Pubertal Development in Rett Syndrome Deviates From Typical Females

BackgroundRett syndrome is a unique neurodevelopmental disorder, affecting approximately one in 10,000 live female births, most experiencing reduced growth. We characterized pubertal trajectories in females with Rett syndrome. We hypothesized that pubertal trajectory deviates from the general female population with early pubertal onset and delayed menarche.MethodsParticipants were individuals enrolled in the Rett Syndrome Natural History Study with clinical diagnosis of Rett syndrome or mutations in MECP2. Intervals to thelarche, adrenarche, and menarche were assessed by survival analysis; body mass index, mutation type, clinical severity, and pubertal milestone relationships were assessed by log-likelihood test; pathway synchrony (relationship between thelarche, adrenarche, and menarche) was assessed by chi-squared analysis.ResultsCompared with the general female population, more than 25% initiated puberty early, yet entered menarche later (median age 13.0 years). A total of 19% experienced delayed menarche. Median length of puberty, from thelarche to menarche, was 3.9 years. Higher body mass index correlated with earlier thelarche and adrenarche but not menarche; milder mutations correlated with earlier menarche; and milder clinical presentation correlated with earlier thelarche and menarche. Fifty-two percent entered puberty in synchrony, but different from the general population, 15% led with thelarche and 32% with adrenarche.ConclusionsPubertal trajectories in Rett syndrome differ from general population, entering puberty early and reaching menarche later. Body mass index affects pubertal timing, but the relationship between specific mutations, clinical presentation, and underlying neuroendocrine pathology is less clear.     

Earlier menarche can be an indicator of more body fat: study of sexual development and waist circumference in Chinese girls

Objective This paper aims to study the relationship between body fat and sexual development in Chinese girls with different waist circumference.Methods Six thousand one hundred and fifty six girls aged 6-19 were sampled.Their body weight,height,waist circumference,percentage of body fat and secondary sex characteristics were measured.All the subjects were divided into three groups:low class waist circumference,moderate class waist circumference and high class waist circumference.The menarche percentages wer...     

Onset of epilepsy and menarche—Is there any relationship?

PURPOSE: Women with epilepsy have increased frequency of reproductive health problems compared to women without epilepsy. In puberty, reproductive hormonal changes during sexual maturation may affect epilepsy and induce the debut of seizures as indicated in some studies. On the other hand, epileptic activity affects sex hormone function, which may induce alterations in pubertal endocrine maturation and thereby menarche age. We wanted to investigate the relation between epilepsy and menarche age in a larger population of female epilepsy patients. METHODS: A retrospective, questionnaire study of a cohort of 265 female outpatients from three Norwegian hospitals and 142 controls, aged 18-45 years was conducted. Parameters regarding epilepsy and reproductive health issues were registered. Perimenarche was defined as 2 years before and 2 years after the year of menarche. RESULTS: There was a significantly higher frequency of patients with epilepsy debut between 10 and 18 year compared to 0-9 years (p<0.01). There was, however, no significant difference in occurrence of epilepsy debut in the perimenarche period compared to the 5 year periods before and after perimenarche, and no significant difference in epilepsy debut in the year of menarche compared to the 5 years before or after. Menarche age was not significantly different in those with epilepsy debut before or after menarche. Epilepsy type (idiopathic generalised or partial) did not influence the menarche age. CONCLUSIONS: The study did not confirm the former observations of clustering of epilepsy debut at menarche or in the perimenarche period or alterations in menarche age in girls with epilepsy. However, onset of epilepsy is more frequent in the adolescent years (10-18), than in childhood (0-9).     

汉族与回族青春期女生身体形态发育差异性分析

目的 分析汉族与回族青春期女生身体形态发育的差异性,为探索身体形态发育的民族差异性提供依据。方法 从2010年全国学生体质与健康调研数据中,抽取12~15岁汉族、回族青春期女生身高、体重、胸围、坐高、上臂部皮褶厚度(triceps skinfold thickness,TST)、肩胛部皮褶厚度(scapular skinfold thickness,SST)及“是否已来潮”指标,按“是否已来潮”分层分析汉族与回族青春期女生身体形态发育差异。结果 12~15岁各年龄组汉族青春期女生报告“已来潮”率均高于回族(P值均＜0.05)。已来潮及未来潮青春期女生,身高、体重、胸围、坐高、TST、SST汉族与回族学生平均差异均无统计学意义(P值均＞0.05),但12岁未来潮女生坐高、TST,汉族高于回族(P值均＜0.05); 已来潮女生,13岁胸围、14岁身高、体重、胸围、BMI指标汉族高于回族(P值均＜0.05)。结论 汉族与回族青春期女生形态发育指标平均差异不明显,仅在青春期中后期(14岁)汉族学生高于回族学生,探索形态发育民族差异应考虑是否已初潮及年龄因素的影响。     

African-American/white differences in the age of menarche: accounting for the difference

Lifetime health disparity between African-American and white females begins with lower birthweight and higher rates of childhood overweight. In adolescence, African-American girls experience earlier menarche. Understanding the origins of these health disparities is a national priority. There is growing literature suggesting that the life course health development model is a useful framework for studying disparities. The purpose of this study was to quantify the influence of explanatory factors from key developmental stages on the age of menarche and to determine how much of the overall race difference in age of menarche they could explain. The factors were maternal age of menarche, birthweight, poverty during early childhood (age 0 through 5 years), and child BMI z-scores at 6 years. The sample, drawn from the US National Longitudinal Surveys of Youth Child-Mother file, consisted of 2337 girls born between 1978 and 1998. Mean age of menarche in months was 144 for African-American girls and 150 for whites. An instrumental variable approach was used to estimate a causal effect of child BMI z-score on age of menarche. The instrumental variables were pre-pregnancy BMI, high gestational weight gain and smoking during pregnancy. We found strong effects of maternal age of menarche, birthweight, and child BMI z-score (-5.23, 95% CI [-7.35,-3.12]) for both African-Americans and whites. Age of menarche declined with increases in exposure to poverty during early childhood for whites. There was no effect of poverty for African-Americans. We used Oaxaca decomposition techniques to determine how much of the overall race difference in age of menarche was attributable to race differences in observable factors and how much was due to race dependent responses. The African-American/white difference in childhood BMI explained about 18% of the overall difference in age of menarche and birthweight differences explained another 11%.     

汉族女孩月经初潮年龄与生长发育的关系

目的:探讨月经初潮年龄与人体形态、机能、素质指标的相关关系,为采取干预措施和健康教育提供理论依据。方法:从文献中收集2005年全国30个省市汉族女生的生长发育指标共15项,对所有生长发育指标与汉族女生月经初潮年龄进行简单相关分析和多重线性回归分析。结果:在简单相关分析中,有5个因素与月经初潮年龄相关,其中有2个因素进入多重线性回归分析中,分别是体重和握力。结论:汉族女生的部分生长发育指标与青春期发育密切相关。     

Relationship Between Body Mass Index and Early Menarche of Adolescent Girls in Seoul

Objectives

The object of this study was to determine the relationship between body mass index (BMI) and early menarche in adolescent girls in Seoul.

Methods

A retrospective study was conducted with 144 middle school students in Seoul who provided informed consent. We measured their body composition, and used the questionnaire survey method for data collection from November to December 2008. Past elemental body composition data were collected from elementary school health records of first year of middle school.

Results

The early menarcheal group was taller and heavier than the late menarcheal group (p<0.05 from 8-12 years old). The body fat percentage (%), BMI were higher in the early menarcheal girls than the late-menarcheal girls (p<0.05, age at 13). In the result of multiple logistic regression, the BMI at the age of 8 and 9 was associated with early menarche after adjusting for birth weight, breast feeding and age at menarche of the mother (BMI at the age of 8: p for trend=0.01, BMI at the age of 9: p for trend=0.04). An increase in BMI from 7 to 8 year was associated with early menarche after adjusting for birth weight, breast feeding, age at menarche of the mother (p for trend=0.048).

Conclusions

The BMI at the age of 8 and 9 was associated with the early menarche of girls and increase in BMI from 7 to 8 year was associated with the early menarche of girls. These results suggest that BMI and increase in BMI before menarche cause early menarche. Although this study does not represent all Korean adolescent girls, it is one of the few studies that have investigated the temporal relationship between BMI and early menarche.     

Association between age at menarche and risk of diabetes in adults: results from the EPIC-Norfolk cohort study

Aims/hypothesis Earlier age at menarche is associated with increased BMI and obesity risk from early childhood through to adulthood. We hypothesised that earlier age at menarche would also predict subsequent diabetes risk. Methods This was a population-based prospective cohort study of 13,308 women, who were aged 40 to 75 years between 1993 and 1997 and participating in the Norfolk cohort of the European Prospective Investigation into Cancer and Nutrition (EPIC-Norfolk). We used data on age at menarche and ascertained diabetes incidence to 2005. Results There were 734 cases of diabetes (363 incident and 371 prevalent cases). Mean age at menarche was lower in women with diabetes than in non-diabetic women (12.8 vs 13.0 years, p = 0.008). Compared with the earliest quintile (menarche at 8–11 years), women in the oldest quintile (menarche at 15–18 years) had lower BMI (25.5 vs 27.4 kg/m², p < 0.0001) and a reduced risk of diabetes (OR 0.66 [95% CI 0.51–0.86] adjusted for age, family history, physical activity, smoking, occupational social class, parity and use of hormonal preparations). The association between age at menarche and diabetes was linear (adjusted OR 0.91 [95% CI 0.87–0.96] per 1 year later menarche) and appeared to be completely mediated by adult BMI or waist circumference (OR 0.98 [95% CI 0.93–1.03], further adjusted for BMI at age 40–75 years). Conclusions/interpretation Earlier age at menarche increases the risk of diabetes in women and this association appears to be mediated by increased adiposity. History of earlier menarche may help to identify women with increased subsequent risk of diabetes.     

四川地区汉族女大学生月经初潮年龄的调查

[目的]调查分析四川地区汉族女大学生月经初潮年龄(menarcheal age,MA)及其与成年期身高(bodyheight,BH)、体重(body weight,BW)和居住环境(inhabited environment,IE)等的关系。[方法]让446名女大学生回顾并填写调查表,测定其BH和BW,然后用统计软件SPSS 11.0进行分析。[结果]四川地区汉族女大学生平均月经初潮年龄13.33(13.33±1.18)岁。城市组较农村组提前0.44岁,二者差异有统计学意义(t=3.966,P﹤0.001)。城市与农村女大学生成年期身高之间的差异有统计学意义(t=3.118,P﹤0.05)。平均MA与BH呈正相关,与BW呈负相关。[结论]四川地区女大学生月经初潮年龄13.33岁,与城乡生活环境有关。月经初潮越早的女生,成年后体重越重,身高越矮。