title: Concordant and discordant sexual maturation among U.S. children in relation to body weight and BMI.
abstract: OBJECTIVE
  This study investigates the extent to which discordant Tanner stages for sexual maturity indicators are associated with weight and body mass index (BMI) and their variation during adolescence. Discordant children with large differences in weight and BMI may require additional monitoring of their growth during adolescence.
  
  
  METHODS
  Weight, BMI and Tanner stages, pubic hair in each gender, breast development in girls and genital development in boys, from 2103 boys and 2104 girls aged 8-18 years (average age 13.34 years) from the National Health and Nutrition Examination Survey III (NHANES III, 1988-1994) were analyzed. These cross-sectional data were grouped as concordant: assessed stages for paired indicators were equivalent, or as discordant: assessed stage for one paired indicator was greater or less than the other by one or more stages. Weight and BMI were compared separately by gender and race between concordant and discordant groups using analysis of covariance adjusted for age.
  
  
  RESULTS
  Approximately 65-69% of all children were concordant, genital stage equaled pubic hair stage for boys and breast stage equaled pubic hair stage for girls. For all three racial groups, boys whose genital stage was more advanced than their pubic hair stage had significantly smaller weight and BMI (p<.05) than either concordant boys or boys whose pubic hair stage was more advanced than their genital stage. For all three racial groups, girls whose breast stage was more advanced than their pubic hair stage had significantly greater weight and BMI than girls whose pubic hair stage was more advanced than breast stage. Non-Hispanic black and Mexican-American girls whose breast stage was more advanced than their pubic hair stage had significantly greater weight and BMI that the respective concordant girls.
  
  
  CONCLUSIONS
  Substantial and significant differences occur in weight and BMI among discordant and concordant children, and these differences are larger than between early and late maturing children.
authors.affiliation: Department of Community Health, School of Medicine, Wright State University, Dayton, Ohio, USA. christine.schubert@wright.edu
authors.forename: Christine M
authors.initials: CM
authors.lastname: Schubert
authors.forename: William Cameron
authors.initials: WC
authors.lastname: Chumlea
authors.forename: Howard E
authors.initials: HE
authors.lastname: Kulin
authors.forename: Peter A
authors.initials: PA
authors.lastname: Lee
authors.forename: John H
authors.initials: JH
authors.lastname: Himes
authors.forename: Shumei S
authors.initials: SS
authors.lastname: Sun
mesh_terms: D000293:Adolescent / Q000502:physiology; D017668:Age of Onset; D015992:Body Mass Index; D001835:Body Weight; D002648:Child; D005260:Female; D006801:Humans; D044469:Racial Groups; D012741:Sexual Maturation