Applicability of a novel mathematical model for the prediction of adult height and age at menarche in girls with idiopathic central precocious puberty

OBJECTIVES: Unfavorable predicted adult height and psychosocial inadequacy represent parameters used to guide therapeutic intervention in girls with central precocious puberty. Gonadotropin-releasing hormone analog is the first-line treatment. The aim of this study was to compare two methods used to predict adult height and assess a validated tool for predicting the age at menarche in girls with central precocious puberty. METHODS: The predicted adult height of 48 girls with central precocious puberty was calculated at diagnosis using the Bayley-Pinneau method based on average and advanced bone age tables and compared with the predicted adult height calculated using a mathematical model. In addition, the age at spontaneous menarche was predicted using the new formulae. After Gonadotropin-releasing hormone analog treatment, the predicted adult height was calculated using only the Bayley-Pinneau tables. RESULTS: The achieved adult height was within the target height range in all treated girls with central precocious puberty. At diagnosis, the predicted adult height using the Bayley-Pinneau tables was lower than that using the mathematical model. After the Gonadotropin-releasing hormone analog treatment, the predicted adult height using the Bayley-Pinneau method with the average bone age tables was the closest to the achieved adult height. Using the formulae, the predicted age at spontaneous menarche was 10.1±0.5 yr. The Gonadotropin-releasing hormone analog treatment significantly postponed this event until 11.9±0.7 yr in these "idiopathic" central precocious puberty girls, highlighting the beneficial effect of this treatment. CONCLUSION: Both initial adult height prediction methods are limited and must be used with caution. The prediction of the age at spontaneous menarche represents an innovative tool that can help in clinical decisions regarding pubertal suppression.

Association of age at menarche with the risks of diabetes mellitus and metabolic syndrome in adulthood in Shanghai Jiading community postmenopausal women / 中华内分泌代谢杂志

Objective To investigate the association of age at menarche with the risks of diabetes and metabolic syndrome ( MS) in adulthood in Shanghai community postmenopausal women. Methods A total of 10375 residents over 40 years in Jiading, Shanghai were identified by a cluster sampling method. After taking standardized questionnaire surveys, physical examinations, and biochemical parameters testing, we gathered their lifestyle and medicine information. A total of 4723 postmenopausal women were enrolled in the study. The population was divided into three groups according to age at menarche, and their risks of MS and diabetes in various groups were compared. Results After multivariate adjustment, postmenopausal women with a menarche age<15 years had a 29％increased risk of diabetes(95％CI 1.03-1.61) and a 45％ increased risk of MS(95％ CI 1.20-1.76) in adulthood, compared with those with menarcheal age at 15-18 years. Among the five components of MS, earlier age of menarche was associated with higher risks of hypertriglyceridemia, low high density lipoprotein-cholesterol, and central obesity. Conclusions In Shanghai Jiading community postmenopausal women, age at menarche is associated with the risk of diabetes and MS, independent of the body mass index in adulthood.

Associations between season of birth and age both at menarche and at menopause / 中华流行病学杂志

Objective To examine the associations between season of birth and factors as age at menarche,age at menopause and reproductive span.Methods A total of 285 186 female from the China Kadoorie Biobank,with complete data on critical variables and had menarche at 9-18 years old,were included.A total of 132 373 female with natural menopause were included for the analysis on age at menopause and reproductive span.Multiple linear regression models were used to assess the associations of birth season and the age at menarche,menopause,and reproductive span.Subgroup analyses were performed on birth cohorts and urban/rural residence.Results Compared with the Spring-born (March,April,and May),participants who were born in Summer (June,July,and August),Autumn (September,October,and November),and Winter (December,January,and February)appeared late on both age at menarche and menopause.Multivariable-adjusted coefficients (95％ CI)appeared as 0.14 (95％CI:0.13-0.16),0.26(95％CI:0.24-0.27),0.10 (95％CI:0.08-0.12) for age at menarche respectively and 0.14 (95％CI:0.08-0.20),0.18 (95％CI:0.12-0.24),0.09 (95％CI:0.03-0.16) for age at menopause respectively.No statistically significant association was found between the season of birth and reproductive span.The association was consistent between urban and rural residents and across the birth cohorts.Conclusions female born in spring showed both earlier age on both menarche and menopause,compared to the ones born in other seasons.Our findings suggested that exposures in early life with some degree of seasonal variation might influence the development of female reproductive system.

Associations between season of birth and age both at menarche and at menopause / 中华流行病学杂志

Objective To examine the associations between season of birth and factors as age at menarche,age at menopause and reproductive span.Methods A total of 285 186 female from the China Kadoorie Biobank,with complete data on critical variables and had menarche at 9-18 years old,were included.A total of 132 373 female with natural menopause were included for the analysis on age at menopause and reproductive span.Multiple linear regression models were used to assess the associations of birth season and the age at menarche,menopause,and reproductive span.Subgroup analyses were performed on birth cohorts and urban/rural residence.Results Compared with the Spring-born (March,April,and May),participants who were born in Summer (June,July,and August),Autumn (September,October,and November),and Winter (December,January,and February)appeared late on both age at menarche and menopause.Multivariable-adjusted coefficients (95％ CI)appeared as 0.14 (95％CI:0.13-0.16),0.26(95％CI:0.24-0.27),0.10 (95％CI:0.08-0.12) for age at menarche respectively and 0.14 (95％CI:0.08-0.20),0.18 (95％CI:0.12-0.24),0.09 (95％CI:0.03-0.16) for age at menopause respectively.No statistically significant association was found between the season of birth and reproductive span.The association was consistent between urban and rural residents and across the birth cohorts.Conclusions female born in spring showed both earlier age on both menarche and menopause,compared to the ones born in other seasons.Our findings suggested that exposures in early life with some degree of seasonal variation might influence the development of female reproductive system.

Determinants of age at menarche in Korean elementary school girls / 한국영양학회지

PURPOSE: During the recent decades, the age at menarche continued to decline in Korea and worldwide. Prior studies have suggested that early menarche may increase the risk of various social, psychological, and physical health problems in young adolescent girls, but little is known about the determinants associated with early menarche. The purpose of this study is to evaluate independent determinants of early menarche among 5th~6th female graders in South Korea. METHODS: Our analysis was conducted in 95 menarcheal girls and 95 age-matched pre-menarcheal girls residing in Daegu, South Korea. Demographic and lifestyle characteristics were collected using survey questionnaires for children and parents. Dietary information was assessed by 2 day~24 hour food records and survey questionnaires, which were completed by both children and their parents. Anthropometric data were obtained from the student health check-ups at the school. RESULTS: A multiple logistic regression analysis using a conditional likelihood method was performed for simultaneous evaluation of several risk factors. There were significant differences in that higher proportion of obesity (OR, odds ratio = 5.60, 95% CI, confidence interval = 1.34~23.42), shorter sleep duration (OR = 0.45, 95% CI = 0.23~0.87), and younger mother's age at menarche (OR = 0.64, 95% CI = 0.44~0.93) were observed in the menarcheal group compared to the premenarcheal group. CONCLUSION: These findings indicate a possible association of sleep duration, mother's menarcheal age, and obesity with age at menarche. A well-planned, prospective cohort study is warranted to examine causal relationship.

GWAS for sarcopenia related phenotype-univariate analysis and bivariate analy-sis / 中国免疫学杂志

Objective:To identify potentially pleiotropic genes for lean body mass ( LBM ) and age at menarche ( AAM).Methods:The discovery sample consisted of 1 692 unrelated female subjects of European ancestry.The replication sample consisted of 801 unrelated female subjects of Han Chinese ancestry.A total of 909,622 single nucleotide polymorphisms (SNPs) were genotyped in both samples with the Affymetrix genome-wide genotyping array SNP 6.0.Bivariate genome-wide association analyses were then performed to the appendicular LBM and AAM.Results: Two SNP rs1860547 and rs11030746 identified by the bivariate GWAS were significant at the genome-wide significance (GWS) level;their P-values were <0.05 after replications.In the upstream of rs1860547, two genes KCNA1 and KCNA5 were found to be important for both LBM and AAM.In the downstream of rs11030746, one gene KCNA4 was found.Univariate GWAS also identified both SNPs to be significant at the GWS level; their P-values were <0.05 after replications.In the upstream of rs1860547 , two genes KCNA1 and KCNA5 are found to be important for LBM.In the downstream of rs11030746 , one gene KCNA4 was found.Conclusion:KCNA1, KCNA4 and KCNA5 are likely to be pleiotropic genes closely related to both LBM and AAM in European females.

The monthly rhythm of incidence and age at menarche: thirty five years of research: The circa-vacation-study expectancy rhythm of incidence and age at menarche

The hypothesis that the vacation-study-expectancy scholar regime produces most of the monthly rhythm of the age at menarche (AaM) was tested. Studies on monthly menarche incidence (MI) refuted climatic factors as a main factor in this rhythm, and indicated that the main factor of this rhythm is the succession of expectancies of study (Stu-months) or vacation (Vac-months) months within a year. Thus the hypothesis of seasonal circa-annual rhythm should be modified to the circa-[vacation (fiesta)]-[study (non-fiesta)]-expectancies rhythm for the MI and age at menarche annual rhythms. In several countries Vac-months had higher MI than Stu-months. The high MI of Vac-months was followed by a large decrease when girls started their studies and a MI increase occurred as vacations approached. The hypothesis proposes that at the end of vacations and at the beginning of the study period the AaM should be lowest, and then the mean of AaM should increase because of the menarche delay of girls whose menarche was arrested by the initiation of school work. This pattern was found in four independent samples, from Chile, Colombia, USA and Brazil. The probability that this result be due to random fluctuation of means is extraordinarily low (P<10-8). I conclude that the influence of the expectancy of vacation and study periods on the monthly rhythm of the age at menarche is a real process that accounts for most of this rhythm.

Teenage pregnancy in the Philippines: Trends, correlates and data sources / Journal of the ASEAN Federation of Endocrine Societies

@#Results from cumulative years of the National Demographic and Health Survey and the latest result of the 2011 Family Health Survey, shows that teenage pregnancy in the Philippines, measured as the proportion of women who have begun childbearing in their teen years, has been steadily rising over a 35-year period. These teenage mothers are predominantly poor, reside in rural areas and have low educational attainment. However, this paper observes a trend of increasing proportions of teenagers who are not poor, who have better education and are residents of urban areas, who have begun childbearing in their teens. Among the factors that could help explain this trend are the younger age at menarche, premarital sexual activity at a young age, the rise in cohabiting unions in this age group and the possible decrease in the stigma of out-of-wedlock pregnancy.

Original research paper age at menarche and affecting bio-social factors among the girls of Lucknow, Uttar Pradesh.

The age at which first menstrual bleeding occurs in female, i.e menarche is viewed as an excellent physiological marker of adolescent maturation. The aim of this study is to determine the mean age at menarche among adolescent girls and to assess the influence of some Bio-social parameters affecting it.This study was conducted among 150 adolescent girls in the age group of 10 to 19 years, randomly selected from urban & rural government schools of Lucknow. 75 girls from each school were selected from November 2009 to March 2010. This was a cross sectional descriptive study. Girls were studied about their socioeconomic status, weight, height, place of residence. Out of 150 cases studied 108 cases were having menstruation, most frequent age of menarche being 13 years when 32 cases (29.63%) had its onset. The lowest age was 8 years and highest was 15 year. Mean age at menarche was found to be 12.43 ± 1.49. There seems to be definite association of various factors which modify the age at menarche like socio-economic status, body mass index, place of residence.

CONSTRUCTION OF DELAYED MENARCHE EVALUATION IN KOREAN FEMALE ATHLETES / 体力科学

In the present study we conducted a regression analysis of age at menarche against Maximum Peak Velocity (MPV) of height in non-athlete Korean girls which was derived with the wavelet interpolation method, and composed linear to quartic regression polynomials to obtain the best regression polynomial. We then applied the age at menarche and age at MPV of height of athletes to the best polynomial regression evaluation, and investigated the validity of a delayed menarche evaluation that we constructed. Moreover, the relation between delayed menarche and menstrual status was examined by investigating delayed menarche and menstrual pain in individuals for the first time. The subjects were 124 second year female students at a physical education high school in the suburbs of Pusan, South Korea. A questionnaire survey of these girls was conducted, from which their date of birth, age at menarche, and athletic activities in elementary, junior high, and high school were obtained. In addition, health check records were examined retrospectively, and longitudinal growth data for height were obtained from the 1st year of elementary school (7 years old) until the second year of high school (17 years old). Next, the same survey as above was also done for second year students at a general high school in the same area, as a control group. Three hundred forty-five non-athletes for whom all data were available were selected. As the results, the third order polynomial was found to be most suitable for the regression polynomial. When it was applied to individual female Korean athletes with respect to the regression evaluation, positive scores were obtained for many athletes and an overall delay in menarche was seen. Delayed menarche was not seen, however, in archery athletes. A strong delay in menarche was thus found in Korean athletes. And it was shown that 80% had moderate or greater menstrual pain and a close relation with menstrual abnormalities, the effectiveness of the delayed menarche evaluation was further validated.

Age of menarche in girls of Uttarakhand.

Menarche is a physiological and developmental phenomenon significant in the life of a female. It occurs between the ages of 10 to 16 years. Study suggests that menarche tends to appear earlier in life as the social, nutritional and economic condition of society improves. There is paucity of information about menarchial age in hilly regions of Uttarakhand. Therefore, this research was undertaken to determine age of menarche and its variation with geographical, seasonal and nutritional status. This study was carried out through a questionnaire in 450 girl students between age 17-26 years at Uttarakhand Forest Hospital Trust, Medical College, Haldwani, India. The mean age of onset of menarche was 13.6 (+ 1.1) years. The monthly occurrence of menarche had peaks in May-June. The mean menarchial age of girls belonging to plain area was 13.18+ 1.31 years, which showed significantly earlier onset as compared to girls from hilly area (14.21 + 1.46 years). In hilly areas girls having vegetarian diet had significantly higher age of menarche (14.60 + 1.33 years), compared to girls having non-vegetarian diet (14.09 + 1.56 years). Therefore altitude, season and nutritional status have bearing on the mean menarchial age in girls of Uttarakhand.

Age of Onset, Nutritional Determinants, and Seasonal Variations in Menarche in Rural Bangladesh.

Menarche is an important milestone in the development of female adolescents. The study assessed the age at menarche using recall, its seasonality, and association with marital and nutritional status (using midupper arm circumference [MUAC]) among 3,923 female adolescents aged 12-19 years in a rural area of Bangladesh. At the time of assessment, most (88%) adolescents had attained menarche at the mean (standard deviation [SD]) age of 12.8 (1.4) years. Age of onset of menarche among married adolescents (13%) occurred earlier than in those who were unmarried (12.6±1.3 years vs 12.9±1.4 years, p<0.01). Age at menarche was negatively associated with MUAC after adjusting for age and marital status (β=-0.10, p<0.01). More than 50% of the adolescents had an onset of menarche during winter (χ2=634.97; p<0.001), with peaks in December and January. In this rural population, the current age at menarche was found to be slightly lower than the previous estimates of 13.0 years in Bangladesh. An early onset of menarche was associated with season and better nutritional status of the female adolescents and may be associated with early marriage.

Reproductive Factors Related to Serum Estrogen, Progesterone, and Sex Hormone Binding Globulin in Postmenopausal Women in Korea / 한국역학회지

The etiology of breast cancer is not yet clear. Several epidemiologic studies have supported the concepts that endogenous female sex hormones, i.e., estrogen and progesterone, may play a central role in the development of breast cancer. Female reproductive factors such as menstruation, pregnancy, and breast feeding are well-known risk factors of breast cancer. There have been many suggestions that all these factors are midiated by female sex hormeones. However, only a few studies have evaluated the relationship between the reproductive factors and endogenous female sex hormones. This study was designed to evaluate the relationship between the reproductive factors and endogenous female sex hormones in Korean women. We analyzed the relationship between reproductive factors and female sex hormones in 153 premenopausal women 153 postmenopausal women who participated in a community health promotion program in Haman County, Korea. The questionnaires about reproductive factors were completed by personal interview. Serum level of total estradiol(E2), progesterone(:g), and sex hormone binding globulin(SHBG) were measured by radioimmunoassay. There was no significant correlation between age at menarche and E2 in both premenopausal and postmenopausal groups. In postmenopausal subjects, E2 level increased significantly with the age at menopause increasing(r=0.25, p=0.009), adjusting for the potential confounding effect of both age and body mass index. There was a positive correlation between E2 and the intervals between age at menarche and age at menopause(r=0.25, p=0.009). Moreover, the serum level of SHBG was significantly correlated with total months of breast feeding(r=0.19, p=0.048), as well as with age at first fullterm pregnancy(r=-0.24, p=0.01). However, Pg was correlated with none of reproductive factors in both groups. This study observed that female reproductive factors, e.g., age at menopause, breast feeding, age at first fullterm pregnancy, were correlated with serum female hormones, particularly E2 and SHBG. The results provide an evidence that the relationship between the reproductive factors and breast cancer risk may be mediated, at least in part, through serum female hormones, especially estradiol in Korean women.