PMC9641365_01
Prevalence of testicle, breast, and pubic hair development according to pubertal stages at different ages in girls (A) and boys (B). Ph, pubic hair; T, testicle; B, breast.
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The prevalence of sexual development >=B2/PH2 in girls and T2/PH2 in boys at different ages was depicted in  Figure 1 .
Prevalence of Tanner stages >=II in different obesity categories in girls (A, B) and boys (C, D). In Figure A, C, normal refers to children with normal body mass index.
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As shown in  Figure 2 , general obesity and central obesity had an obvious influence on sexual development in both genders at different ages.
PMC9641365_02
Relationship between precocious puberty and physical growth. In Figures (A, B), the blue line refers to girls with Tanner stages>=II at 6-year-old, and the red line refers to girls with Tanner stages>=II at 7-year-old. In Figures (C, D), the red line refers to boys with Tanner stages>=II at 7-year-old, and the green line refers to boys with Tanner stages>=II at 8-year-old.
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Figure 3A , the mean height of girls with Tanner stages>=II at 6-year-old and 7-year-old was 125.01 +- 9.71 cm and 131.46 +- 5.69 cm, which was equivalent to the 50th centile of a normal 7.9-year-old and 8.9-year-old girl, respectively ( Figure 3A ). For boys with Tanner stages >=II at 7-year-old and 8-year-old, the mean height was 133.93 +- 9.71 cm and 141.15 +- 7.07 cm, which was correspondent to the 50th centile of a normal 9.3-year-old and 10.6-year-old boy, respectively ( Figure 3C ). Tanner stages >=II at 6-year-old and 7-year-old, the mean BMI was 16.56 +- 4.11 kg/m2 and 17.71 +- 2.93 kg/m2, which was equivalent to the 50th centile of a normal 9.9-year-old and 11.9-year-old girl, respectively ( Figure 3B ). Tanner stages >=II at 7-year-old and 8-year-old was 19.04 +- 3.13 kg/m2 and 20.05 +- 4.29 kg/m2, which was correspondent to the 50th centile of a normal 14-year-old and 15.3-year-old boy, respectively ( Figure 3D ). Taken together, it appears that physical growth, especially BMI must be kept above a certain threshold level to initiate puberty development. The threshold was much higher in boys than in girls, which was in accordance with the above observations (higher prevalence of obesity and lower rate of precocious puberty in boys).