SYSTEMATIC REVIEW article
Front. Endocrinol.
Sec. Obesity
This article is part of the Research TopicLong-term Sequelae of Childhood ObesityView all 3 articles
The Relationship Between Childhood Obesity and Male Puberty Development: A Systematic Review and Meta-Analysis
Provisionally accepted
Wenhua Feng*
Chaonan Ren- Mianzhu People's Hospital, Mianzhu, China
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Objective: This meta-analysis aimed to investigate the risks and physiological development differences during puberty in overweight and obese boys. Methods: Following the PRISMA 2020 guidelines and AMSTAR criteria, we systematically searched PubMed, EMBASE, and Web of Science, with a cutoff date of July 2025. After applying strict inclusion and exclusion criteria and performing quality assessments, statistical analysis was conducted using STATA 17.0 and Review Manager (version 5.4). Results: A total of 12 prospective cohort studies meeting the inclusion and exclusion criteria were included in the analysis. The meta-analysis indicated that overweight boys had a significantly higher risk of early testicular enlargement compared to normal-weight boys (overweight RR 1.38, obese RR 1.43). Regional differences were observed, with significant variations in the association between overweight status and early testicular enlargement risk in the U.S. and Asia-Pacific regions. Overweight and obese boys older than 6 years had a stronger association with early testicular enlargement. Furthermore, overweight boys experienced an earlier onset of early testicular enlargement compared to normal-weight boys (MD -0.23, p=0.002), while no significant difference was observed in obese boys (MD -0.23, p=0.10). In terms of pubic hair development, overweight (RR 1.24, p<0.00001) and obese boys (RR 1.42, p<0.00001) were at a higher risk for early development, and overweight boys developed pubic hair earlier (MD -0.38, p=0.0008). No significant difference was found in peak height velocity between obese and normal-weight boys (MD -0.32, p=0.09). Conclusion: Overweight and obesity have notable effects on male puberty development, particularly with respect to early testicular enlargement and pubic hair development.
Keywords: boys, Childhood Obesity, Puberty development, testicular enlargement, pubic hair development, peak height velocity
Received: 23 Sep 2025; Accepted: 31 Oct 2025.
Copyright: © 2025 Feng and Ren. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenhua Feng, drfengwenhua@163.com
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