaiian, and Pacific Islander children and adolescents (54.61% boys; 12.96% Asian Indian, 22.24% Chinese, 26.46% Filipino, 1.80% Japanese, 1.66% Korean, 1.96% Native Hawaiian and Pacific Islander, 0.86% Other South Asian, 3.26% Other Southeast Asian, 5.99% Vietnamese, 0.74% multiethnic, and 22.05% multiracial), the overall median ages for girls' pubarche and thelarche were 10.98 years (95% CI, 10.96-11.01 years) and 10.13 years (95% CI, 10.11-10.15 years), respectively. For boys' pubarche and gonadarche, median ages were 12.08 years (95% CI, 12.06-12.10 years) and 11.54 years (95% CI, 11.52-11.56 years), respectively. Differences between subgroups with earliest and latest median age at onset were 14 months for girls' pubarche, 8 months for thelarche, 8 months for boys' pubarche, and 4 months for gonadarche. In general, Asian Indian, Native Hawaiian and Pacific Islander, and Other South Asian subgroups had the earliest ages at onset across pubertal markers, while East Asian youths exhibited the latest onset. Restricting to those with healthy body mass index did not substantially change the findings. Conclusions and Relevance: In this cohort study of Asian American, Native Hawaiian, and Pacific Islander children and adolescents, pubertal timing varied considerably across ethnic subgroups. Further investigation is warranted to assess whether these differences contribute to observed health disparities in adulthood, such as type 2 diabetes and cardiovascular diseases.
- Subjects
CALIFORNIA; HAWAIIANS; ADOLESCENCE; ADOLESCENT development; PUBERTY; ASIAN Americans; KOREAN Americans; BODY mass index; RESEARCH funding; PACIFIC Islanders; RETROSPECTIVE studies; CHINESE Americans; SOUTH Asian Americans; VIETNAMESE Americans; DESCRIPTIVE statistics; RACE; LONGITUDINAL method; JAPANESE Americans; MEDICAL records; ACQUISITION of data; INDIANS (Asians); CONFIDENCE intervals; DATA analysis software; FILIPINO Americans
- Publication
JAMA Network Open, 2024, Vol 7, Issue 5, pe2410253
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2024.10253