Understanding the regulation of puberty timing has relevance to developmental and human biology and to the pathogenesis of various diseases. Recent large-scale genome-wide association studies on puberty timing and adult height, body mass index (BMI) and central body shape provide evidence for shared biological mechanisms that regulate these traits. There is a substantial genetic overlap between age at menarche in women and BMI, with almost invariable directional consistency with the epidemiological associations between earlier menarche and higher BMI. By contrast, the genetic loci identified for age at menarche are largely distinct from those identified for central body shape, while alleles that confer earlier menarche can be associated with taller or shorter adult height. The findings of population-based studies on age at menarche show increasing relevance for other studies of rare monogenic disorders and enrich our understanding of the mechanisms that regulate the timing of puberty and reproductive function.

1.
Parent AS, et al: The timing of normal puberty and the age limits of sexual precocity: variations around the world, secular trends, and changes after migration. Endocr Rev 2003;24:668-693.
2.
Elks CE, et al: Age at menarche and type 2 diabetes risk: The EPIC-InterAct study. Diabetes Care 2013;36:3526-3534.
3.
Lakshman R, et al: Early age at menarche associated with cardiovascular disease and mortality. J Clin Endocrinol Metab 2009;94:4953-4960.
4.
Morris DH, Jones ME, Schoemaker MJ, Ashworth A, Swerdlow AJ: Secular trends in age at menarche in women in the UK born 1908-93: results from the Breakthrough Generations Study. Paediatr Perinat Epidemiol 2011;25:394-400.
5.
Hosokawa M, Imazeki S, Mizunuma H, Kubota T, Hayashi K: Secular trends in age at menarche and time to establish regular menstrual cycling in Japanese women born between 1930 and 1985. BMC Womens Health 2012;12:19.
6.
Cabanes A, et al: Decline in age at menarche among Spanish women born from 1925 to 1962. BMC Public Health 2009;9:449.
7.
Euling SY, et al: Examination of US puberty-timing data from 1940 to 1994 for secular trends: panel findings. Pediatrics 2008;121(suppl):S172-S191.
8.
Adanu RMK, et al: Secular trends in menarcheal age among Ghanaian women in Accra. J Obstet Gynaecol 2006;26:550-554.
9.
Silva HP, Padez C: Secular trends in age at menarche among Caboclo populations from Pará, Amazonia, Brazil: 1930-1980. Am J Hum Biol 2006;18:83-92.
10.
Sørensen K, Aksglaede L, Petersen JH, Juul A: Recent changes in pubertal timing in healthy Danish boys: associations with body mass index. J Clin Endocrinol Metab 2010;95:263-270.
11.
Kaplowitz P: Pubertal development in girls: secular trends. Curr Opin Obstet Gynecol 2006;18:487-491.
12.
Herbison AE: Genetics of puberty. Horm Res 2007;68(suppl 5):75-79.
13.
Valdes-Socin H, et al: Reproduction, smell, and neurodevelopmental disorders: genetic defects in different hypogonadotropic hypogonadal syndromes. Front Endocrinol (Lausanne) 2014;5:109.
14.
Layman LC, et al: Delayed puberty and hypogonadism caused by mutations in the follicle-stimulating hormone beta-subunit gene. N Engl J Med 1997;337:607-611.
15.
Aittomäki, K, et al: Mutation in the follicle-stimulating hormone receptor gene causes hereditary hypergonadotropic ovarian failure. Cell 1995;82:959-968.
16.
Tüttelmann F, et al: Combined effects of the variants FSHB -211G>T and FSHR 2039A>G on male reproductive parameters. J Clin Endocrinol Metab 2012;97:3639-3647.
17.
Weiss J, et al: Hypogonadism caused by a single amino acid substitution in the beta subunit of luteinizing hormone. N Engl J Med 1992;326:179-183.
18.
Teles MG, et al: A GPR54-activating mutation in a patient with central precocious puberty. N Engl J Med 2008;358:709-715.
19.
Silveira LG, et al: Mutations of the KISS1 gene in disorders of puberty. J Clin Endocrinol Metab 2010;95:2276-2280.
20.
Abreu AP, et al: Central precocious puberty caused by mutations in the imprinted gene MKRN3. N Engl J Med 2013;368:2467-2475.
21.
Schreiner F, Gohlke B, Hamm M, Korsch E, Woelfle J: MKRN3 mutations in familial central precocious puberty. Horm Res Paediatr 2014;82:122-126.
22.
Macedo DB, et al: Central precocious puberty that appears to be sporadic caused by paternally inherited mutations in the imprinted gene makorin ring finger 3. J Clin Endocrinol Metab 2014;99:E1097-E1103.
23.
Bernard G, et al: Mutations of POLR3A encoding a catalytic subunit of RNA polymerase Pol III cause a recessive hypomyelinating leukodystrophy. Am J Hum Genet 2011;89:415-423.
24.
Margolin DH, et al: Ataxia, dementia, and hypogonadotropism caused by disordered ubiquitination. N Engl J Med 2013;368:1992-2003.
25.
Shi Y, et al: Identification of CHIP as a novel causative gene for autosomal recessive cerebellar ataxia. PLoS One 2013;8:e81884.
26.
Shi C.-H, et al: Ataxia and hypogonadism caused by the loss of ubiquitin ligase activity of the U box protein CHIP. Hum Mol Genet 2014;23:1013-1024.
27.
Montague CT, et al: Congenital leptin deficiency is associated with severe early-onset obesity in humans. Nature 1997;387:903-908.
28.
Chehab FF: Early onset of reproductive function in normal female mice treated with leptin. Science 1997;275:88-90.
29.
Strobel A, Issad T, Camoin L, Ozata M, Strosberg AD: A leptin missense mutation associated with hypogonadism and morbid obesity. Nat Genet 1998;18:213-215.
30.
Clement KA: Mutation in the human leptin receptor gene causes obesity and pituitary dysfunction. Nature 1998;392:398-401.
31.
Farooqi IS, et al: Beneficial effects of leptin on obesity, T cell hyporesponsiveness, and neuroendocrine/metabolic dysfunction of human congenital leptin deficiency. J Clin Invest 2002;110:1093-1103.
32.
Cheung CC, et al: Leptin is a metabolic gate for the onset of puberty in the female rat. Endocrinology 1997;138:855-858.
33.
Farooqi IS, et al: Clinical and molecular genetic spectrum of congenital deficiency of the leptin receptor. N Engl J Med 2007;356:237-247.
34.
Weedon MN, et al: An in-frame deletion at the polymerase active site of POLD1 causes a multisystem disorder with lipodystrophy. Nat Genet 2013;45:947-950.
35.
Perry JRB, et al: Parent-of-origin-specific allelic associations among 106 genomic loci for age at menarche. Nature 2014;514:92-97.
36.
Locke AE, et al: Genetic studies of body mass index yield new insights for obesity biology. Nature 2015;518:197-206.
37.
Shungin D, et al: New genetic loci link adipose and insulin biology to body fat distribution. Nature 2015;518:187-196.
38.
Wood AR, et al: Defining the role of common variation in the genomic and biological architecture of adult human height. Nat Genet 2014;46:1173-1186.
39.
Cousminer DL, et al: Genome-wide association study of sexual maturation in males and females highlights a role for body mass and menarche loci in male puberty. Hum Mol Genet 2014;23:4452-4464.
40.
Kaprio J, et al: Common genetic influences on BMI and age at menarche. Hum Biol 1995;67:739-753.
41.
Speliotes EK, et al: Association analyses of 249,796 individuals reveal 18 new loci associated with body mass index. Nat Genet 2010;42:937-948.
42.
Randall JC, et al: Sex-stratified genome-wide association studies including 270,000 individuals show sexual dimorphism in genetic loci for anthropometric traits. PLoS Genet 2013;9:e1003500.
43.
Juul A, Magnusdottir S, Scheike T, Prytz S, Skakkebaek NE: Age at voice break in Danish boys: effects of pre-pubertal body mass index and secular trend. Int J Androl 2007;30:537-542.
44.
Lee JM, et al: Body mass index and timing of pubertal initiation in boys. Arch Pediatr Adolesc Med 2010;164:139-144.
45.
Elks CE, et al: Thirty new loci for age at menarche identified by a meta-analysis of genome-wide association studies. Nat Genet 2010;42:1077-1085.
46.
Horikoshi M, et al: New loci associated with birth weight identify genetic links between intrauterine growth and adult height and metabolism. Nat Genet 2013;45:76-82.
47.
D'Aloisio AA., DeRoo LA., Baird DD, Weinberg CR, Sandler, DP: Prenatal and infant exposures and age at menarche. Epidemiology 2013;24:277-284.
48.
Mueller NT, et al: Earlier menarche is associated with fatty liver and abdominal ectopic fat in midlife, independent of young adult BMI: the CARDIA study. Obesity (Silver Spring) 2015;23:468-474.
49.
Willemsen RH, Elleri D, Williams RM, Ong KK, Dunger DB: Pros and cons of GnRHa treatment for early puberty in girls. Nat Rev Endocrinol 2014;10:352-363.
50.
Onland-Moret NC, et al: Age at menarche in relation to adult height: the EPIC study. Am J Epidemiol 2005;162:623-632.
51.
Ong KK, et al: Timing of voice breaking in males associated with growth and weight gain across the life course. J Clin Endocrinol Metab 2012;97:2844-2852.
52.
Hoggart CJ, et al: Novel approach identifies SNPs in SLC2A10 and KCNK9 with evidence for parent-of-origin effect on body mass index. PLoS Genet 2014;10:e1004508.
53.
Peters J: The role of genomic imprinting in biology and disease: an expanding view. Nat Rev Genet 2014;15:517-530.
54.
Lomniczi A, et al: Epigenetic control of female puberty. Nat Neurosci 2013;16:281-289.
55.
Kurian JR, Terasawa E: Epigenetic control of gonadotropin releasing hormone neurons. Front Endocrinol (Lausanne) 2013;4:61.
56.
Kanherkar RR, Bhatia-Dey N, Csoka AB: Epigenetics across the human lifespan. Front Cell Dev Biol 2014;2:49.
57.
Jackson RS, et al: Obesity and impaired prohormone processing associated with mutations in the human prohormone convertase 1 gene. Nat Genet 1997;16:303-306.
58.
Tucker RP, et al: Teneurin-2 is expressed in tissues that regulate limb and somite pattern formation and is induced in vitro and in situ by FGF8. Dev Dyn 2001;220:27-39.
59.
Hoch RV, Soriano P: Context-specific requirements for Fgfr1 signaling through Frs2 and Frs3 during mouse development. Development 2006;133:663-673.
60.
Nagl F, et al: Retinoic acid-induced nNOS expression depends on a novel PI3K/Akt/DAX1 pathway in human TGW-nu-I neuroblastoma cells. Am J Physiol Cell Physiol 2009;297:C1146-C1156.
61.
Cho S, Cho H, Geum D, Kim K: Retinoic acid regulates gonadotropin-releasing hormone (GnRH) release and gene expression in the rat hypothalamic fragments and GT1-1 neuronal cells in vitro. Brain Res Mol Brain Res 1998;54:74-84.
62.
Perry JRB, et al: Meta-analysis of genome-wide association data identifies two loci influencing age at menarche. Nat Genet 2009;41:648-650.
63.
Ong KK, et al: Genetic variation in LIN28B is associated with the timing of puberty. Nat Genet 2009;41:729-733.
64.
He C, et al: A large-scale candidate gene association study of age at menarche and age at natural menopause. Hum Genet 2010;128:515-527.
65.
Shinoda G, et al: Fetal deficiency of lin28 programs life-long aberrations in growth and glucose metabolism. Stem Cells 2013;31:1563-1573.
66.
Tian J, Dang H, Nguyen AV, Chen Z, Kaufman DL: Combined therapy with GABA and proinsulin/alum acts synergistically to restore long-term normoglycemia by modulating T-cell autoimmunity and promoting β-cell replication in newly diabetic NOD mice. Diabetes 2014;63:3128-3134.
67.
Kumar S, Lombard DB: Mitochondrial sirtuins and their relationships with metabolic disease and cancer. Antioxid Redox Signal 2015;22:1060-1077.
68.
Charalambous M, et al: DLK1/PREF1 regulates nutrient metabolism and protects from steatosis. Proc Natl Acad Sci USA 2014;111:16088-16093.
69.
Migliano AB, Vinicius L, Lahr MM: Life history trade-offs explain the evolution of human pygmies. Proc Natl Acad Sci USA 2007;104:20216-20219.
70.
Fagny M, et al: Exploring the occurrence of classic selective sweeps in humans using whole-genome sequencing data sets. Mol Biol Evol 2014;31:1850-1868.
71.
Bartolomei MS, Ferguson-Smith AC: Mammalian genomic imprinting. Cold Spring Harb Perspect Biol 2011;3:a002592.
72.
Wilkins JF, Haig D: What good is genomic imprinting: the function of parent-specific gene expression. Nat Rev Genet 2003;4:359-368.
73.
Crespi B: The evolutionary biology of child health. Proc Biol Sci 2011;278:1441-1449.
74.
Lango Allen H, et al: Hundreds of variants clustered in genomic loci and biological pathways affect human height. Nature 2010;467:832-838.
75.
Scott RA, et al: Large-scale association analyses identify new loci influencing glycemic traits and provide insight into the underlying biological pathways. Nat Genet 2012;44:991-1005.
76.
Manning AK, et al: A genome-wide approach accounting for body mass index identifies genetic variants influencing fasting glycemic traits and insulin resistance. Nat Genet 2012;44:659-669.
77.
Morris AP, et al: Large-scale association analysis provides insights into the genetic architecture and pathophysiology of type 2 diabetes. Nat Genet 2012;44:981-990.
78.
Heid IM, et al: Meta-analysis identifies 13 new loci associated with waist-hip ratio and reveals sexual dimorphism in the genetic basis of fat distribution. Nat Genet 2010;42:949-960.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.