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Blood lead concentration and delayed puberty in girls.
N Engl J Med. 2003 Apr 17; 348(16):1527-36.NEJM

Abstract

BACKGROUND

Environmental lead exposure has been linked to alterations in growth and endocrine function. It is not known whether such exposure affects pubertal development.

METHODS

We analyzed the relations between blood lead concentration and pubertal development among girls (defined as females 8 to 18 years of age) who were enrolled in a cross-sectional study (the third National Health and Nutrition Examination Survey) in which race was self-reported or proxy-reported: 600 were non-Hispanic white, 805 were non-Hispanic African-American, and 781 were Mexican-American girls. Puberty was measured on the basis of the age at menarche and Tanner stage for pubic-hair and breast development.

RESULTS

Geometric mean lead concentrations were less than 3 microg per deciliter (0.144 micromol per liter) in all three groups. As compared with concentrations of 1 microg per deciliter (0.048 micromol per liter), lead concentrations of 3 microg per deciliter were associated with decreased height (P<0.001), after adjustment for age, race, and other factors, but not with body-mass index or weight. Blood lead concentrations of 3 microg per deciliter were associated with significant delays in breast and pubic-hair development in African-American and Mexican-American girls. The delays were most marked among African-American girls; in this group, the delays in reaching Tanner stages 2, 3, 4, and 5 associated with a lead concentration of 3 microg per deciliter as compared with 1 microg per deciliter were 3.8, 5.3, 5.8, and 2.1 months, respectively, for breast development and 4.0, 5.5, 6.0, and 2.2 months, respectively, for pubic-hair development; the associated delay in age at menarche was 3.6 months. In white girls, there were nonsignificant delays in all pubertal measures in association with a lead concentration of 3 microg per deciliter.

CONCLUSIONS

These data suggest that environmental exposure to lead may delay growth and pubertal development in girls, although confirmation is warranted in prospective studies.

Authors+Show Affiliations

National Center for Environmental Assessment, Office of Research and Development, Environmental Protection Agency, Washington, DC 20460, USA. selevan.sherry@epa.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

12700372

Citation

Selevan, Sherry G., et al. "Blood Lead Concentration and Delayed Puberty in Girls." The New England Journal of Medicine, vol. 348, no. 16, 2003, pp. 1527-36.
Selevan SG, Rice DC, Hogan KA, et al. Blood lead concentration and delayed puberty in girls. N Engl J Med. 2003;348(16):1527-36.
Selevan, S. G., Rice, D. C., Hogan, K. A., Euling, S. Y., Pfahles-Hutchens, A., & Bethel, J. (2003). Blood lead concentration and delayed puberty in girls. The New England Journal of Medicine, 348(16), 1527-36.
Selevan SG, et al. Blood Lead Concentration and Delayed Puberty in Girls. N Engl J Med. 2003 Apr 17;348(16):1527-36. PubMed PMID: 12700372.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Blood lead concentration and delayed puberty in girls. AU - Selevan,Sherry G, AU - Rice,Deborah C, AU - Hogan,Karen A, AU - Euling,Susan Y, AU - Pfahles-Hutchens,Andrea, AU - Bethel,James, PY - 2003/4/18/pubmed PY - 2003/4/24/medline PY - 2003/4/18/entrez SP - 1527 EP - 36 JF - The New England journal of medicine JO - N Engl J Med VL - 348 IS - 16 N2 - BACKGROUND: Environmental lead exposure has been linked to alterations in growth and endocrine function. It is not known whether such exposure affects pubertal development. METHODS: We analyzed the relations between blood lead concentration and pubertal development among girls (defined as females 8 to 18 years of age) who were enrolled in a cross-sectional study (the third National Health and Nutrition Examination Survey) in which race was self-reported or proxy-reported: 600 were non-Hispanic white, 805 were non-Hispanic African-American, and 781 were Mexican-American girls. Puberty was measured on the basis of the age at menarche and Tanner stage for pubic-hair and breast development. RESULTS: Geometric mean lead concentrations were less than 3 microg per deciliter (0.144 micromol per liter) in all three groups. As compared with concentrations of 1 microg per deciliter (0.048 micromol per liter), lead concentrations of 3 microg per deciliter were associated with decreased height (P<0.001), after adjustment for age, race, and other factors, but not with body-mass index or weight. Blood lead concentrations of 3 microg per deciliter were associated with significant delays in breast and pubic-hair development in African-American and Mexican-American girls. The delays were most marked among African-American girls; in this group, the delays in reaching Tanner stages 2, 3, 4, and 5 associated with a lead concentration of 3 microg per deciliter as compared with 1 microg per deciliter were 3.8, 5.3, 5.8, and 2.1 months, respectively, for breast development and 4.0, 5.5, 6.0, and 2.2 months, respectively, for pubic-hair development; the associated delay in age at menarche was 3.6 months. In white girls, there were nonsignificant delays in all pubertal measures in association with a lead concentration of 3 microg per deciliter. CONCLUSIONS: These data suggest that environmental exposure to lead may delay growth and pubertal development in girls, although confirmation is warranted in prospective studies. SN - 1533-4406 UR - https://www.unboundmedicine.com/medline/citation/12700372/Blood_lead_concentration_and_delayed_puberty_in_girls_ L2 - https://www.nejm.org/doi/10.1056/NEJMoa020880?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -