Kaiser Permanente study – the first to analyze adolescent onset by Asian ethnicity – may help explain health disparities among Asian adults
The onset of adolescence in Asian youth can vary by up to 14 months depending on ethnic subgroup, according to a new study from Kaiser Permanente. These early-life changes may help explain differences in chronic health conditions among Asian adults.
Ai Kubo, MPH, PhD
“The population that most researchers typically refer to as ‘Asian’ comes from many different places and has different cultures and traditions that can impact health from childhood to adulthood.” said Ai Kubo, MPH, PhD, researcher at Keizer University and lead author. Permanente Research Department. “This is the first study conducted to analyze the onset of puberty by Asian ethnic subgroups, and our findings demonstrate why this study is needed.”
The study, published May 13 in JAMA Network Open, surveyed 107,325 Asian American, Native Hawaiian, and Pacific Islander boys and girls who are members of Kaiser Permanente Northern California. This study investigated the timing of puberty. Based on self-reported information, youth were identified as Asian Indian, Chinese, Filipino, Japanese, Korean, Native Hawaiian and Pacific Islander, Vietnamese, Other South Asian, and Other Southeast Asian9. They were classified into two ethnic subgroups.
Each child was assessed for adolescent development during a routine primary care appointment. The researchers looked at the age of puberty (the first growth of pubic hair) and the penis (early development of the breasts) in girls, and the age of puberty and gonads (growth of the testicles) in boys. The research team also measured each child’s BMI before the onset of puberty.
For girls, the median age at puberty was 10.98 years. However, there were clear variations. The onset of early spring was earliest among other South Asian groups, with a median age of 10.30 years, whereas the median age of early spring for Korean girls was 11.49 years, a 14-month difference. Similarly, the median age for all Teraash was 10.13 years, but the timing ranged from a median of 9.80 years for Native Hawaiian and Pacific Islander girls to 10.47 years for Korean girls, a difference of 8 months. .
Dr. Louise C. Greenspan
The median age at onset of spring for boys was 12.08 years. But there were also distinct variations. Native Hawaiian and Pacific Islander boys had the earliest spring onset, with a median age of 11.72 years, while Chinese boys had the earliest spring onset, with a median age of 12.37 years, a difference of 8 months. . Gonadal variation was less variable, with a median age of 11.54 years, ranging from 11.31 years for Native Hawaiian and Pacific Islander boys to 11.66 years for Chinese boys, a difference of 4 months. .
“The differences between ethnic subgroups are a new finding,” said study co-author Louise C. Greenspan, MD, a pediatric endocrinologist at Permanente Medical Group. “Future analysis will be needed to confirm whether this reflects environmental exposures and lifestyle factors, or whether it is due to a more genetic cause.”
Puberty begins early
Around the world, girls are starting to reach puberty earlier than ever before. For girls, early puberty puts them at higher risk for behavioral and emotional problems in adolescence and for cancer, type 2 diabetes, and cardiovascular disease in adulthood. For boys, evidence suggests that earlier puberty is associated with behavioral problems in adolescence and an increased risk of cardiovascular disease, diabetes, and prostate and testicular cancer in adulthood. There are several.
This is the first study conducted to analyze the onset of puberty by Asian ethnic subgroups, and our findings demonstrate why this study is needed.
— Dr. Ai Kubo
Previous studies examining the timing of puberty have found an association between weight, BMI, and the onset of puberty, with heavier children more likely to start puberty earlier. To see if that was driving the study results, the researchers conducted a secondary analysis that included only young people with a healthy body mass index. The analysis found that variation in the timing of puberty onset remained significantly different among Asian subgroups.
“These findings suggest that lifestyle factors such as diet, physical activity, genetics, metabolic and social factors contribute to disparities in the timing of puberty,” Kubo said. Ta. “While body mass index certainly plays a role, it is not the only reason why we see disparities between races or within ethnic subgroups.”
race and ethnicity
Dr. Juliana Dierdorf
Researchers have typically looked at race and ethnicity broadly, dividing study populations into white, black, Asian, and Latino categories. Racial and ethnic disparities in health care utilization and health outcomes have led to debates about how best to integrate and analyze race and ethnicity in health research. Recently, there has been increased awareness of health disparities that may be overlooked when studies do not separate Asians into Asian ethnic subgroups.
“Asian youth are often ignored or not included in adolescent research,” said lead author Dr. Juliana Dierdorf, an adjunct research scientist and professor at the University of California, Berkeley. “Studies that include Asians are rarely large enough and are not representative of the diversity of Asian subgroups in the United States. Our findings demonstrate that adolescent development in Asian boys and girls is This is an important first step to understanding.”
Kubo added: “We did not expect to see differences in pubertal timing of up to more than a year. This study suggests that focusing only on the overall median may miss ethnic subgroups at higher or lower risk. Our findings also show that ethnic subgroup differences in the timing of puberty are associated with increased risk of type 2 diabetes in adolescence, gestational diabetes, type 2 diabetes, and cardiovascular disease. , suggesting the need for additional research to investigate whether this corresponds to the observed differences in cancer incidence in Asian adult ethnic groups.
This research was funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.
Co-authors include Sara Aghaee, MPH, Lawrence H. Kushi, ScD, and Charles P. Quesenberry, Jr, PhD, in the Department of Research. Julia Acker, M.A., University of California, Berkeley; Shylaja Srinivasan, MD, and Alka M. Kanaya, MD, of the University of California, San Francisco;
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About Kaiser Permanente Research Department
Kaiser Permanente’s Research Division conducts, publishes, and disseminates epidemiology and health services research to improve the health and health care of Kaiser Permanente members and society as a whole. We aim to understand the determinants of disease and health and improve the quality and cost-effectiveness of healthcare. Currently, DOR’s more than 600 staff members are working on more than 450 epidemiology and health services research projects. For more information, visit divisionofresearch.kaiserpermanente.org or follow @KPDOR.
