Racial differences in characteristics of girls presenting with precocious puberty

Background: A secular trend towards earlier pubertal onset as well as racial differences in pubertal timing have been documented in girls in the United States. Neither of these observations has been fully explained, and few studies have examined clinically early puberty and racial differences among precocious puberty patients. We assessed racial variations in the distribution of precocious puberty subtypes and in other characteristics of female patients. Methods: A medical chart review was conducted at a pediatric referral institution to abstract data for descriptive analysis from 50 black and 49 white female patients diagnosed with precocious puberty between 2006 and 2010. Charts were selected consecutively by medical record number from a billing list of recently evaluated patients. The primary outcome compared the distribution of precocious puberty diagnosis subtypes by race. Additional outcomes included age at evaluation, body mass index (BMI), estradiol levels, etiologies and comorbidities, and income level. Results: A borderline significant difference was seen in the distribution of precocious puberty subtypes by race (p=0.0506). Additionally, black patients appeared younger on average in each subtype. The proportion of central precocious puberty (CPP) patients with neurologic findings was considerably greater in whites (50% vs. 8%). Racial differences in estradiol levels varied across subtypes. Low income and BMI were significantly higher among black patients overall (p=0.02 and p<0.0001, respectively) and showed similar differences by subtype. Conclusions: Results suggest that black and white girls with precocious puberty may differ in their clinical presentation. Further study is needed to confirm these results.