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1.
Rev. bras. ginecol. obstet ; 43(10): 789-792, Oct. 2021. graf
Article in English | LILACS | ID: biblio-1357057

ABSTRACT

Abstract Introduction Abnormal uterine bleeding is more frequent in adolescence. Although, most commonly, it has a non-structural etiology, it may be due to any cause described. Clinical case A 12-year-old adolescent, with no relevant personal history, menarche 1 month before, was observed in the emergency department for severemenstrual bleeding with progressive worsening, and hemodynamic repercussion in need of transfusion support. Physiological ovulatory dysfunction associated with possible previously unknown coagulopathy was considered to be the most likely diagnosis and medical treatment was initiated. Without response, the patient was submitted to sedated observation and uterine aspiration, which ultimately led to the diagnosis of a Burkitt Lymphoma. Discussion Although structural causes, and particularly malignancy, whether gynecological or not, are a rare cause of abnormal uterine bleeding in this age group, they must be considered, thus enhancing the fastest and most appropriate treatment.


Resumo Introdução A hemorragia uterina anormal é mais frequente na adolescência. Apesar de maioritariamente de etiologia não estrutural, pode dever-se a qualquer causa descrita. Caso clínico Adolescente de 12 anos, sem antecedentes pessoais relevantes, com menarca há 1 mês, observada no serviço de urgência por hemorragia menstrual grave com agravamento progressivo e repercussão hemodinâmica com necessidade de suporte transfusional. Foi colocada a hipótese de disfunção ovulatória fisiológica associada a eventual coagulopatia desconhecida previamente e foi instituído tratamento médico. Por ausência de resposta a tratamento médico, foi submetida a observação sob sedação e aspiração uterina que evidenciou tratar-se de um Linfoma de Burkitt. Discussão Apesar de as causas estruturais, e particularmente as neoplasias, do foro ginecológico ou não, serem uma causa rara de hemorragia uterina anormal nesta faixa etária, elas devem ser levadas em consideração potenciando assim um tratamento mais célere e adequado.


Subject(s)
Humans , Female , Child , Adolescent , Uterine Hemorrhage , Gynecology , Menarche
2.
Rev. bras. ginecol. obstet ; 43(5): 357-361, May 2021. tab
Article in English | LILACS | ID: biblio-1288562

ABSTRACT

Abstract Objective To study a sample of rheumatoid arthritis (RA) patients for their gynecological/obstetric history and compare them to controls to determine their influences on number of pregnancies, menarche, menopause and reproductive years following RA onset. Methods This is a cross-sectional study of 122 RA patients and 126 controls. Patients and controls were questioned about age of menarche, age of menopause, number of pregnancies and abortions. Reproductive years were calculated as the difference between age at menopause and age at menarche. For comparison, we used the Mann-Whitney, unpaired t, chi-squared, and Spearman tests. The adopted significance was 5%. Results In the RA patients with disease beginning in the postmenopausal years, the period of reproductive years (age at menopause - age of menarche) showed a positive correlation with age at disease onset (rho=0.46; 95% confidence interval [CI]=0.20- 0.55 with p=0.0008). The number of pregnancies was higher in patients with postmenopausal disease onset when compared with those with premenopausal disease onset (median of 3 with interquartile range [IQR]=2-4 versus median of 2 with IQR=1-3; p=0.009), and RA patients had more pregnancies than controls (p=0.0002). Conclusion The present study shows that, in our population, the duration of reproductive years and the number of pregnancies are linked to the onset of RA.


Resumo Objetivo Estudar uma amostra de pacientes com artrite reumatoide (AR), com investigação da história ginecológica e obstétrica, comparando-a com controles, visando conhecer suas influências no número de gestações, menarcas, menopausa e anos reprodutivos no início da AR. Métodos Trata-se de um estudo transversal de 122 pacientes com AR e 126 controles. Pacientes e controles foram questionados sobre idade da menarca, idade da menopausa, número de gestações e abortos. Os anos reprodutivos foram calculados com a diferença entre a idade da menopausa e a idade da menarca. Para comparação, foram utilizados Mann Whitney, Teste t não pareados, Teste qui-quadrado e teste de Spearman. A significância adotada foi de 5%. Resultados Nas pacientes comAR e início da doença na pós-menopausa, o período de anos reprodutivos (idade da menopausa - idade da menarca) apresentou correlação positiva com a idade de início da doença (rho=0,46; intervalo de confiança de 95% [IC95%]=0,20-0,55 com p=0,0008). O número de gestações foi maior nas pacientes cominício da doença no período pós-menopausa quando comparadas às pacientes em pré-menopausa (mediana de 3 comintervalo interquartil [IIQ]=2-4 versusmediana de 2 com IIQ=1-3; p=0,009). Nas pacientes com AR, foi observado ummaior número de gestações do que no grupo controle (p=0,0002). Conclusão O presente estudo mostra que, em nossa população, a diminuição dos anos reprodutivos e o alto número de gestações estão relacionados ao surgimento da AR.


Subject(s)
Humans , Female , Adult , Arthritis, Rheumatoid/etiology , Parity , Arthritis, Rheumatoid/immunology , Arthritis, Rheumatoid/epidemiology , Brazil , Menarche , Menopause , Cross-Sectional Studies , Risk Factors , Age Factors , Postmenopause , Age of Onset , Middle Aged
3.
Arch. endocrinol. metab. (Online) ; 65(5): 632-639, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345198

ABSTRACT

ABSTRACT Objective: Patients with cystic fibrosis (CF) have a high incidence of pubertal and growth delay. In girls with CF, pubertal delay has an important psychological impact. Still, only a few studies have explored the occurrence of pubertal delay in girls with CF. The aims of this study were to compare the pubertal development of girls with CF compared with healthy controls regarding Tanner staging and pelvic ultrasound and, in girls with CF, correlate the findings with those of spirometry, body mass index, Shwachman-Kulczycki score (SKS), and genotyping. Subjects and methods: This was a cross-sectional, case-control study including 35 girls with CF aged 6-17 years and following up at the Pediatric Pulmonology Outpatient Clinic of a tertiary hospital. These patients were compared with 59 healthy controls who had undergone pelvic ultrasound as part of another study conducted by the same group. Girls with CF were consecutively enrolled in the study during their annual routine check-up visit. Data collected in the CF group included spirometry and anthropometric results, SKS values, bone age, occurrence of current cystic fibrosis-related diabetes (CFRD) and Pseudomonas aeruginosa colonization, history of meconium ileus, genotype, ultrasound parameters, and Tanner stage. Results: Pelvic ultrasound findings and Tanner stage reflected less pubertal development in girls with CF compared with healthy controls. Pubertal stage in patients with CF who presented CFRD (3.17 ± 1.16), had chronic colonization by Pseudomonas aeruginosa (3.10 ± 1.10), or were homozygous for the F508del mutation (1.91 ± 1.30) was more delayed than in controls (3.41 ± 1.41). Tanner stage correlated with age at menarche, bone age, and anthropometric and ultrasound data. Conclusions: Girls with CF presented a delay in pubertal development evaluated by Tanner stage and ultrasound parameters, which was more evident in the presence of comorbidities.


Subject(s)
Humans , Female , Cystic Fibrosis/diagnostic imaging , Menarche , Case-Control Studies , Cross-Sectional Studies , Ultrasonography , Puberty
4.
Rev. cuba. med. gen. integr ; 36(2): e1147, abr.-jun. 2020.
Article in Spanish | LILACS, CUMED | ID: biblio-1138965

ABSTRACT

RESUMEN Introducción: El cáncer de mama es el tumor maligno más frecuente entre las mujeres de todo el mundo. Considerando los dos sexos, es el segundo en frecuencia después del cáncer de pulmón. En Cuba, sigue siendo la neoplasia maligna que más se diagnóstica en mujeres. Se estima que una de cada 9 a 12 mujeres con factores de riesgo padecerá la enfermedad a lo largo de su vida en los países del mundo occidental. Objetivo: Profundizar acerca de los factores de riesgo asociados al cáncer de mama. Métodos: Se realizó una revisión bibliográfica temática, observacional y retrospectiva de 25 artículos en el período comprendido desde septiembre 2018 a enero 2019. Se accedió a las bases de datos de Scielo. La búsqueda se hizo en artículos nacionales e internacionales, con textos completos, estos se sometieron a una lectura crítica utilizando métodos teóricos (análisis histórico-lógico y análisis-síntesis) y empíricos (análisis documental). Conclusiones: Se evidenció que el sexo femenino, la edad, el sobrepeso, la obesidad, el tabaquismo, el alcoholismo, el color de la piel, los antecedentes heredofamiliares de cáncer, la edad de la menarquía, la edad de la menopausia, los antecedentes de enfermedades benignas de la mama, el uso de tratamiento de reemplazo hormonal, la cantidad de hijos, el tiempo de lactancia materna y la actividad física, entre otros, constituyen factores de riesgo predisponentes al cáncer de mama, de ahí la importancia del reconocimiento de estos para la prevención y el diagnóstico precoz.


ABSTRACT Introduction: Breast cancer is the most frequent malignant tumor among women worldwide. Considering the two sexes, it is the second in frequency, after lung cancer. In Cuba, it is still the malignant neoplasm that is most diagnosed in women. It is estimated that one in 9 to 12 women with risk factors will suffer the disease throughout their lives in countries of the western world. Objective: To elaborate on the risk factors associated with breast cancer. Methods: A thematic, observational and retrospective bibliographic review of 25 articles was carried out in the period from September 2018 to January 2019. We accessed the Scielo databases. The search was performed in national and international articles, with full texts, which were subjected to critical reading using theoretical (historical-logical analysis and analysis-synthesis) and empirical (documentary analysis) methods. Conclusions: Evidenced showed that the female sex, age, overweight, obesity, smoking, alcoholism, skin color, hereditary family history of cancer, age of menarche, age of menopause, history of benign breast diseases, the use of hormone replacement treatment, the number of children, the time of breastfeeding, physical activity, among others, are risk factors predisposing to breast cancer; hence the importance of recognizing them for prevention and early diagnosis.


Subject(s)
Humans , Female , Tobacco Use Disorder/prevention & control , Tobacco Use Disorder/epidemiology , Breast Neoplasms/epidemiology , Menarche , Menopause , Risk Factors , Alcoholism/prevention & control , Alcoholism/epidemiology
5.
Rev. cuba. endocrinol ; 31(1): e187, ene.-abr. 2020. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1126455

ABSTRACT

RESUMEN Introducción: En la hiperplasia adrenal congénita el aumento de los niveles de andrógenos suprarrenales en las pacientes no tratadas o mal controladas, puede alterar el inicio y/o la progresión puberal (progresión puberal/progresiones puberales?). Objetivos: Describir las características puberales de pacientes con hiperplasia adrenal congénita asignadas como femeninas e identificar si existe asociación entre elementos relacionados con la enfermedad y el inicio y progresión puberales. Métodos: Se incluyeron todas las pacientes con diagnóstico de hiperplasia adrenal congénita asignadas como femeninas, que fueron atendidas en el INEN de enero 2000 a mayo 2019. Resultados: Fueron estudiadas 47 pacientes, con una media de edad de 14,76 ± 7,04 años. Se comprobó un predominio de las formas clínicas clásicas en 25 pacientes (53,19 por ciento), de ellas 11 (23,40 por ciento) fueron formas virilizantes simples, 14 (29,78 por ciento) perdedoras de sal y 22 (46,80 por ciento) formas no clásicas. El inicio del vello pubiano fue a una edad promedio de 7,78 ± 3,2 años. El comienzo de la telarquia resultó en una media de 10,09 ± 2,4 años y la menarquia a los 12,2 ± 2,3 años como promedio. De las 29 pacientes que ya habían menstruado 16 (55,2 por ciento) presentaban irregularidades menstruales. El tiempo entre el inicio puberal y la menarquia fue de 3,4 años en las formas no clásicas, 5,6 años en las perdedoras de sal y 7,0 años en las virilizantes simples. La edad al diagnóstico, la edad de inicio del tratamiento y la dosis de esteroides empleada se relacionaron con algunos aspectos puberales. Conclusiones: El diagnóstico oportuno y el ajuste cuidadoso del esquema esteroideo, constituyen pilares importantes en el inicio y progresión puberales, y en la consecución de ciclos ovulatorios regulares que aseguren desde la adolescencia, un inicio y desarrollo puberales normales y en edades reproductivas, la optimización de la fertilidad(AU)


ABSTRACT Introduction: In the congenital adrenal hyperplasia, the increased levels of adrenal androgens in patients untreated or poorly controlled can alter the start and/or pubertal progression (pubertal progression/pubertal progressions). Objectives: To describe the pubertal characteristics of patients with congenital adrenal hyperplasia assigned as females and to identify whether there is an association between elements related to the disease and the pubertal onset and progression. Methods: There were included all patients diagnosed with congenital adrenal hyperplasia assigned as females that were attended at the National Institute of Endocrinology from January 2000 to May 2019. Results: 47 patients were studied, with an average age of 14.76 ± 7.04 years. It was found a predominance of classic clinical forms in 25 patients (53.19 percent, of which 11 (23.40 percent) had simple virilization forms, 14 (29.78 percent) were salt-losers and 22 (46.80 percent) had non-classical forms. The onset of the pubic hair was at an average age of 7.78 ± 3.2 years. The beginning of the thelarche resulted in an average of 10.09 ± 2.4 years and menarche at the 12.2 ± 2.3 years on average. Of the 29 patients who had menstruated, 16 (55.2 percent) presented menstrual irregularities. The time between the puberty onset and menarche was 3.4 years in the non-classical forms, 5.6 years in the salt-losers, and 7.0 years in the simple virilizations. The age at initial diagnosis treatment and the dose of steroids used were related to some pubertal aspects. Conclusions: Early diagnosis and careful adjustment of the steroid scheme are important pillars in the pubertal onset and progression, the achievement of regular ovulatory cycles, and with it, in the optimization of fertility(AU)


Subject(s)
Humans , Female , Child , Adolescent , Menarche/physiology , Puberty , Adrenal Hyperplasia, Congenital/diagnosis , Menstruation Disturbances/therapy , Epidemiology, Descriptive , Cross-Sectional Studies
6.
J. pediatr. (Rio J.) ; 96(2): 240-246, Mar.-Apr. 2020. tab, graf
Article in English | ColecionaSUS, LILACS, ColecionaSUS, SES-SP | ID: biblio-1135012

ABSTRACT

Abstract Objective: To analyze the association between age at menarche and variables of body composition in girls from the Northern region of Brazil, the Brazilian Legal Amazon. Method: The sample was composed of 926 school girls, aged between 8 and 18 years, divided into two groups, those who had (G1; n = 727; 72.5%) and had not undergone menarche (G2; n = 199; 21.5%), from public and private schools, using the stratified random proportional sampling technique. Weight, fat weight, muscle weight, and body mass index were measured using bioimpedance analysis. Body height was measured using a stadiometer. Age at menarche was obtained using the conventional method. For the evaluation of sexual maturation, self-assessment was performed according to criteria described by Tanner. Results: The highest cumulative distribution of menarche was found at age 11, and presented significant differences between G1 and G2 at ages 11 and 12 years in all variables of body composition, except body mass index Z-score. Fat and muscle mass were associated with age at menarche. Conclusion: The present results support the notion of menarche anticipation in girls from Brazilian Amazon and its association with body composition. Further studies are needed to investigate the influence of other possible factors that may interfere with the time of growth spurt, thus determining the timing of puberty in these girls in comparison to other regions of Brazil.


Resumo Objetivo Analisar a associação entre idade da menarca e variáveis da composição corporal em meninas na região norte do Brasil, a Amazônia brasileira. Método A amostra foi composta por 926 meninas em idade escolar, entre 8 e 18 anos, divididas em dois grupos, com presença de menarca (G1), n = 727 (72,5%) e ausência (G2) n = 199 (21,5%), provenientes de escolas públicas e privadas, com a técnica de amostragem aleatória estratificada proporcional. Peso, massa de gordura, massa muscular e índice de massa corporal foram medidos através da análise de bioimpedância. A altura foi medida com um estadiômetro. A idade da menarca foi obtida pelo método status quo. Para a avaliação da maturação sexual, a autoavaliação foi realizada de acordo com os critérios descritos por Tanner. Resultados A maior distribuição cumulativa da menarca foi encontrada aos 11 anos e apresentou diferenças significativas entre a presença e ausência de menarca aos 11 e 12 anos em todas as variáveis de composição corporal, exceto o escore-z do índice de massa corporal. Massa de gordura e massa muscular foram associadas com a idade da menarca. Conclusão Os resultados apresentados corroboram a antecipação da menarca em meninas da Amazônia brasileira e sua associação com a composição corporal. Mais estudos são necessários para investigar a influência de outros possíveis fatores que podem interferir na época do estirão de crescimento e determinar, assim, a ocorrência da puberdade em meninas amazônicas em comparação com as de outras regiões do Brasil.


Subject(s)
Humans , Female , Child , Adolescent , Body Composition , Menarche , Body Height , Body Weight , Brazil , Body Mass Index , Age Factors , Puberty
7.
Rev. chil. nutr ; 47(2): 247-254, abr. 2020. tab, graf
Article in English | LILACS | ID: biblio-1115495

ABSTRACT

OBJECTIVE: Evaluate the association between early menarche and anthropometric/body composition variables in young female university students. METHODS: Cross-sectional study involving female university students at a public university in northeastern Brazil. Anthropometric and body composition data were collected, along with a self-report of age at menarche. The conceptual model considered demographic, socioeconomic and lifestyle variables as well as the perception of weight in childhood and at menarche. RESULTS: Among the 162 students analyzed, 62.3% were less than 20 years of age. The frequency of underweight and overweight was 8.6% and 22.3%, respectively. The frequency of above-average body fat and obesity was 32.1% and 14.8%, respectively. Early menarche was reported in 35.2%. The frequency of self-reported excess weight in childhood and at menarche was 31.3% and 25.9%, respectively. A statistically significant association was found between early menarche and height < 1st tertile (< 1.62 m). A tendency toward an association was found between early menarche and both weight, circumference in the risk range and the perception of excess weight in childhood and at menarche. CONCLUSION: Current excess weight was more associated with excess weight in childhood and at menarche than the occurrence of early menarche.


OBJETIVO: Evaluar asociación entre menarquia precoz, parámetros antropométricos y de composición corporal en jóvenes universitarias. MÉTODOS: Estudio transversal en 162 jóvenes universitarias del Nordeste brasileño. Se recogieron datos antropométricos, de composición corporal y relato sobre la edad de la menarquia. Se consideraron, además, variables demográficas, socioeconómicas, estilo de vida e histórico del peso. RESULTADOS: De las 162 jóvenes el 62,3% tenía menos de 20 años de edad. Un 8,6% y 22,3% presentaron bajo peso, y exceso de peso respectivamente. La frecuencia de grasa corporal y obesidad por encima de la media fue de 32,1% y 14,8%, respectivamente. La menarquia temprana fue reportada en el 35,2% de los casos. El 31,3% y 25,9% repostaron tener exceso de peso en la infancia y en la menarquia respectivamente. Se verificó asociación estadísticamente significativa entre menarquia precoz y talla <1 tercil (<1,62cm). Además de una tendencia de asociación entre menarquia precoz, circunferencia de la cintura y exceso de peso, tanto en la infancia como en la edad de menarquia. CONCLUSIÓN: el exceso de peso actual está, mas asociado con el exceso de peso en la infancia y la edad de la menarquia que con la menarquia precoz.


Subject(s)
Humans , Female , Adolescent , Adult , Young Adult , Students , Body Composition , Menarche , Anthropometry , Universities , Brazil , Body Mass Index , Cross-Sectional Studies , Age Factors , Overweight
8.
Arq. gastroenterol ; 57(1): 107-109, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1098052

ABSTRACT

ABSTRACT BACKGROUND: Celiac disease (CD) is a chronic enteropathy in response to ingestion of gluten. CD was associated with gynecological disorders. OBJECTIVE: In this retrospective study, we aimed to investigate the age of menarche, age of menopause, number of pregnancies and abortions in Brazilian celiac patients. METHODS: We studied 214 women diagnosed with CD and as control group 286 women were investigated. RESULTS: Regarding the mean age of menarche, a significant difference was found (12.6±1.40 in CD and 12.8±1.22 years in healthy group; P=0.04). Regarding abortions, in CD women 38/214 (17.8%) and 28/286 (9.8%) in the control group reported abortion (P=0.0092, OR:1.98; CI95%=1.1- 3.3). There was no significant difference in the mean age of menopause nor number of pregnancies per woman. CONCLUSION: In this study, we found that celiac women had a higher mean age of menarche and higher risk of spontaneous abortions.


RESUMO CONTEXTO: A doença celíaca é uma enteropatia crônica em resposta à ingestão de glúten e já foi associada a distúrbios ginecológicos. OBJETIVO: Neste estudo retrospectivo, visamos investigar a idade da menarca, idade da menopausa, número de gestações e abortos em pacientes celíacas brasileiras. MÉTODOS: Foram estudadas 214 mulheres com diagnóstico de doença celíaca e no grupo controle, 286 mulheres foram investigadas. RESULTADOS: Em relação à média de idade da menarca foi encontrada diferença significativa (12,6±1,40 na doença celíaca e 12,8±1,22 anos no grupo controle; P=0,04). Em relação aos abortos, nas mulheres com doença celíaca 38/214 (17,8%) relataram ter tido pelo menos um abortamento espontâneo, enquanto que 28/286 (9,8%) no grupo controle relataram aborto (P=0,0092, OR: 1,98; IC95% = 1,1-3,3). Não houve diferença significativa na idade média da menopausa nem no número de gestações por mulher. CONCLUSÃO: Neste estudo, constatamos que as mulheres celíacas apresentaram maior idade média de menarca e maior risco de abortos espontâneos.


Subject(s)
Humans , Female , Adolescent , Adult , Aged , Young Adult , Parity/physiology , Menarche/physiology , Menopause/physiology , Celiac Disease/physiopathology , Abortion, Spontaneous/physiopathology , Case-Control Studies , Retrospective Studies , Middle Aged
9.
J. pediatr. (Rio J.) ; 96(1): 100-107, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1090996

ABSTRACT

Abstract Objective To evaluate height, sexual maturation, and the difference between final and expected height in girls with juvenile idiopathic arthritis and no glucocorticoid treatment for at least six months, as compared to a group of healthy girls. Methods This cross-sectional study involved 44 girls with juvenile idiopathic arthritis, diagnosed according to the International League of Associations for Rheumatology criteria, and 59 healthy controls aged between 8 and 18 (incomplete) years with no comorbid chronic diseases. Demographic data were collected from all participants, and disease and treatment variables were compiled for the patient group. Anthropometric measurements were converted into Z-scores based on World Health Organization standards. Sexual maturation was classified according to Tanner stages. Results Body mass index and height Z-scores were lower in girls with juvenile idiopathic arthritis as compared to control participants. These values differed significantly in Tanner stage II. Three (6.8%) girls with juvenile idiopathic arthritis had height-for-age Z-scores <−2 (short stature). Girls with polyarticular juvenile idiopathic arthritis and higher cumulative glucocorticoid doses were significantly more likely to present with short stature. The percentage of prepubertal girls in the juvenile idiopathic arthritis group was significantly higher than that observed in the control group, (p = 0.012). Age of menarche, adult height, and the difference between actual and expected height did not differ between groups. Conclusion These findings suggest that even six months after the suspension of glucocorticoid treatment, children with polyarticular/systemic juvenile idiopathic arthritis subtypes are still susceptible to low height and delayed puberty.


Resumo Objetivo Avaliar a estatura, maturação sexual e a diferença entre a estatura final e a esperada em meninas com artrite idiopática juvenil (AIJ) sem tratamento com glicocorticoides por pelo menos seis meses, em comparação com um grupo de meninas saudáveis. Métodos Este estudo transversal avaliou 44 meninas com artrite idiopática juvenil, diagnosticadas de acordo com os critérios da International League of Associations for Rheumatology e 59 controles saudáveis, entre oito e 18 anos (incompletos) sem comorbidades por doenças crônicas. Os dados demográficos foram coletados de todos os participantes e as variáveis de doença e tratamento foram compiladas para o grupo de pacientes. As medidas antropométricas foram convertidas em escores-z com base nos padrões da Organização Mundial da Saúde. A maturação sexual foi classificada de acordo com os estágios de Tanner. Resultados Índice de massa corporal e escores-z de estatura foram menores em meninas com artrite idiopática juvenil em comparação com os participantes-controle. Esses valores diferiram significativamente no estágio II de Tanner. Três (6,8%) meninas com artrite idiopática juvenil tinham escores-z de estatura para idade < -2 (baixa estatura). Meninas com artrite idiopática juvenil poliarticular e doses cumulativas de glicocorticoides foram significativamente mais propensas a apresentar baixa estatura. A porcentagem de meninas pré-púberes no grupo artrite idiopática juvenil foi significativamente maior do que a observada no grupo controle (p = 0,012). A idade da menarca, a estatura adulta e a diferença entre a estatura real e a esperada não diferiram entre os grupos. Conclusão Esses achados sugerem que, mesmo após seis meses da suspensão do tratamento com glicocorticoides, as crianças com os subtipos poliarticular/sistêmico de AIJ ainda são suscetíveis a baixa estatura e atraso na puberdade.


Subject(s)
Humans , Female , Child , Adolescent , Arthritis, Juvenile , Sexual Maturation , Body Height , Menarche , Body Mass Index , Cross-Sectional Studies
10.
Rev. salud pública ; 22(1): e303, ene.-feb. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1150170

ABSTRACT

RESUMO Objetivo Identificar e comparar a potência aeróbica entre os estágios maturacionais determinados pela menarca. Métodos Participaram 19 alunas de 10 a 14 anos do ensino fundamental de um colégio particular da cidade Itajubá-MG, praticantes de atividades físicas escolares; seis do estágio M0, sete do estágio M e seis do estágio M1. O estudo empregou uma tipologia quase experimental e delineamento comparativo. Estatisticamente, utilizou-se Anova One-Way para comparar as variáveis entre os estágios de maturação, seguida de post-hoc de Tukey. O nível de significância foi p<0,05. Resultados Descritivamente, a potência aeróbia foi identificado nos três estágios maturacionais, sendo absolutamente: M0 1,7 ± 0,32, para M 2,2 ± 0,26 e para M1 2,6 ± 0,43 L/min e relativamente: M0 41,4 ± 1,72, para M 46,5 ± 4,51, e para M1 43,9 ± 5,42 ml/kg.min. Observou-se diferença significativa com p=0,001 no VO2 máximo absoluto, tendo um aumento progressivo do VO2 máximo absoluto juntamente com a maturação sexual, não havendo diferença significativa do VO2 máximo relativo com p=0,125. Discussão e Conclusão Conclui-se que existe um aumento significativo do VO2 máximo absoluto juntamente com o avanço maturacional, e no VO2 máximo relativo, não identificamos diferenças significativas entre os estágios maturacionais determinados pela menarca com declínio após um ano da ocorrência da menarca.(AU)


ABSTRACT Objective To identify and compare the aerobic power between the maturation stages determined by menarche. Methods Participated 19 students from 10 to 14 years of the primary school of a private school in the city of Itajubá-MG, practicing physical school activities; six from stage M0, seven from stage M and six from stage M1. The study used a quasi-experimental typology and a comparative design. Statistically, Anova One-Way was used to compare variables between maturation stages, followed by Tukey's post-hoc. The level of significance was p<0.05. Results Descriptively, the aerobic power was identified in the three stages of maturation, being absolutely: M0 1.7 ± 0.32, for M 2.2 ± 0.26 and for M1 2.6 ± 0.43 L/min and relatively: M0 41.4 ± 1.72, for M 46.5 ± 4.51 and for M1 43.9 ± 5.42 ml/kg.min. There was a significant difference with p = 0.001 in the absolute maximum VO2, with a progressive increase in the absolute maximum VO2 along with sexual maturation, without significant difference in the relative maximum VO2 with p = 0.125. Discussion the conclusion We conclude that there is a significant increase in the absolute maximum VO2 together with the progression of maturation, and in the relative maximum VO2, we did not identify significant differences between the maturation stages determined by menarche with a decrease after one year of occurrence of menarche.(AU)


RESUMEN Objetivo Identificar y comparar la potencia aeróbica entre las etapas de maduración determinadas por la menarquia. Métodos Participaron 19 estudiantes de 10 a 14 años de la escuela primaria de un colegio privado de la ciudad de Itajubá-MG que practican actividades escolares físicas; seis de la etapa M0, siete de la etapa M y seis de la etapa M1. El estudio empleó una tipología cuasiexperimental y un diseño comparativo. Estadísticamente, se utilizó Anova One-Way para comparar las variables entre las etapas de maduración, seguido del post hoc de Tukey. El nivel de significancia fue p<0.05. Resultados Descriptivamente, se identificó la potencia aeróbica en las tres etapas de maduración, siendo absolutamente: M0 1.7 ± 0.32, para M 2.2 ± 0.26 y para M1 2.6 ± 0.43 L / min y relativamente: M0 41,4 ± 1,72, para M 46,5 ± 4,51 y para M1 43,9 ± 5,42 ml / kg. min. Hubo una diferencia significativa con p = 0.001 en el VO2 máximo absoluto, con un aumento progresivo del VO2 máximo absoluto junto con la maduración sexual, sin diferencia significativa en el VO2 máximo relativo con p=0.125. Discusión Se concluyó que existe un aumento significativo en el VO2 máximo absoluto junto con la progresión de la maduración. En el VO2 máximo relativo no se identificaron diferencias significativas entre las etapas de maduración determinadas por la menarquia con un descenso después de un año de ocurrencia de la menarca.(AU)


Subject(s)
Humans , Female , Child , Adolescent , Oxygen Consumption/physiology , Menarche/physiology , Motor Activity/physiology , Brazil , Epidemiology, Experimental
11.
Arch. latinoam. nutr ; 69(3): 149-156, sept. 2019. tab
Article in Spanish | LILACS, LIVECS | ID: biblio-1053247

ABSTRACT

La menarca constituye un hito madurativo importante. A escala mundial ocurre, en promedio, a los 12,5 años y está sujeta a factores genéticos y/o ambientales. El objetivo fue analizar, en niñas residentes en la periferia urbana de La Plata: a) la edad mediana de menarca y b) si el estado nutricional y la distribución adiposa influyen en la edad de ocurrencia de menarca. Se evaluaron, durante los ciclos 2014-2017, en 657 niñas de 10-14 años: presencia(P)/ausencia(A) de menarca, peso, talla y pliegues subcutáneos tricipital y subescapular. Se determinaron: edad mediana de menarca (EM) según método status quo y regresión logística; estado nutricional -desnutrición, exceso ponderal y normonutrición- empleando como referencia y puntos de corte a la OMS; y distribución de adiposidad según índice subescapular/tricipital, considerando valores >1 indicativos de adiposidad centralizada. Se calcularon en general y por estado nutricional la EM y las prevalencias de ocurrencia comparándose mediante Chi2. La menarca estuvo presente en el 44,10% de las niñas con EM de 12,13 años. Alrededor del 54% de las niñas se mantuvo dentro de los límites normales (P: 41,20%; EM: 12,28 años) y el 45,70% estaban desnutridas; de estas 4,90% mostraron desnutrición debido a la baja estatura (P: 25,00%; MS: 13,40 años) y 40,80% tenían exceso de peso (P: 50,40%; MS: 11,78 años). El 32,72% de las niñas tenían adiposidad centralizada (P: 59,10%; EM: 11,79 años). Los resultados permiten concluir que el estado nutricional influye en la edad mediana de ocurrencia de la menarca, la cual es mayor en las niñas desnutridas y menor en las niñas con exceso ponderal. La disposición centralizada de la adiposidad favorece la presencia de menarca(AU)


Menarche is an important maturation milestone. It normally occurs at an average age of 12.5 years and is influenced by genetic and/or environmental factors. The aim of this study was to analyze in girls residing at suburbs of La Plata city a) the median age of menarche; b) if nutritional status and fat distribution have any influence in the age of menarche. During years 2014 to 2017, 657 girls aged between 10 and 14 years(y) were surveyed, determining: presence(P)/absence(A) of menarche, weight, height, and tricipital and subscapular skinfolds. It was measured: median age of menarche (MA) according to the status quo method and logistic regression; nutritional status -undernutrition, excess weight, and normonutrition- using WHO as a reference and their cut-off points; and the distribution of adiposity through the use of subscapular/tricipital index, considering values >1 an indicative of centralized adiposity. The median age of menarche was calculated both in the general sample and by nutritional status; general and age-prevalence of menarche were compared by Chi2. Menarche was present in 44.10% of the girls with MS of 12.13 years. About 54% of the population stayed within normal limits (P: 41.20%; MS: 12.28 years) and 45.70% were malnourished; of these 4.90% showed malnutrition due to short stature (P: 25.00 %; MS: 13.40 years) and 40.80% had weight excess (P: 50.40%; MS: 11.78 years). 32.72% of the girls had centralized adiposity (P: 59.10%; MS: 11.79 years). These results allow us to conclude that nutritional status influences the median age of menarche: it is higher in undernourished girls and lower in those with weight excess. Centralized disposition of adiposity promotes the presence of menarche(AU)


Subject(s)
Humans , Female , Child , Adolescent , Weight by Height , Menarche , Nutritional Status , Obesity, Abdominal , Social Conditions , Body Weight , Adolescent Nutrition
12.
J. pediatr. (Rio J.) ; 95(1): 106-111, Jan.-Feb. 2019. tab, graf
Article in English | LILACS | ID: biblio-984654

ABSTRACT

Abstract Objective: To estimate the mean age at menarche and its association with nutritional status in Brazilian adolescents. Methods: The study sample included female adolescents aged 12-17 who participated in a multicenter, school-based, country-wide, cross-sectional study entitled The Study of Cardiovascular Risk in Adolescents (Estudo de Riscos Cardiovasculares em Adolescentes [ERICA]). Mean and median ages at menarche in Brazil were estimated. The association of age at menarche with sociodemographic data and nutritional status were described as means and their respective 95% confidence intervals. Survival analysis was used to assess the age at menarche according to nutritional status categories and the log-rank test was used to compare the medians. Bivariate and multivariate analyses were performed using Cox regression to verify the association between menarche and other variables. Results: A total of 73,624 students were evaluated, comprising 40,803 girls, of whom 37,390 reported menarche at a mean age of 11.71 years and a median of 12.41 years. Median age at menarche was lower in overweight and obese girls (p < 0.001). The multivariate analysis showed that excess weight (HR = 1.28; 95% CI 1.21-1.36; p < 0.001) and studying in a private school (HR = 1.06; 95% CI 1.02-1.10; p = 0.003) were associated with menarche. Conclusions: This is a pioneering study in Brazil with national and regional representativeness to estimate the mean and the median age of occurrence of menarche. Adolescents with excess weight had an earlier menarche than their peers, even after adjustment for confounding factors.


Resumo Objetivo: Estimar a média de idade de ocorrência da menarca e sua associação com o estado nutricional em adolescentes brasileiras. Métodos: Foram avaliados dados de meninas com 12 a 17 anos a partir de um estudo seccional de base escolar, com representatividade nacional e macrorregional, o ERICA (Estudo de Riscos Cardiovasculares em Adolescentes). Foram estimadas média e mediana de idade de ocorrência da menarca no Brasil, pelo método recordatório. A associação da idade da menarca com dados sociodemográficos e estado nutricional foi descrita como médias e seus respectivos IC95%. Análise de sobrevida foi utilizada para explorar a idade da menarca segundo categorias de estado nutricional e teste logrank foi utilizado para comparação das medianas. Análises bivariada e multivariada foram realizadas por meio da regressão de Cox para verificar a associação entre menarca e demais variáveis. Resultados: Foram avaliados 73.624 estudantes, 40.803 meninas, das quais 37.390 referiram ter apresentado menarca, sendo a média da idade de ocorrência de 11,71 anos e a mediana de 12,41 anos. As medianas da idade de ocorrência da menarca foram menores naquelas com sobrepeso e obesidade (p < 0,001). A análise multivariada evidenciou que excesso de peso (HR = 1,28, IC95% 1,21-1,36, p < 0,001) e estudar em escola privada (HR = 1,06, IC95% 1,02-1,10, p = 0,003) estão associados à menarca. Conclusões: Este foi o primeiro estudo brasileiro com representatividade nacional a estimar a média de idade de ocorrência da menarca. As adolescentes com excesso de peso apresentaram menarca em idade inferior às demais, mesmo após ajuste.Full English text available from: www.revespcardiol.org/en


Subject(s)
Humans , Female , Child , Adolescent , Menarche/physiology , Nutritional Status/physiology , Ethnic Groups , Cross-Sectional Studies , Age Factors
13.
Article in English | WPRIM | ID: wpr-764511

ABSTRACT

PURPOSE: The aim of this study was to investigate the clinicopathological features of premature ovarian insufficiency (POI) associated with chromosomal abnormalities. MATERIALS AND METHODS: This was a retrospective study of POI patients with chromosomal abnormalities diagnosed between January 2009 and December 2017. The definition of POI is based on hypergonadotropinism of 40 or greater in follicle stimulating hormone (FSH) measurements at age 40 years or less. FSH was measured twice at least 4 weeks apart. Karyotyping using peripheral blood for chromosomal testing was conducted in all patients diagnosed with POI. We analyzed the clinical characteristics and genetic causes of patients who were diagnosed with POI. RESULTS: Forty patients were diagnosed with POI including 9 (22.5%) with identified chromosomal abnormalities. The mean age at diagnosis was 23.1±7.8 years (ranging between 14 and 39). Three patients did not experience menarche. The presenting complaints were short stature in one case, one case of amenorrhea with ambiguous external genitals, one case of infertility, and six related to menstruation such as oligomenorrhea or irregular rhythm. Turner syndrome was diagnosed in four cases, Xq deletion in one case, trisomy X in two cases, and 46,XY disorder of sexual development in two other patients. CONCLUSION: Patients diagnosed with POI carrying the same type of chromosomal abnormality manifest different phenotypes. The management protocol also needs to be changed depending on the diagnosis. A karyotype is indicated for accurate diagnosis and proper management of POI in patients, with or without stigmata of chromosomal abnormalities.


Subject(s)
Amenorrhea , Christianity , Chromosome Aberrations , Diagnosis , Female , Follicle Stimulating Hormone , Humans , Infertility , Karyotype , Karyotyping , Menarche , Menstruation , Oligomenorrhea , Phenotype , Retrospective Studies , Sexual Development , Trisomy , Turner Syndrome
14.
Article in English | WPRIM | ID: wpr-764298

ABSTRACT

BACKGROUND: This study was conducted to explore the effect of known risk factors, focusing on risk factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, in consideration of interaction among East-Asian women. METHODS: Case-control study with 2,123 cases and 2,121 controls with mammographic density was conducted. Using the mammographic film, breast density was measured using Breast Imaging-Reporting and Data System. To identify the association of selected reproductive factors including age at menarche, age at menopause, number of children, family history of breast cancer, and age at first birth according to breast density, stratified analysis was conducted according to breast density groups and interaction effects was assessed. The results were presented with adjusted OR and 95% CIs. RESULTS: Significant interaction effect between age at first birth and breast density on breast cancer (P = 0.048) was observed. Women with age at first birth ≥ 28 years old showed increased breast cancer risk in extremely dense breast group (≥ 75%) (OR = 1.627, 95% CI = 1.190–2.226). However, women with fatty breast (< 50%) and heterogeneously dense breast (50%–75%) did not show an increased association. Age at menarche, age at menopause, number of children, and family history of breast cancer did not show significant interaction with breast cancer and similar risk patterns were observed. CONCLUSIONS: Age at first birth showed significant interaction with breast density on breast cancer risk. Further studies considering biologically plausable model between exposure, intermediate outcomes and breast cancer risk with prospective design need to be undertaken in East Asian women.


Subject(s)
Asian Continental Ancestry Group , Birth Order , Breast Neoplasms , Breast , Case-Control Studies , Child , Female , Humans , Information Systems , Menarche , Menopause , Prospective Studies , Reproductive History , Risk Factors
17.
São Paulo; s.n; 2019. 191 p.
Thesis in Portuguese | LILACS | ID: biblio-1045892

ABSTRACT

Introdução: A obesidade é um problema de saúde pública e tem sido associada ao início da puberdade, no entanto, há controvérsia sobre a consistência e plausibilidade biológica dessa associação. Alguns nutrientes e grupos de alimentos tais como proteínas de origem animal, laticínios e bebidas adoçadas têm sido associados à puberdade precoce, enquanto proteínas origem vegetal, com puberdade tardia. Entretanto, a dieta é fenômeno complexo porque alimentos não são consumidos isoladamente; sendo importante avaliar a dieta de forma global. Objetivo: Investigar a relação entre dieta, estado nutricional e início da puberdade em adolescentes chilenos. Metodologia: Foram utilizados dados secundários de adolescentes de ambos sexos (idade média: 12.5 anos) do Growth and Obesity Cohort Study, de Santiago, Chile, avaliados durante os anos 2014-2015. Dados sociodemográficos, aferições antropométricas (peso, estatura), avaliação puberal (estágio de Tanner, idade do início da menarca) e recordatório alimentar de 24 horas (R24h); foram utilizados para o presente estudo. Do total de 1196 participantes da coorte, 882 adolescentes tinham dados de consumo alimentar e medidas antropométricas; desses, 270 meninas apresentaram dados prospectivos de dieta antes do início da menarca. Alimentos provenientes do R24h, foram classificados em grupos de alimentos segundo suas características nutricionais, cultura alimentar e corrigidos pela variância intrapessoal da ingestão por procedimentos estatísticos da plataforma online Multiple Source Method. Os padrões da dieta foram identificados por análise fatorial exploratória. O relato implausível de energia foi categorizado como sub-relatores, plausível e super-relatores, e como porcentagem para o ajuste dos modelos de regressão múltipla. Regressão logística múltipla foi usada para identificar fatores associados e impacto do subrelato em nutrientes e grupos de alimentos (manuscrito 1) e associação entre padrões da dieta e excesso de peso (manuscrito 2). A associação longitudinal entre padrões de dieta e tempo até início da menarca foi verificada por meio da análise de regressão de Cox (manuscrito 3). Todas as análises foram realizadas com um nível de confiança do 95%. Resultados: A frequência de adolescentes sub-relatores, plausíveis e super-relatores foi 50.7%, 40.5% e 8.8%, respectivamente; sendo maior em adolescentes com excesso de peso e meninos. A prevalência de excesso de peso do GOCS foi 51.6%. Quatro padrões foram identificados explicando 24.9% da variabilidade da dieta. "Breakfast/Once" e "Meats and Vegetables" foram associados com maior ingesta de sódio, "Western" com gordura saturada e "Sweet Snack" com açúcar de adição (p<0.05). Adolescentes com maior aderência (terceiro tercil) aos padrões "Western" e "Sweet Snack" apresentaram maior chance de ter excesso de peso (OR=1.67; IC95%:1.103-2.522 e OR=1.86; IC95%:1.235-2.792; respectivamente) quando comparado aqueles com menor aderência (primeiro tercil); o padrão "Meats & Vegetables" também foi associado positivamente ao excesso de peso (OR=1.83; IC 95%: 1.219-2.754). Em adolescentes do sexo feminino foram identificados três padro?es "Breakfast/Once, "Prudent" e "Western"; explicando 19.4% da variabilidade da dieta. Meninas com excesso de peso e que aderiram mais ao padrão "Prudent" (terceiro tercil) tinham 55% menor risco de apresentar uma idade de menarca precoce (HR=0.51; IC95%:0.31-0.85) quando comparado àquelas com menor aderência (primeiro tercil). Conclusões: Padrões de dieta identificados revelaram uma baixa qualidade da dieta e foram associados ao excesso de peso, nas análises transversais. Nas análises longitudinais, o padrão "Prudent" associou-se com um menor risco de idade da menarca precoce, em meninas com excesso de peso. Esperamos que esses achados fomentem futuras pesquisas e auxiliem as atuais políticas de saúde publica no Chile.


Introduction: Obesity, a public health problem, has been associated with the early onset of puberty; however, there is controversy about the consistency and biological plausibility of this association. Some specific nutrients and food groups have been associated with puberty such as vegetable proteins, milk, sugar-sweetened beverages have been associated with an early onset puberty and animal proteins with late onset puberty. However, foods or nutrients are not consumed in isolation, and it is important to evaluate the overall diet. Objective: To investigate the relationship between diet, nutritional status and onset of puberty in Chilean adolescents. Methodology: Secondary data were used of adolescents of both sexes (mean age: 12.5 years) from the Growth and Obesity Cohort Study (GOCS) of Santiago, Chile, evaluated between 2014-2015. Sociodemographic data, anthropometric measurements (weight, height), pubertal evaluation (tanner stage, age at menarche) and 24-hour dietary recall (24HR) were used to the present study. From a total of 1.196 adolescents of the cohort, 882 adolescents had food consumption data and anthropometric measurements, from this number, 270 girls have prospective dietary data before onset of menarche. Foods from 24HR were classified into food groups according to their nutritional characteristics, feeding culture and corrected by intrapersonal variance intake by statistical procedures of Multiple Source Method´s online platform. Dietary patterns were identified by exploratory factor analysis. Misreporting was categorized as under-reporting, plausible and over-reporting estimated and as percentage to models adjustment. Multiple logistic regression was used to relate under-reporting and their associated factors (manuscript 1). The association between dietary patterns and overweight was verified by logistic regression models (manuscript 2). The longitudinal association between dietary patterns and time to age at menarche was verified by Cox regression analysis (manuscript 3). All analyzes were performed with a 95% confidence level. Results: The frequencies of under-reporting, plausible and over-reporting adolescents were 50.7%, 40.5% and 8.8%; respectively, being higher in overweight and boys. The prevalence of overweight on GOCS was 51.6%. Four patterns were identified, explaining 24.9% of dietary variability. "Breakfast/Once" and "Meats and Vegetables" were associated with higher sodium intake, "Western" with saturated fat and "Sweet Snack" with added sugar (p<0.05). Adolescents with higher (third tertile) adherence to "Western" and "Sweet Snack" patterns had higher odds of being classified as overweight (OR=1.67; 95% CI:1.103-2.522 and OR=1.86; 95% CI:1.235-2.792 respectively) when compared to those of lower adherence (first tertile); "Meats and Vegetables" pattern was also associated with overweight (OR=1.83; 95% CI:1.219-2.754). In girls, three patterns were identified: "Breakfast/Once", "Prudent" and "Western"; explaining 19.4% of dietary variability. Girls with excess weight had a higher adherence to "Prudent" pattern had a later age at menarche compared to those with lower adherence (HR=0.51; IC95%: 0.31-0.85). Conclusions: Identified dietary patterns showed poor diet quality that were associated to excess weight on cross-sectional analyzes. Longitudinal analyze of the "Prudent" pattern was associated with a later age at menarche on girls with excess weight. Hopefully, these findings may incentive future researches and help current public health policies in Chile.


Subject(s)
Adolescent , Menarche , Weight Gain , Adolescent , Puberty , Adolescent Nutrition , Obesity
18.
Article in English | WPRIM | ID: wpr-762618

ABSTRACT

Primary amenorrhea is a symptom with a substantial list of underlying etiologies which presents in adolescence, although some conditions are diagnosed in childhood. Primary amenorrhea is defined as not having menarche until 15 years of age (or 13 years with secondary sex characteristics). Various etiologies of primary amenorrhea include outflow tract obstructions, gonadal dysgenesis, abnormalities of the central nervous system, various endocrine diseases, chronic illnesses, psychologic problems, and constitutional delay of puberty. The management of primary amenorrhea may vary considerably depending on the patient and the specific diagnosis. In this article, the various causes, evaluation, and management of primary amenorrhea are reviewed with special emphasis on congenital sex hormonal disorders.


Subject(s)
Adolescent , Amenorrhea , Central Nervous System , Chronic Disease , Diagnosis , Endocrine System Diseases , Female , Gonadal Dysgenesis , Humans , Menarche , Puberty
19.
Article in English | WPRIM | ID: wpr-762607

ABSTRACT

Over the last decades, the onset of puberty in girls has occurred earlier, but the tempo of pubertal progression has been relatively slower, resulting in a younger age at puberty onset without a change in age at menarche. Sufficient energy availability and adiposity contribute to early pubertal development, and environmental factors, such as endocrine-disrupting chemicals (EDCs), may affect not only the control of energy balance, but also puberty and reproduction. EDCs are hormonally active substances that can perturb puberty by acting both peripherally on target organs, such as adipose tissue or adrenal glands, and/or centrally on the hypothalamic-pituitary-gonadal (HPG) axis. Depending on whether the exposure takes place earlier during fetal and neonatal life or later during early childhood, EDCs can lead to different outcomes through different mechanisms. Evidence of associations between exposures to EDCs and altered pubertal timing makes it reasonable to support their relationship. However, human epidemiologic data are limited or inconsistent and cannot provide sufficient evidence for a causal relationship between EDC exposure and changes in pubertal timing. Further investigation is warranted to determine the overall or different effects of EDCs exposure during prenatal or childhood windows on pubertal milestones and to reveal the underlying mechanisms, including epigenetic marks, whereby early-life exposure to EDCs affect the HPG-peripheral tissue axis.


Subject(s)
Adipose Tissue , Adiposity , Adolescent , Adrenal Glands , Endocrine Disruptors , Epigenomics , Female , Humans , Menarche , Puberty , Reproduction
20.
Rev. chil. endocrinol. diabetes ; 11(4): 134-140, dic. 2018. tab, graf
Article in Spanish | LILACS | ID: biblio-968555

ABSTRACT

Introduction: Puberty normally begins after 8 years in girls and 9 years in boys. Objective: To determine the prevalence of signs of precocious puberty (PP), breast development in girls, premature gonadal development (PGD), premature adrenarche (PA), menarche age (MA) and its association with nutritional status (NS). Material and Methods: From a sample of 3.010 children from 5 to 14 years randomly selected in Santiago of Chile were chosen a subsample of 873 kids according to the cutoff to define PP. Survey was applied to obtain MA. Logistic regression were used to evaluate the relationship between PP and NS. Results: In boys the prevalence of PGD and PP was 8.55% and 3.16% respectively, no relationship was found with nutritional status In girls the prevalence of breast development and PA was 8.13% and 0.9% respectively. Only there be association between PP and NS in women: with a prevalence of 1,2%, 13,9% and 21,1% in well-nourished, Overweight and obesity are at greater risk of showing PP compared with eutrophic girls with an OR of 25,5 (IC 95% 3,2-203,0) and 46.93 (IC 95% 6,1-361,5). MA was 12,01 ± 0,94 years in eutrophic girls and 11,40 ± 0,96years in obese girls (p< 0,05). Conclusion: There was a positive correlation in females between overweight and obesity an PP and MA. There is a secular trend in MA, to compare these findings with other national studies. Obesity could have an important role in explaining the advancement observed in pubertal development.


Introducción: El desarrollo puberal se inicia normalmente después de los 8 años en niñas y de los 9 años en varones. Objetivo: Estimar la prevalencia de signos de pubertad precoz (sPP): crecimiento genital (CG) en varones, telarquia en niñas y vello púbico (VP) en ambos sexos; y determinar edad de la menarquia (EM) en una muestra de escolares de Santiago de Chile), y evaluar la asociación de estas variables con el estado nutricional (EN). Material y Métodos: Se examinaron 3.010 escolares de clase media baja de 6 a 14 años, pertenecientes a 10 colegios de Santiago de Chile y seleccionados aleatoriamente. En todos ellos se consignó peso, talla, IMC y desarrollo puberal según Tanner. Se aplicó una encuesta a los padres para obtener la EM a la población total de mujeres (n= 1.433). Para determinar sPP se analizaron por separado los 867 niños (62% mujeres) menores a la edad establecida como puntos de corte para definir PP. Se utilizó regresión logística para determinar la asociación existente entre sPP y el EN. Resultados: En varones la prevalencia de CG y VP fue de 8,55% y 3,16% y no se asocio al EN. La prevalencia de telarquia y VP en niñas fue de 8,13% y 0,9% respectivamente. Se observó una fuerte asociación entre telarquia y EN con prevalencias de 1.2%, 13.9% y 21.1% en eutróficas, sobrepeso y obesas, respectivamente (p< 0,0001) (Gráfico 1). La presencia de sobrepeso y/o obesidad otorgan un mayor riesgo de presentar telarquia, vs comparación con las niñas eutróficas con un OR de 25,5 (IC 95% 3,2-203,0) y 46.93 (IC 95% 6,1-361,5), respectivamente. La EM fue 12,01 ± 0,94 años en niñas eutróficas siendo de 11,40 ± 0,96 años en niñas obesas (p< 0,05). Conclusión: Se observó una correlación positiva solo en el sexo femenino entre malnutrición por exceso, telarquia precoz y EM. Se observa una tendencia secular en la EM al comparar los hallazgos con otros estudios nacionales.


Subject(s)
Humans , Male , Female , Child , Adolescent , Puberty, Precocious/epidemiology , Menarche/physiology , Nutritional Status , Overweight/epidemiology , Obesity/epidemiology , Puberty, Precocious/etiology , Logistic Models , Chile , Sex Factors , Anthropometry , Risk , Prevalence , Genitalia/growth & development
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