陕西省青春期少女月经初潮年龄分布及其与体质指数的关系研究

目的　了解陕西省青春期少女的月经初潮年龄现状及其与BMI的关系。方法　选取2007年7—8月陕西省关中、陕南、陕北地区营养与健康生物学调查中处于青春期的少女（10~19岁）534例为调查对象,采用自行设计的调查问卷进行面对面调查。问卷内容包括：一般资料（年龄、受教育年限）、家庭背景（家庭人口数、家庭收入来源）、体格检查（身高、体质量等）,分析青春期少女的月经初潮年龄分布情况。根据美国疾病预防控制中心（CDC）标准按年龄别百分位数对BMI进行分类：低体质量（BMI<5%）、体质量正常（5%≤BMI<85%）、超重（85%≤BMI<95%）。采用多因素Logistic回归分析分析月经初潮与BMI的关系。结果　534例青春期少女中已来月经初潮的446例（83.5%）,未来月经初潮的88例（16.5%）。农村和城区已来月经初潮的青春期少女月经初潮年龄及其分布情况比较,差异均有统计学意义（P<0.05）。陕北已来月经初潮的青春期少女月经初潮年龄大于关中、陕南（P<0.05）。不同体质量已来月经初潮的青春期少女月经初潮年龄分布情况比较,差异有统计学意义（P<0.05）。多因素Logistic回归分析结果显示,校正前低体质量与是否来月经初潮呈正相关（P<0.05）;当校正了年龄、城乡和家庭背景因素后,低体质量与是否来月经初潮呈正相关（P<0.05）,与体质量正常者相比,低体质量者不来月经初潮的风险增加11.39倍。校正前超重与是否来月经初潮呈正相关（P<0.05）;校正年龄、城乡和家庭背景因素后,两者无相关性（P>0.05）。结论　陕西省青春期少女的月经初潮年龄在不同地区和城乡间存在显著差异,月经初潮年龄的早晚与其BMI的大小有关联,BMI过小青春期少女的月经初潮年龄有延后的趋势。     

Age at menarche and depression at the age of 31 years: findings from the Northern Finland 1966 Birth Cohort Study

OBJECTIVE: Early age at menarche has been found to be associated with higher oestrogen levels among girls around the onset of puberty and in early adulthood. The role of oestrogen in depression is not clear, although it affects serotonergic functions in the central nervous system (CNS). We wanted to test the hypothesis that age at menarche is associated with depression in young adulthood. METHODS: The material consisted of 3952 women born in 1966 in Northern Finland. Depression was defined by the Hopkins Symptom Checklist-25 (HSCL-25), the use of antidepressants and by self-reported lifetime depression diagnosed by physician. Menarcheal age was divided as 9-11, 12-15 and 16 years or over. RESULTS: The prevalence of depression was 1.8-fold in current depression, 2.8-fold in the use of antidepressants and 2.1-fold in self-reported physician-diagnosed depression in women with menarche at the age of 16 years or later. After adjusting for confounders, the significant positive association between current depression and late menarche remained, but the use of antidepressants and depression diagnosed by physician had not statistically significant association with the age of menarche. CONCLUSION: A possible explanation for the result may be oestrogen as a protective factor against depression.     

Menstrual Attitudes Among Black and White Premenarcheal Girls

PROBLEM. To determine if a difference exists between black and white fifth-grade girls' attitudes about menarche and menstruation.
METHODS. The Menstrual Attitude Questionnaire-Adolescent Form (Brooks-Gunn & Ruble, 1980) was used to collect data from 55 premenarcheal females, ages 10-12 years.
FINDINGS. The findings indicated no difference between black and white girls in Affirmation or Worry. Like older samples, the girls were moderate in affirmation. Unlike older samples, they evidenced less worry.
CONCLUSION. Analysis of the instrument used in this study raises questions in general regarding its use as originally developed. In addition, specific questions were raised about its use with different cultural groups.     

Self-perceptions of pubertal timing and patterns of peer group activities and dating behavior among heterosexual adolescent girls

This study identified patterns of past and concurrent peer group and dating behavior in a sample of adolescent girls (N = 511; aged 17–19 years; 49% White). Peer group activities and dating behaviors were classified as occurring in either early (ages 10–13 years), middle (ages 14–16 years), or late (ages 17–19 years) adolescence according to the age at which each participant indicated the activity/behavior was first experienced. Latent class analysis identified four latent classes: Early Interactions/Early Daters (15%), Early Interactions/Late Daters (17%), Early Interactions/Middle Daters (33%) and Middle Interactions/Middle Daters (35%). Class membership was associated with girl's perceived pubertal timing. Compared to Early Interactions/Early Daters, girls in the Early Interactions/Late Daters class reported higher levels of pubertal timing, indicating greater perception that their pubertal development was late relative to peers. Late perceived pubertal timing is potentially relevant for dating but not necessarily other mixed- and cross-sex peer interactions.     

Weight and Body Mass Index at Menarche are Associated with Premenopausal Bone Mass

Adolescence is a critical time for skeletal growth and mineralization. Exposure to protective or detrimental factors during this period may influence peak bone mass attainment and subsequent development of osteoporosis. In order to evaluate the association of body size during adolescence with subsequent adult bone mass, we conducted a follow-up study of a community-based cohort of girls who participated in a growth and sexual maturation study 30 years ago. Data from the original study included age at menarche, height at menarche and weight at menarche. Follow-up evaluation of 119 subjects, now premenopausal women ages 40–45 years, included bone mineral density (BMD) measurements of the total body, lumbar spine, femoral neck, total hip, and ultradistal radius by dual-energy X-ray absorptiometry. After adjustment for current adult weight and other factors related to bone mass, weight at menarche was found to be positively associated with subsequent adult BMD. Similarly, body mass index (BMI) at menarche was positively associated with adult BMD. In contrast, age at menarche was not found to predict adult BMD. When the subjects were divided into quartiles based on their BMI at menarche, subjects in the lowest quartile of BMI at menarche had adult mean BMD that was 8–15% lower at the measured sites compared with subjects in the highest quartile of BMI at menarche. In conclusion, low body weight and low BMI at menarche appear to be significant predictors of reduced bone mass in healthy premenopausal women ages 40–45 years. Received: 15 August 2000 / Accepted: 2 January 2001     

Serum PBDEs and age at menarche in adolescent girls: analysis of the National Health and Nutrition Examination Survey 2003-2004

Background

Polybrominated diphenyl ethers (PBDEs), widely used as flame retardants since the 1970s, have exhibited endocrine disruption in experimental studies. Tetra- to hexa-BDE congeners are estrogenic, while hepta-BDE and 6-OH-BDE-47 are antiestrogenic. Most PBDEs also have antiandrogenic activity. It is not clear, however, whether PBDEs affect human reproduction.

Objectives

The analysis was designed to investigate the potential endocrine disruption of PBDEs on the age at menarche in adolescent girls.

Methods

We analyzed the data from a sample of 271 adolescent girls (age 12–19 years) in the National Health and Nutrition Examination Survey (NHANES), 2003–2004. We estimated the associations between individual and total serum BDEs (BDE-28, -47, -99, -100, -153, and -154, lipid adjusted) and mean age at menarche. We also calculated the risk ratios (RRs) and 95% confidence intervals (CI) for menarche prior to age 12 years in relation to PBDE exposure.

Results

The median total serum BDE concentration was 44.7 ng/g lipid. Higher serum PBDE concentrations were associated with slightly earlier ages at menarche. Each natural log unit of total BDEs was related to a change of −0.10 (95% CI: −0.33, 0.13) years of age at menarche and a RR of 1.60 (95% CI: 1.12, 2.28) for experiencing menarche before 12 years of age, after adjustment for potential confounders.

Conclusion

These data suggest high concentrations of serum PBDEs during adolescence are associated with a younger age of menarche.     

中国9～18岁汉族女生月经初潮年龄的地域分布及趋势分析

目的:分析我国9～18岁汉族女生月经初潮年龄及1995年来的变化趋势。方法:利用2005年和1995年全国学生体质健康调研数据,2005年有效人数为92 767人,1995年有效人数为85 433人,用概率单位回归法计算月经初潮年龄(age at menarche,AAM)。结果:2005年我国女生的AAM为12.76岁,其中,城市女生为12.60岁,乡村女生为12.92岁,城市比乡村提前约0.32岁。各地区间AAM差异明显,华东、华北地区AAM最早,西南、中南、东北地区次之,西北地区最晚。AAM最早的前5个省级行政单位分别是北京(12.27岁)、上海(12.32岁)、四川(12.48岁)、福建(12.50岁)和天津(12.51岁);AAM最晚的5个省级行政单位分别是青海(14.09岁)、湖北(13.33岁)、黑龙江(13.10岁)、宁夏(13.08岁)和湖南(12.87岁)。2005年城、乡女生AAM分别比1995年提前0.22岁和0.34岁。结论:我国9～18岁汉族女生月经初潮发生城市早于乡村,西北地区最晚。女生月经初潮有提前的趋势,乡村较城市更明显;月经初潮在城乡间、地区间差异有缩小趋势。     

A cross-sectional survey of factors influencing bone mass in junior high school students

Objective

The purpose of this study is to investigate factors influencing the osteo-sono assessment index (OSI) in junior high school students (boys, girls who had reached menarche, and girls who had not).

Methods

A total of 9,743 students (4,974 boys and 4,769 girls) in Ehime Prefecture participated in this study. We measured body mass index (BMI) and calcaneal bone mass using OSI. In parallel, participants answered a questionnaire relating to age, sex, menarche, exercise habits, milk intake, and history of bone fractures during the preceding year. To determine the factors influencing OSI, we calculated an individual standardized partial regression coefficient (β) using multiple linear regression (MLR) analysis.

Results

For boys, MLR showed that BMI (β = 0.300), age (β = 0.260), current exercise habits (β = 0.106), and milk intake per day in primary school (β = 0.085) statistically significantly influenced OSI. For girls who had reached menarche, BMI (β = 0.302), current exercise habits (β = 0.237), age (β = 0.140), and bone fracture during the preceding year (β = 0.036) influenced OSI. For girls who had not reached menarche, current exercise habits (β = 0.242), BMI (β = 0.135), and age (β = 0.085) influenced OSI.

Conclusions

There were differences between the factors related to OSI among boys, girls who had reached menarche, and girls who had not. BMI, exercise habits, and age were the common factors related to OSI. Particularly for girls, exercise habits had a great influence on OSI.     

Age at menarche in Turkish adolescents in Kahramanmaras,Eastern Mediterranean region of Turkey

Objectives To determine the age at menarche in adolescents in the Eastern Mediterranean city of Kahramanmaras, Turkey.

Methods The study was conducted in primary and high schools of Kahramanmaras, during the academic year 2003–2004. Data of 8212 female students were collected by using a standard questionnaire. Mean and median ages at menarche (with 95% confidence intervals) were calculated by Kaplan–Meier survival analysis. Also, probit analysis was performed to determine the age at menarche for all girls by estimating the age at which 10, 25, 50, 75 and 90% of the girls reached menarche.

Results According to the answers obtained through the questionnaire, 5506 (67.5%) of 8161 respondents had had their menarche. Mean age at menarche was 13.04 years (95% CI: 13.01–13.06), and median age 13.00 years (95% CI: 12.97–13.03). According to probit analyses, the probability of menstruating before the age of 11.48 years was 10% and before 15.08 years 90%.

Conclusion We provide data about age at menarche in Kahramanmaras, an Eastern Mediterranean city of Turkey.     

Diurnal patterns of salivary cortisol across the adolescent period in healthy females

When examining the diurnal profile of the hormone cortisol in children and adolescents developmental issues are particularly relevant. Previous findings regarding relationships between cortisol secretory activity and reproductive (pubertal) maturation lack clarity and may reflect methodological inconsistencies between studies. This study examined the diurnal cortisol profile across female adolescence, with a particular focus on an obvious and unique marker of development: menarche. In a cross-sectional design, 61 healthy female adolescents aged 9-18 years (mean age 13.89 years, S.D.+/-2.72) collected eight saliva samples per day on two consecutive weekdays. Samples were collected at awakening, 15, 30 and 45min and 3, 6, 9 and 12h post-awakening in order to capture both the cortisol awakening response (CAR) and the subsequent period of decline. Demographic information was recorded and participants also completed the Spielberger State-Trait Anxiety Inventory. Patterns of cortisol secretion exhibited good intra-individual stability across the two sampling days. Participants evidenced a robust diurnal pattern, with cortisol levels peaking approximately 30-45min post-awakening (the CAR) and steadily declining concentrations over the remainder of the day. Differences according to developmental status (in terms of whether or not participants had experienced first menses: menarche) were observed in the time of peak secretion of the CAR, and these distinct patterns could not be accounted for by group differences in demographic, situational or psychological characteristics measured in this study. This effect for the CAR was associated with the onset of menarche alone, unlike cortisol levels over the remainder of the day. For those who had undergone menarche, were older and of greater BMI, cortisol levels remained higher over the day. There was a significant difference in cortisol concentrations at 6h post-awakening between pre- and post-menarche groups. Again, these differences in daytime cortisol secretory activity could not be attributed to situational or psychological factors. Establishing patterns of cortisol secretion in healthy female adolescents provides an important baseline from which to investigate hypothalamic-pituitary-adrenal (HPA) physiology, measured via salivary cortisol, in adolescent populations with known or suspected psychopathology.