Xiou WANG, Yi SONG, Ziqin LIU
Journal of Clinical Research in Pediatric Endocrinology - 2026;18(1):58-65
Objective: To evaluate the published associations between obesity, overweight, and central obesity and the risk of early puberty in boys. Methods: A comprehensive systematic search was conducted in accordance with PRISMA guidelines using the Web of Science and PubMed databases up to December 31, 2024. Study quality was assessed using the Newcastle-Ottawa Scale. Statistical analyses were performed using R software (version 4.4.2), with odds ratios (ORs) and 95% confidence intervals (CIs) calculated. Results: A total of 15,452 studies were initially identified, of which six high-quality studies (n=64,485) met the inclusion criteria after screening. The analysis found that obesity [defined by body mass index (BMI)] was significantly associated with an increased risk of testicular enlargement (OR=1.27, 95% CI: 1.19-1.36). Overweight also increased the risk of testicular enlargement (OR=1.20, 95% CI: 1.11-1.29). Obesity was significantly associated with an increased risk of pubarche (OR=1.37, 95% CI: 1.23-1.53). Funnel plots and sensitivity analyses indicated no significant publication bias, and the results remained robust. Conclusion: This study demonstrated that obesity and overweight are reported to be associated with an increased risk of early puberty in boys. Childhood obesity appears to be an important determinant of earlier pubertal onset, though the relationship may follow a non-linear pattern at extreme BMI levels. The potential implications for adult reproductive health warrant further investigation.
