Psychoactive Substance Use and Associated Factors Among Adolescent Commercial Tricycle Riders in Tamale, Ghana: A Cross-Sectional Study.

Childhood obesity has become an increasingly serious global public health challenge. It is not merely a matter of being overweight, but a chronic disease characterised by the abnormal accumulation of adipose tissue (, ). The World Health Organization (WHO) defines it as “abnormal or excessive fat accumulation that may impair health” (). According to a WHO report, the global obesity rate among children and adolescents aged 5–19 years has increased from 2% to 8% since 1990 until 2022 (). Childhood obesity may persist into adulthood and is closely associated with increased risks of chronic noncommunicable diseases like cardiovascular disease, type 2 diabetes, cancer, as well as premature death (, ). It also triggers psychological issues such as low self-esteem and anxiety, placing a heavy long-term burden on individual health and healthcare systems. PP refers to the premature onset of puberty, characterized by early development of secondary sexual characteristics and physical maturation. As a pediatric endocrine disorder, it can be classified based on whether the hypothalamic-pituitary-gonadal (HPG) axis is activated, distinguishing central precocious puberty (CPP) from peripheral precocious puberty (PPP). Puberty onset before age 8 in girls and before age 9 in boys is typically defined as PP (). Notably, the incidence of PP exhibits significant gender and regional disparities (–), with girls showing a much higher prevalence than boys. Furthermore, the detection rate of childhood PP is relatively higher in areas with higher economic development and rapid urbanization. Alongside the rising prevalence of childhood obesity, the global incidence of childhood PP has also shown a marked increase, currently ranging from 0.1‰ to 0.2‰ and continuing to rise annually (). PP accelerates skeletal maturation and impairs final adult height; it can also lead to psychological problems such as low self-esteem, and increase the risk of developing chronic conditions in adulthood, including metabolic syndrome, cardiovascular disease, polycystic ovary syndrome and hormone-related cancers (, ). Epidemiological data indicate that childhood obesity and PP are highly co-occurring conditions and share similar health risks, and obesity is a major independent risk factor for PP (–). Similarly, PP can also act as an independent risk factor for childhood obesity (), suggesting a bidirectional association between the two. The combined effects of obesity and PP amplify lifelong health risks for children (, , ). This suggests a potential association between the two; existing research has explored this association from multiple perspectives, including endocrine regulation, molecular genetics, environmental exposure, and individual psychological and social factors. However, research is scattered across multiple disciplines, including paediatrics, endocrinology, epidemiology, nutrition and psychology, making it difficult for individual researchers to keep abreast of all developments comprehensively. At present, numerous bibliometric studies at home and abroad have systematically analyzed the research status, hotspots and evolutionary trends of childhood obesity alone, forming a well-established research system for this single disease (, ). Nevertheless, there is still a lack of systematic bibliometric research focusing specifically on the comorbidity of childhood obesity and precocious puberty. The overall knowledge framework, research hotspots and future development trends in this field remain unclear. Accordingly, it is essential to conduct comprehensive bibliometric and thematic analysis to fill this research gap.