Mediterranean diet and female reproductive health over lifespan: a systematic review and meta-analysis.

OBJECTIVE: We conducted a systematic review and meta-analysis of the effects of Mediterranean diet on female reproductive health outcomes over the life-course. DATA SOURCES: We searched PubMed, Embase, MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and ClinicalTrials.gov to identify eligible studies published till February 2022. Eligible references from identified studies and review articles were also considered. STUDY ELIGIBILITY CRITERIA: Randomized controlled trials, prospective cohort studies, or nested case-control studies examining Mediterranean diet and major female reproductive outcomes over the lifespan, including clinical outcomes from childhood to adulthood (menarche, polycystic ovary syndrome, endometriosis, and outcomes related to fertility, pregnancy, and menopause), were included for review. METHODS: Two independent reviewers screened and performed data extraction and risk-of-bias assessment. We performed random-effects meta-analysis to obtain summary relative risks and 95% confidence intervals for major female reproductive outcomes. Subgroup analyses were performed for several pregnancy outcomes according to timing of the interventions for randomized controlled trials and timing of the dietary assessment for observational studies. RESULTS: Thirty-two studies (9 randomized controlled trials, 22 prospective cohort studies, and 1 nested case-control study) involving 103,204 predominantly White women (>95%) were included. The pooled relative risk (95% confidence interval) comparing randomization to Mediterranean diet vs a control diet based on 7 randomized controlled trials was 0.74 (0.55-0.99) for gestational diabetes mellitus, 0.45 (0.26-0.76) for preterm birth, 0.71 (0.51-1.00) for gestational hypertension, and 0.82 (0.54-1.22) for preeclampsia; the effect sizes for preterm birth were greater in randomized controlled trials that initiated the interventions in first trimester vs after first trimester (P heterogeneity=.02). We observed inverse associations for all the above-mentioned pregnancy outcomes based on 9 cohort studies. There was suggestive evidence of favorable associations between Mediterranean diet adherence with fertility and gestational weight management. Limited studies suggested associations between higher Mediterranean diet adherence and later time to menarche and fewer vasomotor menopausal symptoms, null associations for polycystic ovary syndrome-like phenotype and pregnancy loss, and positive associations for luteal phase deficiency. CONCLUSION: Adherence to Mediterranean diet may lower risks of adverse pregnancy outcomes among predominantly White populations. For fertility-related outcomes, available evidence supporting potential beneficial effects is suggestive yet limited. For other reproductive outcomes across the lifespan, data remains sparse.

Secular trend and urban-rural disparity for age at spermarche among Chinese Han boys from 1995 to 2019.

AIM: To examine the secular trend and the urban-rural disparity of spermarche among Chinese Han boys from 1995 to 2019. METHODS: A total of 392 775 boys of Han ethnicity aged 11-18 years were extracted from the 1995, 2000, 2005, 2010, 2014 and 2019 Chinese National Surveys on Students' Constitution and Health. The median age at spermarche was estimated using the status quo data and probit analysis. The chi-square, ANOVA and LSD tests were used to compare the differences between the year-subgroups. U-test was used to compare the difference between urban and rural areas at each year. RESULTS: The median age at spermarche in Chinese Han boys decreased from 14.6 years in 1995 to 13.9 years in 2019 (p < 0.001). The rural boys showed a faster decreasing pace with a 1-year advance of age at spermarche while the urban boys had only a 0.5-year decrement, and there was still a statistically significant difference between urban-rural areas in 2019 (p < 0.001). Similar to urban-rural disparity, the age gap at spermarche between areas with different urbanisation rates became smaller over time. CONCLUSIONS: In general, spermarche in Chinese Han boys showed a decreasing trend, but the pace was slowing down. The urban-rural disparity in puberty development still existed but was gradually narrowing.

Anemia and associated factors among adolescent girls and boys at 10-14 years in rural western China.

BACKGROUND: Evidence on anemia and associated factors among young adolescent girls and boys in rural western China is limited. METHODS: We used data from a follow-up study of adolescents (10-14 years) born to women who participated in a randomized trial of antenatal micronutrient supplementation in western China. Anemia was defined by World Health Organization standards. Logistic regression was used to examine the factors associated with anemia. RESULTS: The overall prevalence of anemia was 11.7% (178/1517). Female adolescents were 1.73 (95% CI 1.21, 2.48) times more likely to have anemia as compared to males. Adolescents whose mothers had completed high school were 0.35 (95% CI 0.13, 0.93) times less likely to be anemic, compared to those of whom had < 3 years of formal education. Household wealth was also inversely associated with anemia. The association of puberty status with anemia was modified by adolescent sex (P-value for interaction was 0.04); males with greater than mild pubertal development had reduced odds (OR 0.35, 95% CI 0.15, 0.83) of anemia while there was no association among females (OR 0.72, 95% CI 0.29, 1.78). Consumption of flesh foods (OR 0.58, 95% CI 0.38, 0.89), eggs (OR 0.60, 95% CI 0.38, 0.93), and having a meal frequency of three times or more per day (OR 0.68, 95% CI 0.48, 0.96) were also associated with a lower likelihood of anemia. CONCLUSIONS: Anemia was a mild public health problem among young adolescents in rural western China. Nutritional and social determinants were identified as predictors, warranting interventions to reduce the risk of anemia among this critical age group.

Self-assessed puberty is reliable in a low-income setting in rural Pakistan.

Objectives Staging sexual maturation is an integral component of adolescent research. The Pubertal Development Scale (PDS) is commonly used as a puberty self-assessment tool because it avoids the use of images. Among the youth living in rural Pakistan, we determined the accuracy of self-reported pubertal assessments using a modified PDS compared to the 'gold standard' of physically assessed Tanner stages by a physician. Methods The strength of agreement between self-assessed puberty using a modified PDS and the 'gold' standard of physician-assessed Tanner stages was reported using weighted kappa (κ w) for girls (n = 723) of 9.0-14.9 years of age or boys (n = 662) of 10.0-15.9 years of age living in the rural District of Matiari. Results Agreement between the gold standard and self-assessment for puberty was substantial, with a κ w of 0.73 (95% confidence interval [CI]: 0.67; 0.79) for girls and a κ w of 0.61 (95% CI: 0.55; 0.66) for boys. Substantial agreement was observed for both boys and girls classified as thinness but only for girls with a normal body mass index. Those who were classified as severely thin had moderate agreement. The prevalence of overestimation was 18.5% (95% CI: 15.9-21.5) for girls and 2.7% (95% CI: 1.7-4.3) for boys, while the prevalence of underestimation estimation was 8.0% (95% CI: 6.2-10.2) for girls and 29.0% (95% CI: 25.8-32.6) for boys. Conclusions Most girls and boys assessed their pubertal development with substantial agreement with physician assessment. Girls were better able to assess their puberty, but they were more likely to overestimate. Agreement for boys was also substantial, but they were more likely to underestimate their pubertal development. In this rural Pakistan population, the PDS seems to be a promising tool for self-assessed puberty.

Nectin-like molecule 2, a necessary sexual maturation regulator, participates in congenital hypogonadotropic hypogonadism.

BACKGROUND: Congenital hypogonadotropic hypogonadism (CHH) is a rare genetically heterogeneous disorder. We aimed to determine the prevalence and pathogenesis of NECL2 (Nectin-like molecule 2) variants in a cohort of female patients with CHH. METHODS: We sequenced and determined the prevalence of NECL2 variants in 68 female patients with CHH and 243 healthy controls collected from an academic medical center. Further cellular and animal studies were performed to verify the pathogenicity of the mutations. Necl2 knockout female mice were generated, and their puberty development was observed. RESULTS: A novel NECL2 variant (c.1052_1060del, p.Thr351_Thr353del) was detected in 4 of 68 (5.9%) patients with CHH. Its prevalence was significantly higher in CHH patients than in healthy controls (0%). At the cellular level, the necl2 variant leads to a decrease in gonadotropin-releasing hormone. In animal models, we found that the Necl2 protein was expressed in the hypothalamus, especially in the ventromedial hypothalamic nucleus of mice. Necl2 knockout female mice showed delayed puberty and an irregular estrous cycle, consistent with CHH patient phenotypes. CONCLUSIONS: Our findings predict that NECL2 may be a new candidate gene for CHH and that the NECL2 protein plays a critical role in the progression of puberty development.

Turner syndrome with rapidly progressive puberty: a case report and literature review.

This report describes a clinically rare and atypical case of 46,X,idic(X)(q21.32)/45,X-type Turner syndrome with rapidly progressive puberty development. After 11 months of treatment with recombinant human growth hormone (rhGH), the child's height increased. After 18 months of treatment with rhGH, the child showed secondary sex characteristics. The child was followed up for 1 year after the appearance of the secondary sex characteristics, and regular menses were still present. This case indicates that modern molecular biology techniques should be used rationally to further investigate the existence of X-chromosome translocations and occult chimeras to prevent misdiagnosis.

The research advance on the effects of environmental endocrine disruptors on the adolescent girls / 中华内分泌代谢杂志

Endocrine-disrupting chemicals ( EDCs ) are widely found in people's daily supplies or environments. The individuals in the world contact with these substances through different pathways. Adolescent-developed individuals are more sensitive to these substances. The integration of many environmental factors through epigenetic modification affects the starting age of puberty. Although there are various related studies, it is impossible for humans to contact only a single substance, and there is still much doubt about the additive effect of EDCs mixtures with similar mechanisms of action. Therefore, analytical scientists, molecular biologists, toxicologists, epidemiologists, endocrinologists, gynecologists, obstetricians, and oncologists are required to conduct multidisciplinary research to address and to discuss all the scientific results. It may have far-reaching implications for formulating the prevention strategies and individualized health plans.

[Analysis on the current situation of insufficient sleep and its association with physical exercise among Chinese Han students aged 9-18 years, in 2014].

Objective: To describe the situation of insufficient sleep and the association between insufficient sleep and physical exercise, among Chinese Han students aged 9-18 years. Methods: We selected 172 197 Chinese Han students aged 9-18 years from the project 2014 Chinese National Survey on Students Constitution and Health. The average sleep duration per day of less than 9 h for children aged 9-12 years and of less than 8 h for adolescents aged 13-18 years, were defined as insufficient sleep. We described the distribution of sleep duration and the prevalence rates of insufficient sleep for each subgroup. Logistic regression models were established to assess the association between insufficient sleep and physical exercise. Results: In 2014, 6.6%, 30.8%, 26.3%, 20.8%, 13.8% and 1.8% of the Chinese Han students self-reported sleep duration were <6, 6-, 7-, 8- and ≥10 h, respectively. The overall prevalence rate of insufficient sleep was 77.2%, with 75.8% for boys and 78.6% for girls. No gender disparity was found at each 9-11 age groups. However, in the 12-18 age groups, the prevalence rates for girls were significantly higher than that for boys. The prevalence rates of insufficient sleep for primary school, middle school and high school students were66.6%, 74.1% and 93.8%, respectively. Rates were increasing with age for children aged 9-12 years and adolescents aged 13-18 years respectively. The three provinces with the lowest prevalence rates of insufficient sleep were Zhejiang (68.8%), Jiangsu (66.7%) and Shaanxi (65.2%). Data from the logistic regression models revealed that, when comparing to those students with only exercise of <0.5 h per day, the exercise hours of 0.5-1 h (OR=0.72, 95%CI: 0.69-0.74) or ≥1 h (OR=0.46, 95%CI: 0.44-0.47) per day seemed as protective factors for insufficient sleep. When compared with physical exercise frequency <2 times per week, the 2 times (OR=0.82, 95%CI: 0.78-0.86) or >2 times (OR=0.65, 95%CI: 0.62-0.68) frequencies also appeared as protective. Conclusions: The prevalence rate of insufficient sleep prevailing among students aged 9-18 years was high, in China. Our data called for setting up effective measures to deal with this situation.

Environmental lead exposure and pubertal trajectory classes in South African adolescent males and females.

The effects of environmental lead exposure in the neuro-endocrine system have been shown to impact the maturation and tempo of puberty development in adolescents. In low and middle income countries very little is known regarding the detrimental health effects of childhood lead exposure with regard to the tempo of puberty development. To help address this gap in data, we examined the association between lead exposure and puberty progression in males and females. Study participants from the urban Birth to Twenty Plus (BT20+) birth cohort in Soweto-Johannesburg, South Africa with data for blood lead levels at age 13years, cord blood lead levels, pubic hair development and breast development in females, and pubic hair development and genital development in males, were included in this study. The sample comprised 1416 study participants (n=684 females). Pubertal development trajectory classes were defined using Latent Class Growth Analysis. Data were examined for (i) an association between cord blood lead levels and pubertal trajectory classes; and (ii) an association between blood lead levels at age 13years and pubertal trajectory classes. In females, there was an association between adolescent elevated blood lead levels (≥5µg/dL) and lower level of maturation at age 9years and slower progression of pubic hair and breast development (relative risk ratio (RRR)=0.45, p<0.0001; 95% CI (0.29-0.68)) and (RRR=0.46, p<0.01; 95% CI (0.27-0.77)), respectively. In males, elevated blood lead levels at birth were associated with slower tempo of pubic hair development (RRR=0.20, p<0.05). Findings from this study suggest a possible role for environmental lead in altering pubertal development in South African adolescents as shown by slower tempo of progression through the Tanner stages pubertal development in females and males. There were also gender-differences between the effects of prenatal and postnatal lead exposure during pubertal development.

Analysis on the current situation of insufficient sleep and its association with physical exercise among Chinese Han students aged 9-18 years, in 2014 / 中华流行病学杂志

Objective To describe the situation of insufficient sleep and the association between insufficient sleep and physical exercise,among Chinese Han students aged 9-18 years.Methods We selected 172 197 Chinese Han students aged 9-18 years from the project 2014 Chinese National Survey on Students Constitution and Health.The average sleep duration per day of less than 9 h for children aged 9-12 years and of less than 8 h for adolescents aged 13-18 years,were defined as insufficient sleep.We described the distribution of sleep duration and the prevalence rates of insufficient sleep for each subgroup.Logistic regression models were established to assess the association between insufficient sleep and physical exercise.Results In 2014,6.6％,30.8％,26.3％,20.8％,13.8％ and 1.8％ of the Chinese Han students self-reported sleep duration were ＜6,6-,7-,8-and ≥ 10 h,respectively.The overall prevalence rate of insufficient sleep was 77.2％,with 75.8％ for boys and 78.6％ for girls.No gender disparity was found at each 9-11 age groups.However,in the 12-18 age groups,the prevalence rates for girls were significantly higher than that for boys.The prevalence rates of insufficient sleep for primary school,middle school and high school students were 66.6％,74.1％ and 93.8％,respectively.Rates were increasing with age for children aged 9-12 years and adolescents aged 13-18 years respectively.The three provinces with the lowest prevalence rates of insufficient sleep were Zhejiang (68.8％),Jiangsu (66.7％) and Shaanxi (65.2％).Data from the logistic regression models revealed that,when comparing to those students with only exercise of ＜0.5 h per day,the exercise hours of 0.5-1 h (OR=0.72,95％ CI:0.69-0.74) or ≥1 h (OR=0.46,95％ CI:0.44-0.47) per day seemed as protective factors for insufficient sleep.When compared with physicalexercise frequency ＜2 times per week,the 2 times (OR=0.82,95％CI:0.78-0.86) or ＞2 times (OR=0.65,95％CI:0.62-0.68) frequencies also appeared as protective.Conclusions The prevalence rate of insufficient sleep prevailing among students aged 9-18 years was high,in China.Our data called for setting up effective measures to deal with this situation.

Analysis on the current situation of insufficient sleep and its association with physical exercise among Chinese Han students aged 9-18 years, in 2014 / 中华流行病学杂志

Objective To describe the situation of insufficient sleep and the association between insufficient sleep and physical exercise,among Chinese Han students aged 9-18 years.Methods We selected 172 197 Chinese Han students aged 9-18 years from the project 2014 Chinese National Survey on Students Constitution and Health.The average sleep duration per day of less than 9 h for children aged 9-12 years and of less than 8 h for adolescents aged 13-18 years,were defined as insufficient sleep.We described the distribution of sleep duration and the prevalence rates of insufficient sleep for each subgroup.Logistic regression models were established to assess the association between insufficient sleep and physical exercise.Results In 2014,6.6％,30.8％,26.3％,20.8％,13.8％ and 1.8％ of the Chinese Han students self-reported sleep duration were ＜6,6-,7-,8-and ≥ 10 h,respectively.The overall prevalence rate of insufficient sleep was 77.2％,with 75.8％ for boys and 78.6％ for girls.No gender disparity was found at each 9-11 age groups.However,in the 12-18 age groups,the prevalence rates for girls were significantly higher than that for boys.The prevalence rates of insufficient sleep for primary school,middle school and high school students were 66.6％,74.1％ and 93.8％,respectively.Rates were increasing with age for children aged 9-12 years and adolescents aged 13-18 years respectively.The three provinces with the lowest prevalence rates of insufficient sleep were Zhejiang (68.8％),Jiangsu (66.7％) and Shaanxi (65.2％).Data from the logistic regression models revealed that,when comparing to those students with only exercise of ＜0.5 h per day,the exercise hours of 0.5-1 h (OR=0.72,95％ CI:0.69-0.74) or ≥1 h (OR=0.46,95％ CI:0.44-0.47) per day seemed as protective factors for insufficient sleep.When compared with physicalexercise frequency ＜2 times per week,the 2 times (OR=0.82,95％CI:0.78-0.86) or ＞2 times (OR=0.65,95％CI:0.62-0.68) frequencies also appeared as protective.Conclusions The prevalence rate of insufficient sleep prevailing among students aged 9-18 years was high,in China.Our data called for setting up effective measures to deal with this situation.

Secular trends in age at menarche among Chinese girls from 24 ethnic minorities, 1985 to 2010.

BACKGROUND: Declining age at menarche has been observed in many countries. In China, a decrease of 4.5 months per decade in the average age at menarche among the majority Han girls has recently been reported. However, the trends in age at menarche among ethnic minority girls over the past 25 years remain unknown. OBJECTIVES: To compare the differences in median age at menarche among girls aged 9-18 years across 24 ethnic minorities in 2010 and to estimate the trends in age at menarche in different ethnic minorities from 1985 to 2010. DESIGN: We used data from six cross-sectional Chinese National Surveys on Students' Constitution and Health (1985, 1991, 1995, 2000, 2005, and 2010). The median age at menarche was estimated by using probit analysis. RESULTS: In 2010, the ethnic minorities with the earliest age at menarche were the Koreans (11.79 years), Mongolians (12.44 years), and Zhuang (12.52 years). The three ethnic minorities with the latest age at menarche were the Sala (14.32 years), Yi (13.74 years), and Uighurs (13.67 years). From 1985 to 2010, the age at menarche declined in all 24 minority groups. The Lisu, Kazakh, and Korean minorities showed the largest reductions in age at menarche by 1.79 (p<0.05), 1.69 (p<0.05), and 1.57 (p<0.05) years, respectively, from 1985 to 2010. The Yi, Sala, and Li minorities showed the smallest reductions, with age at menarche declining by only 0.06 (p>0.05), 0.15 (p>0.05), and 0.15 (p>0.05) years, respectively, in the same period. CONCLUSION: A large variation in age at menarche was observed among different ethnic minorities, with the earliest age at menarche found among Korean girls. A reduction in the average age at menarche appeared among most of the ethnic minorities over time, and the largest decrease was observed in Lisu, Kazakh, and Korean girls. Thus, health education should focus on targeting the specific needs of each ethnic minority group.

The preventive effect of breast-feeding for longer than 6 months on early pubertal development among children aged 7-9 years in Korea.

OBJECTIVE: The present study was performed to investigate whether breast-feeding is associated with early pubertal development among children 7-9 years old in Korea. DESIGN: Children were divided into those who did and did not receive breast-feeding for 6 months or longer in accordance with the recommendations of the WHO. Pubertal status was determined by clinical examination using Tanner staging. SETTING: Prospective observational study. SUBJECTS: We conducted a follow-up study of children aged 7-9 years in 2011 who had taken part in the Ewha Birth & Growth Cohort study. RESULTS: Fifty (22.8%) of the total of 219 children were in early puberty, with the proportion being slightly higher for girls (24.1%) than boys (21.4%). Children who had entered early puberty were taller, weighed more and had a higher concentration of insulin-like growth factor 1. Moreover, the change in weight Z-score from birth to follow-up was significantly lower in children who were breast-fed than in those who were not (weight Z-score change: 0.32 (sd 1.59) v. 0.77 (sd 1.61), respectively, P=0.04). Comparison of breast-feeding by puberty status indicated a preventive association with early puberty in children who were breast-fed for 6 months or longer (OR=0.37; 95% CI 0.18, 0.74). This association remained significant after adjustment for relevant covariates. CONCLUSIONS: These results demonstrate a beneficial association between breast-feeding and early pubertal development, especially in those breast-fed for 6 months or longer. The study suggests that interventions would need to start early in life to prevent early pubertal development.

Subfoveal choroidal thickness in 1323 children aged 11 to 12 years and association with puberty: the Copenhagen Child Cohort 2000 Eye Study.

PURPOSE: To investigate subfoveal choroidal thickness and ocular- and systemic-associated factors in a population-based cohort of children. METHODS: Cross-sectional, observational study where 1323 healthy 11- and 12-year-old children were examined with enhanced-depth imaging spectral-domain optical coherence tomography (EDI-SD-OCT), ocular interferometric biometry, blood pressure manometry, and measurement of height, weight, nonmydriatic refraction, and best-corrected visual acuity. Self-reported stage of pubertal development was classified as Tanner stages 1 through 4. RESULTS: Mean subfoveal choroidal thickness was 369 ± 81 µm in girls and 348 ± 72 µm in boys. Longer axial length was associated with a thinner subfoveal choroid (-27.2 [95% confidence interval (CI) -32.7 to -21.7] µm/mm; P < 0.0001), adjusting for age and sex. There was no difference in choroidal thickness between sexes (P = 0.14) after adjusting for age and axial length. In girls, the choroid was thickest in participants in the more advanced stage of pubertal development (54.2 [95% CI 20.7-87.7] µm for Tanner 4 versus Tanner 1, P = 0.0015) and increased with body height (19.2 [95% CI 10.8-27.5] µm/10 cm, P < 0.0001). There was no effect of height or puberty in boys, who were less sexually mature than girls. CONCLUSIONS: Choroidal thickness in girls increased with body height and sexual maturation. The results suggest that puberty promotes choroidal thickening in girls, an effect that may be mediated by the pubertal growth spurt. The lack of pubertal effect in boys may be related to a smaller proportion of boys in this study having entered puberty.

Changes on secular growth among minority girls in China from 1985 to 2005 / 中华流行病学杂志

Objective To analyze the trend of secular growth among the minority girls in China from 1985 to 2005 in order to develop national and local intervention strategies and measures to improve their physical fitness and health.Methods A total of 19 Chinese minoritt girls,including Mongolian,Hui,Zhuang,Korean,Tibetan,Miao,Buyi,Dong,Yao,Bai,Tujia,Hani,Dai,Lisu,Wa,Nakhi,Tu,Qiang and Salar were sampled from the 1985 and 2005 Chinese national surveys to study the students' physical fitness and health.Probit analyses were used to calculate age at menarche (AAM),and the heights and weights of 17-years-old girls in various minority groups.Results From 1985 to 2005,the increments of adult heights and weights increased significantly in many minority groups.The average height of girls aged 17 years old in each minority group had an increase of 150 cm in 2005.Ethnic groups with height growth rates of more than 1 cm per decade in girls aged 17 years old were Korean ( 1.47 cm/decade),Tujia( 1.38 crn/decade),Qiang ( 1.32 cm/decade),Bai ( 1.25 cm/decade),Hui ( 1.13 cm/decade) and Buyi ( 1.07 cm/decade).And the mionority ethnics with weight growth rates of more than 1 kg per decade in girls aged 17 years old were Mongolian ( 1.79 kg/decade),Korean ( 1.69 kg/decade),Tibetan ( 1.66 kg/decade),Nakhi ( 1.39 kg/decade),Qiang ( 1.28 kg/decade) and Hui ( 1.10 kg/decade).The overall AAM showed a downward rate in all the 19 minority groups,but with different degrees.Tujia,Yao and Nakhi showed the largest reductions,with AAMs as 2.15,1.76 and 1.38 years earlier in 2005 than in 1985,respectively.Conclusion Our data suggested that the downward secular trend in AAMs and the increments of adult heights might reflect the secular growth change in the major minority groups during the past 20 years,but there was an obvious disequilibrium of puberty development and increments of heights in adults between the minority groups.

Follow-up Studies on the Effects of Serum Leptin on Puberty Development in Schoolboys / 中国医师杂志

Objective To explore the effect of serum leptin on puberty development in schoolboys.Methods 170 health schoolboys were investigated on the first spermatorrhea time and detected the levels of serum leptin, testosterone,follicle stimulating hormone (FSH), luteinizing hormone (LH). Case-controlled study was carried by multivariable logistic regression in puberty development of schoolchildren with and without spermatorrhea. Meanwhile, follow-up studies on the independent influencing factors on the puberty development were applied to this investigation in continuous two years.Results The levels of serum leptin, testosterone,FSH and LH of schoolboys with spermatorrhea were significantly higher than those of schoolboys without spermatorrhea. Multiple logistic regression analysis demonstrated that the serum leptin,testosterone, FSH, and bodyweight were the independent influence factors in puberty of the schoolboy.The levels of serum leptin,testosterone of pre-spermatorrhea schoolboys were significantly higher than schoolboys without spermatorrhea.Conclusions Serum leptin,testosterone, FSH, and bodyweight were the independent influence factors in puberty of the schoolboy.The levels of serum leptin and testosterone had obviously changed before spermatorrhea.