Association of Obesity and Overweight with Early Puberty in Boys: A Meta Analysis

To evaluate the associations between obesity, overweight, and central obesity and the risk of early puberty in boys. 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 (NOS). Statistical analyses were performed using R software (version 4.4.2), with odds ratios (ORs) and 95% confidence intervals (CIs) calculated. A total of 15,452 studies were initially identified, of which 6 high-quality studies (n=64,485) met the inclusion criteria after screening. The analysis revealed that obesity (defined by 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. This study demonstrates that obesity and overweight are significantly associated with an increased risk of early puberty in boys. Childhood obesity represents 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.