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Abstract
The onset of puberty in adolescents and whether it is related to obesity is an ongoing
topic for debate. Epidemiological cross-sectional and longitudinal studies show a
shift towards earlier onset of puberty in girls who are obese; however, the situation
is less clear in boys. Boys who are overweight seem to mature earlier, and boys who
are obese mature later, than boys at a healthy weight. The underlying mechanisms are
not yet fully understood, and whether earlier onset of puberty in obese girls is based
on the activation of the hypothalamic-pituitary-gonadal axis is unclear. The most
promising link between obesity and puberty is the adipokine leptin and its interaction
with the kisspeptin system, which is an important regulator of puberty. However, peripheral
action of adipose tissue (eg, via other adipokines, aromatase activity) could also
be involved in changes to the onset of puberty. In addition, nutritional factors,
epigenetics, or endocrine disrupting chemicals are potential mediators linking the
onset of puberty to obesity. This Review summarises our knowledge concerning the relationship
between obesity and onset and tempo of puberty, and the consequences of early puberty
on obesity.