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The effect of obesity and concomitant insulin resistance on pubertal development is incompletely elucidated. To determine how measures of adiposity and insulin resistance are associated with pubertal maturation in boys and girls. Breast and pubic hair Tanner stage and testicular volume by orchidometry were determined by physical examination in children. Ovarian volume was estimated by trans-abdominal ultrasound. Fat mass, skeletal age, and fasting serum for insulin and glucose, total T, estradiol, estrone, dehydroepiandrosterone-sulfate, and androstenedione were measured at the National Institutes of Health Clinical Research Center. There was a positive association between obesity and measures of estrogen exposure breast development and skeletal age in both sexes. Positive correlations were seen for girls between BMI and pubic hair development and between insulin resistance and T production, whereas adiposity was negatively associated with pubic hair in boys. Significant sexual dimorphisms in the manifestations of pubertal development are seen in obese girls and boys.
