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Journal of Pediatric Endocrinology and Metabolism

Editor-in-Chief: Kiess, Wieland

Ed. by Bereket, Abdullah / Darendeliler, Feyza / Dattani, Mehul / Gustafsson, Jan / Luo, Fei Hong / Toppari, Jorma / Turan, Serap Demircioglu


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2191-0251
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Volume 32, Issue 6

Issues

Self-rated Tanner stage and subjective measures of puberty are associated with longitudinal gonadal hormone changes

Ben W.R. BalzerORCID iD: https://orcid.org/0000-0001-7116-2339
  • Corresponding author
  • Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, Australia
  • University of Sydney, Discipline of Child and Adolescent Health, Westmead, Australia
  • University of New South Wales, School of Women’s and Children’s Health, Randwick, NSW, Australia
  • orcid.org/0000-0001-7116-2339
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Frances L. Garden
  • University of New South Wales, South-Western Sydney Clinical School, Liverpool, NSW, Australia
  • Ingham Institute of Applied Medical Research, Liverpool, NSW, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Mazen Amatoury
  • Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Georgina M. Luscombe / Karen Paxton / Catherine I. Hawke / David J. Handelsman / Katharine S. Steinbeck
  • Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, Australia
  • University of Sydney, Discipline of Child and Adolescent Health, Westmead, Australia
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2019-05-14 | DOI: https://doi.org/10.1515/jpem-2019-0017

Abstract

Introduction

In large community-based studies of puberty, Tanner staging by a clinician is often not possible. We compared self-rated Tanner staging and other subjective ratings of pubertal development with serum hormone levels measured by liquid chromatography-tandem mass spectrometry (LC-MS/MS) to reassess the utility of self-rated pubertal stage using highly sensitive and specific hormone analysis.

Methods

Adolescents and their parents enrolled in the Adolescent Rural Cohort study of Hormones and health, Education, environments and Relationships (ARCHER) answered annual survey questions on pubertal development. Annually, adolescents provided blood samples for serum testosterone and estradiol measured by LC-MS/MS.

Results

Longitudinally, self-rated Tanner stage was positively associated with serum testosterone and estradiol levels in both sexes. Confirmation by adolescent and parent that puberty had commenced was associated with higher gonadal hormone levels in both sexes. Parent and adolescent responses demonstrated ‘fair’ to ‘moderate’ agreement.

Conclusions

Over a 3-year follow-up, self-rated Tanner staging and simple questions regarding pubertal onset and development are positively associated with adolescent gonadal hormone concentrations in serum measured by mass spectrometry. Thus, self-report of puberty stage still has a role in large community-based studies where physical examination is not feasible.

Keywords: adolescent; gonadal hormones; puberty; Tanner stage

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About the article

Corresponding author: Ben W.R. Balzer, BMedSc, MBBS, Academic Department of Adolescent Medicine, The Children’s Hospital at Westmead, Westmead, NSW 2145, Australia; University of Sydney, Discipline of Child and Adolescent Health, Westmead, Australia; and University of New South Wales, School of Women’s and Children’s Health, Randwick, NSW, Australia, Phone: +61 2 9845 2507, Fax: +61 2 9845 2517


Received: 2019-01-10

Accepted: 2019-03-14

Published Online: 2019-05-14

Published in Print: 2019-06-26


Funding Source: Australian National Health and Medical Research Council

Award identifier / Grant number: #1003312

The ARCHER Study was supported by the Australian National Health and Medical Research Council (NHMRC), Funder Id: http://dx.doi.org/10.13039/501100000925, Project Grant #1003312, Rotary Health Research Foundation, Sydney Medical School Foundation and the Thyne Reid Foundation. The funding sources were not involved in the conduct of the study or the planning, writing or submission of this manuscript. No honoraria, grants or other forms of payment were given to anyone to produce this manuscript.


Author contributions: BWRB carried out the data analysis and wrote and revised the manuscript. FLG contributed to the data analysis and reviewed and revised the manuscript. MM and GML carried out the data analysis and reviewed and revised the manuscript. CH made substantial contributions to study conception and design and reviewed and revised the manuscript. KP was involved in study conception and design, coordinated and supervised data collection and reviewed and revised the manuscript. DJH was substantially involved in the study conception and design, designed and performed LC-MS/MS assays and reviewed the manuscript. KSS was substantially involved in the study conception and design and critically reviewed the manuscript. All authors approved the final manuscript as submitted. The investigators acknowledge the ARCHER participants and their families for contributing their time and effort, and the schools and communities of the Central West of NSW, Australia who were key to recruitment of this cohort and Janet Symons and Lisa Riley for day-to-day running of the study. Contributions from ARCHER study investigators not named in this paper are as follows. Substantial contributions to study conception, design protocols and questionnaire development were made by Philip Hazell (University of Sydney; mental health measures), Rachel Skinner (University of Sydney; sexual and reproductive risk taking measures), Rebecca Ivers (University of Sydney; injury risk taking behaviours), Robert Booy (University of Sydney; epidemiology and infectious diseases), Margot Rawsthorne (University of Sydney; parenting, social competency and social capital measures) and Andrew Martin (University of Sydney; educational learning and engagement measures). Robert Cumming (University of Sydney) contributed substantially to the study design, in particular expertise on power analysis and statistical analysis. Adrian Bauman (University of Sydney) contributed to sampling, cohort design and adolescent self-report measures. David L Bennett (University of Sydney) contributed to recruitment and community engagement protocols. Jean Starling (University of Sydney) contributed to community engagement, recruitment and mental health measures. Gregory Fulcher (University of Sydney) contributed to study design, in particular to the assessment of metabolic status. Geoffrey Morgan (University of Sydney) contributed to study design in relation to geocoding. Chin Moi Chow (University of Sydney) contributed to assessment of sleep measures. Mary Lam (University of Sydney) contributed to the development of online survey instruments. Ngiare Brown (University of Wollongong) provided expertise on engagement and recruitment of indigenous participants. Patrick Kelly (University of Sydney) provided statistical support and analysis.

Employment or leadership: None declared.

Honorarium: None declared.

Competing interests: The authors have no conflicts of interest to disclose.


Citation Information: Journal of Pediatric Endocrinology and Metabolism, Volume 32, Issue 6, Pages 569–576, ISSN (Online) 2191-0251, ISSN (Print) 0334-018X, DOI: https://doi.org/10.1515/jpem-2019-0017.

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