{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:02:24Z","timestamp":1791316944389,"version":"4.3.1"},"reference-count":49,"publisher":"MDPI AG","issue":"6","license":[{"start":{"date-parts":[[2024,6,13]],"date-time":"2024-06-13T00:00:00Z","timestamp":1718236800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Limited knowledge is available about the association between autistic spectrum disorder (ASD) and precocious puberty. Our study examined the association between the two medical conditions and effect modification by sex and neuropsychiatric comorbidities in a nationwide population. To compare the risk of precocious puberty between ASD and non-ASD cases, we conducted a Cox regression analysis using ASD as the exposure and time to precocious puberty as the outcome. We adjusted for sex, attention-deficit\/hyperactivity disorder (ADHD), tic disorder, obsessive\u2013compulsive disorder (OCD), anxiety disorder, intellectual disability, and epilepsy. We performed a moderation analysis to examine the potential moderating effects of sex and comorbidities. Patients with ASD were prone to have precocious puberty, with an adjusted hazard ratio (aHR) of 1.80 (95% CI: 1.61\u20132.01). For effect modification, sex, specifically females, moderated the association between ASD and precocious puberty, with a relative excess risk due to interaction (RERI) of 7.35 (95% CI 4.90\u20139.80). No significant effect modification was found for any of the comorbidities within the scope of additive effect modification. We found that patients with ASD were prone to precocious puberty, regardless of sex or comorbid neuropsychiatric disorders. Girls with ASD are at a particularly higher risk of developing precocious puberty.<\/jats:p>","DOI":"10.3390\/jpm14060632","type":"journal-article","created":{"date-parts":[[2024,6,14]],"date-time":"2024-06-14T03:52:53Z","timestamp":1718337173000},"page":"632","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["The Association between Autism Spectrum Disorder and Precocious Puberty: Considering Effect Modification by Sex and Neuropsychiatric Comorbidities"],"prefix":"10.3390","volume":"14","author":[{"given":"Yi-Chun","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Psychiatry, Changhua Christian Children\u2019s Hospital, Changhua 500, Taiwan"},{"name":"Department of Psychiatry, Changhua Christian Hospital, Changhua 500, Taiwan"},{"name":"Department of Healthcare Administration, Asia University, Taichung 413, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3143-3672","authenticated-orcid":false,"given":"Yin-To","family":"Liao","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, China Medical University, Taichung 404, Taiwan"},{"name":"Department of Psychiatry, China Medical University Hospital, Taichung 404, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mei-Hong","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology, Sing Wish Hospital, Kaohsiung 813, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vincent Chin-Hung","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Medicine, Chang Gung University, Taoyuan 333, Taiwan"},{"name":"Department of Psychiatry, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2934-5814","authenticated-orcid":false,"given":"Yi-Lung","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Healthcare Administration, Asia University, Taichung 413, Taiwan"},{"name":"Department of Psychology, Asia University, Taichung 413, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1149417","DOI":"10.3389\/fendo.2023.1149417","article-title":"Precocious puberty under stressful conditions: New understanding and insights from the lessons learnt from international adoptions and the COVID-19 pandemic","volume":"14","author":"Street","year":"2023","journal-title":"Front. 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