Puberty Timing and Markers of Cardiovascular Structure and Function at 25 Years: A Prospective Cohort Study
Authors: Maher Gillian M. , Ryan Lisa , McCarthy Fergus P. , Hughes Alun , Park Chloe , Fraser Abigail , Howe Laura D. , Kearney Patricia M. , O’Keeffe Linda M. 
Published: November 2020

AbstractImportanceWhether earlier onset of puberty is associated with higher cardiovascular risk in early adulthood is not well understood.ObjectiveTo examine the association between puberty timing and markers of cardiovascular structure and function at age 25 years.DesignProspective birth cohort study.SettingThe Southwest region of England.ParticipantsParticipants in the Avon Longitudinal Study of Parents and Children (ALSPAC), born between April 1, 1991, and December 31, 1992.ExposureAge at peak height velocity (aPHV), an objective and validated growth-based measure of puberty onset.Main Outcomes and MeasuresCardiovascular structure and function at age 25 years: carotid intima-media thickness (CIMT), left ventricular mass index (LVMI) and relative wall thickness (RWT), pulse wave velocity (PWV) and systolic blood pressure (SBP). Multiple imputation was used to impute missing data on covariates and outcomes. Linear regression was used to examine the association between aPHV and each measure of cardiac structure and function, adjusting for maternal age, gestational age, household social class, maternal education, mother’s partner’s education, breastfeeding, parity, birthweight, maternal body mass index, maternal marital status, maternal prenatal smoking status, and height and fat mass at age 9. All analyses were stratified by sex.ResultsA total of 2752-4571 participants were included in the imputed analyses. A one-year older aPHV was not strongly associated with markers of cardiac structure and function in males and females at 25 years and most results spanned the null value. In adjusted analyses a one-year older aPHV was associated with 0.003mm (95% Confidence Interval (CI): 0.00001, 0.006) and 0.0008mm (95% CI: −0.002, 0.003) higher CIMT; 0.02m/s (95% CI: −0.05, 0.09) and 0.02m/s (95% CI: −0.04, 0.09) higher PWV; and 0.003mmHg (95% CI: −0.60, 0.60) and 0.13mmHg (95% CI: −0.44, 0.70) higher SBP, among males and females respectively. A one-year older aPHV was associated with −0.55g/m2.7 (95% CI: −0.03, −1.08) and −0.89g/m2.7 (95% CI: −0.45, −1.34) lower LVMI and −0.001 (95% CI: −0.006, 0.002) and −0.002 (95% CI: −0.006, 0.002) lower RWT among males and females.Conclusions and RelevanceEarlier puberty is unlikely to have a major impact on pre-clinical cardiovascular risk in early adulthood.Key PointsQuestionIs puberty timing associated with cardiovascular structure and function at age 25 years?FindingsAdjusted estimates from this prospective birth cohort study suggest no strong evidence of association between age at puberty (measured using age at peak height velocity) and carotid intima-media thickness (CIMT), left ventricular mass index (LVMI), and relative wall thickness (RWT), pulse wave velocity (PWV), and systolic blood pressure (SBP) at age 25 years among males and females, with results spanning the null in all but LVMI.MeaningEarlier puberty is unlikely to have a major impact on pre-clinical cardiovascular risk in early adulthood.