Early-life obesity as a risk factor for central precocious puberty - A commentary on "Incidence of central precocious puberty and the role of body mass index in Korea"

Sep 30, 2026

Editorial commentary examining how early childhood obesity may increase risk for central precocious puberty (CPP), using Korean epidemiologic findings that quantify rising CPP incidence and link higher obesity levels at ages 2–6 years to earlier pubertal onset. It contrasts consistent obesity–CPP associations in girls with mixed results in boys, then outlines plausible metabolic and hormonal pathways involving leptin, insulin, adipokines, and obesity-related inflammation that could activate the hypothalamic-pituitary-gonadal axis. The commentary emphasizes clinical relevance and the need for further mechanistic work.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages2

Reading Time5 min

AccessFree to download

Background and rising incidence

Evidence from Korea and international comparisons

Obesity–CPP association

Differences between girls and boys

Potential mechanisms

Metabolic and hormonal pathways

Conclusion

Editorial [https://doi.org/10.6065/apem.2525012edi06](https://doi.org/10.6065/apem.2525012edi06)[ ](https://doi.org/10.6065/apem.2525012edi06)[Ann Pediatr Endocrinol Metab 2025](Ann Pediatr Endocrinol Metab 2025);[30:285-286](30:285-286) Early-life obesity as a risk factor for central precocious puberty – A commentary on "Incidence of central precocious puberty and the role of body mass index in Korea" Hae Sang Lee Department of Pediatrics, Ajou University School of Medicine, Ajou University Hospital, Suwon, Korea See the article “Incidence of central precocious puberty and the role of body mass index in Korea” via [https://](https://)[ ](https://)[doi.org/10.6065/apem.2550024.012](doi.org/10.6065/apem.2550024.012) . Address for correspondence: Hae Sang Lee Department of Pediatrics, Ajou, University Hospital, Ajou University School of Medicine, 164 World cupro, Yeongtong-gu, Suwon 16499, Korea Email: [seaon98@ajou.ac.kr](seaon98@ajou.ac.kr) [https://orcid.org/0000-0002-9684-](https://orcid.org/0000-0002-9684-)[ ](https://orcid.org/0000-0002-9684-)4042 The rising incidence of central precocious puberty (CPP) has become a global clinical concern, and the Korean experience provides a particularly striking example of this accelerating trend [1,2]. The study by Chung [3] provides important epidemiologic evidence by quantifying national trends in CPP incidence and examining the relationship between early childhood obesity and pubertal onset in Korea. Compared with 2012, the incidence ofCPP increased substantially by 2020 in both sexes. Importantly, higher degrees of obesity between ages 2 and 6 years were significantly associated with an increased risk of CPP, with this association being more pronounced in boys than in girls [3]. Previous studies have consistently shown that the incidence ofCPP has increased over time in countries worldwide. In Korea, Kim et al. [4] reported a significant rise in CPP incidence among girls between 2004 and 2010 using national health insurance data, suggesting that earlier pubertal onset had already begun more than a decade ago. Subsequent Korean studies confirmed that this increase has continued in recent years, indicating a persistent upward trend rather than a temporary change [5]. Similar findings have been reported in other countries. In Denmark, Bräuner et al. [6] demonstrated a sixfold increase in CPP incidence in girls and afifteenfold increase in boys from 1998 to 2017, highlighting that the rise in CPP isnot confined to East Asian populations [6]. These rising incidences of CPP may be explained by the increased awareness of early pubertal development among parents and clinicians, as well as by the growing prevalence of childhood obesity, which may contribute to earlier activation of puberty. One of the most interesting findings of this study is that excess weight gain in early childhood was associated with a higher risk of CPP compared with normal weight. Children who were overweight or obese between 2 and 6 years of age showed a significantly increased risk of CPP, and this association was particularly strong in boys [3]. The link between obesity and CPP is well established in girls, and previous studies have consistently reported a higher prevalence of obesity among girls with CPP [7]. In contrast, findingsin boys have been inconsistent. Some studies have suggested that obesity is associated with earlier pubertal onset in boys, while others have reported delayed puberty in obese boys, possibly due to suppression of the hypothalamic pituitary gonadal axis [8]. These conflicting results highlight the complexity of the relationship between obesity and pubertal development in boys. Therefore, further studies are needed to better understand the mechanisms by which early life obesity influences pubertal timing in boys. Although the exact mechanisms by which obesity accelerates pubertal onset are not fully understood, several metabolic and hormonal pathways are thoug

FAQs

What does the commentary say about the trend of central precocious puberty incidence?

It describes a rising incidence of CPP as a global clinical concern, highlighting that Korea shows a particularly strong accelerating trend over time.

How is early-life obesity linked to central precocious puberty?

The commentary states that higher degrees of obesity between ages 2 and 6 years are significantly associated with increased CPP risk, with a stronger association in boys than in girls.

Which biological pathways are proposed to explain how obesity may accelerate pubertal onset?

It suggests multiple interacting mechanisms, including leptin-mediated activation of hypothalamic kisspeptin neurons, insulin resistance and hyperinsulinemia effects on gonadotropin secretion and sex steroid bioavailability, and modulation by other adipokines plus low-grade inflammation.

Sep 30, 2026

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