A new study has identified delayed puberty in adolescent males as a significant independent risk factor for developing early-onset type 2 diabetes, regardless of body weight or socioeconomic factors.
The research, presented at the first Joint Congress between the European Society of Paediatric Endocrinology (ESPE) and the European Society of Endocrinology (ESE), revealed that boys with delayed puberty were approximately 2.5 times more likely to develop type 2 diabetes (T2D) in early adulthood compared with their peers without delayed puberty.
Researchers examined medical records of 964,108 Israeli adolescent males aged 16 to 19 years who were recruited for military service between 1992 and 2015. Of these, 4,307 (0.45%) were diagnosed with delayed puberty by board-specified specialists based on physical examination and laboratory evaluation. After following the participants until December 31, 2019, investigators found that adolescent boys with delayed puberty had a 2.5-fold higher risk of developing T2D, and the association remained strong even after adjusting for potential confounding variables.
"To our knowledge, our large-scale study is the first to report an association between delayed puberty in adolescent boys and an increased risk of developing T2D," said lead author Orit Pinhas-Hamiel, MD, of Sheba Medical Center, Isreal.
The incidence rate of T2D per 105 person-years was 140.3 in the delayed puberty group versus 41.3 in adolescents without delayed puberty. This risk remained materially unchanged after adjustment for birth year, socioeconomic status, cognitive function, education level, and country of birth. Even after accounting for body weight, the risk for T2D was 37% higher in boys with delayed puberty.
The association was further strengthened when restricted to patients who were diagnosed at or before 35 years of age and persisted after controlling for baseline health status.
"Our results are surprising as delayed puberty is generally considered a benign condition," said Dr. Pinhas-Hamiel. "We think the higher risk of early T2D in boys with delayed puberty may be due to a window of opportunity during development when the body is especially sensitive to hormones and environmental factors—similar to how early childhood shapes language skills or how puberty affects bone strength."
This comprehensive nationwide cohort study represents a significant advancement in understanding metabolic risk factors because previous research had suggested contrasting results, noted Pinhas-Hamiel.
The study was conducted by researchers from multiple Israeli institutions, including Sheba Medical Center, Tel Aviv University, the Maccabi Healthcare Services, the Israel Defense Forces Medical Corps, the Gertner Institute for Epidemiology and Health Policy Research, and the Israel Center for Disease Control. Data on delayed puberty diagnoses were collected from the Israel Defense Forces Medical Corps, while diabetes data were retrieved from the Israeli National Diabetes Registry.
Source: ESPE-ESE Press Release