Nutritional, glycometabolic and genetic factors affecting menarcheal age in cystic fibrosis

Aims of this study were to investigate menarcheal age (MA) and menarcheal determinants in 25 girls with cystic fibrosis (CF) and to compare their MA with their respective mothers'. Patients' MA (13.3 +/- 1.1 yr) was on average significantly higher (p<0.0005) than that of the respective mothers (12.2 +/- 1.0 yr) and positively related to it (r=0.055, p<0.005). Six girls experienced menarche after 14.2 yr, ie after the uppest limit of their mothers' MA range. The only parameter which significantly differentiated these 6 patients from the remaining 19 cases was body mass percentile (BMP). Moreover, in the entire patient series a negative correlation was found between MA and BMP. None of the other clinical parameters correlated significantly with MA. No differences in terms of MA were detected in the subgroups of patients with a different glucose tolerance (GT) status and the 12 girls with a pathological GT were not older at menarche than those with normal GT. No correlations were found between either glucose or insulin areas during oral GT test and MA. In the subgroups of patients with a different genotype menarche occurred at a similar age, irrespectively of their genotype. On the basis of our findings we conclude that: a) a menarcheal delay of approximately 1 yr exists between CF girls and their mothers; b) menarcheal delay in CF is not related to either genotype or disease severity or glycometabolic status; c) the only two factors which are able to affect MA in CF are maternal MA and nutritional status.     

TAKING A DIFFERENT PATH: MENSTRUAL PREPARATION FOR ADOLESCENT GIRLS LIVING APART FROM THEIR MOTHERS

Menarche is a significant yet anxiety producing event. Preparation for menarche combats this anxiety. When adolescent girls reach menarche they often seek information about menstruation from their mothers. Yet not every girl lives with her mother. The purpose of my grounded theory study is to explore the menarcheal experience of 16 girls living without their mothers. The findings indicate that prior to menarche participants experienced similarities to girls who lived with their mothers. Differences became apparent at menarche when participants had to wait for an available female to answer questions, did not have a female available to ask, or felt embarrassed discussing menstruation with their fathers. Providers need to be sensitive to menarcheal preparation issues for girls living without their mothers.     

Taking a different path: menstrual preparation for adolescent girls living apart from their mothers

Menarche is a significant yet anxiety producing event. Preparation for menarche combats this anxiety. When adolescent girls reach menarche they often seek information about menstruation from their mothers. Yet not every girl lives with her mother. The purpose of my grounded theory study is to explore the menarcheal experience of 16 girls living without their mothers. The findings indicate that prior to menarche participants experienced similarities to girls who lived with their mothers. Differences became apparent at menarche when participants had to wait for an available female to answer questions, did not have a female available to ask, or felt embarrassed discussing menstruation with their fathers. Providers need to be sensitive to menarcheal preparation issues for girls living without their mothers.     

Update on Age at Menarche in Italy: Toward the Leveling Off of the Secular Trend

PurposeTo update the information on age at menarche in the Italian population and to verify the influence of genetic, nutritional, and socioeconomic factors on menarcheal age. Recent studies suggest that the magnitude of the secular trend toward an earlier age at menarche is slackening in industrialized countries.MethodsThis multicenter study was conducted on a large, population-based sample of Italian high school girls (n = 3,783), using a self-administered questionnaire. The questionnaire was used to gather information on the girls, including demography, anthropometry, menarcheal date, regularity of menses, behavioral habits, and physical activity. The questionnaire was also used to gather information on parents, including demography and mothers' and sisters' menarcheal ages. The median age at menarche and its 95% confidence interval were estimated by means of Kaplan-Meier survival analysis. To identify the independent predictive factors of age at menarche, multivariate mixed-effects models were applied.ResultsThe median age at menarche of the subjects was 12.4 years (95% confidence interval: 12.34–12.46). The girls had their first menses approximately one-quarter of a year (median–0.13) earlier than did their mothers (p < .0001). Among all variables, parents' birth area, body mass index, family size, and the mother's menarcheal age were significantly and independently associated with age at menarche.ConclusionsThis study confirmed the reduction in the trend toward earlier menarche in Italy. The results also confirmed that genetic and nutritional factors are strong markers for early menarche. Currently, socioeconomic factors do not seem to play as significant a role as in the past.     

Nutritional factors affecting the menarcheal state of adolescent school girls in Alexandria

The nutritional status of adolescents plays a dominant role in determining the maturation status. The aim of the present work was to assess the mean age of menarche and the main nutritional factors affecting it. A cross-sectional study of 1606 girls was conducted in primary and preparatory schools in Alexandria. Every girl was subjected to anthropometric assessment including weight, height, mid upper arm circumference (MUAC), waist circumference, hip circumference and triceps skin-fold thickness. BMI and body fat percentage were calculated. A 24 hours diet recall method was used to assess the dietary intake. The mean age of menarche was 11.98+/-0.96 years. The mean MUAC, triceps skin-fold thickness, waist circumference and hip circumference were significantly higher among menstruating girls as compared to non-menstruating. (p<0.01). Only 7.5% of the females less than the 5th percentile of BMI (thinness) were menstruating, while the corresponding figure for those at or more than 85th percentile (overweight) was 65.6% and this was statistically significant (X 2 (2) =102.8, P<0.001). Girls who attained menstruation demonstrated a higher significant mean percent of body fat (43.40+/-10.0) as compared to non menstruating ones (35.41+/-7.87), ( t=17.09, P<0.001). The oldest age at menarche was noted when the protein, iron and caloric intake was less than 80% of the RDAs. However after adjustment of other variables direct relation was detected between age of girls and their age of menarche and those in private school had earlier age of menarche than those in governmental one. The nutritional status of the adolescents had a significant association with the onset of menstruation and the age at menarche.     

Maternal Pre-pregnancy BMI, Gestational Weight Gain, and Age at Menarche in Daughters

Life course theory suggests that early life experiences can shape health over a lifetime and across generations. Associations between maternal pregnancy experience and daughters’ age at menarche are not well understood. We examined whether maternal pre-pregnancy BMI and gestational weight gain (GWG) were independently related to daughters’ age at menarche. Consistent with a life course perspective, we also examined whether maternal GWG, birth weight, and prepubertal BMI mediated the relationship between pre-pregnancy BMI and daughter’s menarcheal age. We examined 2,497 mother-daughter pairs from the 1979 National Longitudinal Survey of Youth. Survival analysis with Cox proportional hazards was used to estimate whether maternal pre-pregnancy overweight/obesity (BMI ≥ 25.0 kg/m²) and GWG adequacy (inadequate, recommended, and excessive) were associated with risk for earlier menarche among girls, controlling for important covariates. Analyses were conducted to examine the mediating roles of GWG adequacy, child birth weight and prepubertal BMI. Adjusting for covariates, pre-pregnancy overweight/obesity (HR = 1.20, 95 % CI 1.06, 1.36) and excess GWG (HR = 1.13, 95 % CI 1.01, 1.27) were associated with daughters’ earlier menarche, while inadequate GWG was not. The association between maternal pre-pregnancy weight and daughters’ menarcheal timing was not mediated by daughter’s birth weight, prepubertal BMI or maternal GWG. Maternal factors, before and during pregnancy, are potentially important determinants of daughters’ menarcheal timing and are amenable to intervention. Further research is needed to better understand pathways through which these factors operate.     

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.     

Fifty-year trends in serial body mass index during adolescence in girls: the Fels Longitudinal Study

BACKGROUND: A decline in the age at menarche was recently reported for US girls. Although it is possible that this recent drop stems from the concurrent increase in childhood obesity, few longitudinal studies of growth and development have been undertaken to specifically address the temporal relation between growth, adiposity, and the age at menarche. OBJECTIVE: The objective was to simultaneously examine the effects of birth cohort (secular trend) and rate of maturation (age at menarche) on the timing and pattern of increases in body mass index (BMI) during adolescence in girls. DESIGN: We applied mixed-effects polynomial models to serial BMI data, spanning from 6 y before menarche to 6 y after menarche, obtained from 211 girls enrolled in the Fels Longitudinal Study. We examined the effects of birth cohort (defined as girls born 1929-1946, 1947-1964, and 1965-1983) and age at menarche (defined as < or =11.9 y, 12.0-13.1 y, and > or =13.2 y) on the magnitude and velocity of BMI during adolescence. RESULTS: BMI and BMI velocity in girls born after 1965 were significantly greater than those of girls of earlier birth cohorts, despite stability in the mean age at menarche. Although girls with early menarche tended to have significantly higher BMIs than did girls with average or later menarche, these differences did not emerge until after menarche. CONCLUSION: These data suggest that increases in relative weight are a consequence, rather than a determinant, of the age at menarche and that secular changes in BMI and in the mean age at menarche could be independent phenomena.     

Body mass index in children and adolescents according to age and pubertal stage

OBJECTIVE: To evaluate the dependence of body mass index (BMI) values on pubertal stage in subjects similar in age. DESIGN, SUBJECTS AND MEASUREMENTS: Height and weight were recorded cross-sectionally in school subjects from three provinces in central Italy. The subjects were subdivided into three groups: (1) 4271 school subjects (2125 males and 2146 females; 8.5-15.5 y old), in whom the pubertal development was also recorded, were selected to subdivide BMI values according to pubertal stage and age; (2) 6345 females (10.5-14.5 y old), who were asked whether or not they had had their first menstrual period, were selected to subdivide BMI values according to age in pre-menarche and post-menarche girls, separately; and (3) 1919 females (10.5-14.5 y old), who had presented their menarche within the previous 6 months, were selected to subdivide short-term post-menarche BMI values according to age. RESULTS: The medians and interquartile ranges of BMI varied according to age and pubertal stage. Kruskall-Wallis test performed in subjects similar in age demonstrated that significant differences existed among the medians of BMI values of subjects at different pubertal stages in 12-14-y-old males (P<0.05), and in 11-14-y- old females (P<0.001). The difference also proved to be significant between stage I and stage II (P<0.05) in 10-y-old females, but not in 10-11-y-old males. The Kruskal-Wallis test performed in subjects similar in pubertal stage demonstrated that significant differences among the medians of BMI at different ages existed only in females at stages II and III. A significant positive trend was observed in both genders according to pubertal stage for BMI values of subjects similar in age (z-test for trend, P<0.01). On the contrary, a negative age trend proved to be significant in females at stages I (P<0.01), II (P<0.01) and III (P<0.001), but not in males when the subdivision of BMI was made according to age in subjects similar in pubertal stage. BMI values were significantly higher in post-menarche girls as compared to pre-menarche girls similar in age (P<0.001). However, at partial regression analysis BMI values were influenced by pubertal stage and, to a lesser extent, by age, but not by menarcheal status. An inverse association between short-term post-menarche BMI and age was observed, with the highest values in girls presenting menarche at 11 y of age (P<0.05). The negative trend was demonstrated at the z-test for trend (P<0.001). CONCLUSIONS: BMI values depend on pubertal degree of maturation, especially in girls. This influence should be taken into account when BMI is evaluated in adolescents. Sponsor: University of Perugia, Region of Umbria.     

Correlation of body mass index levels with menarche in adolescent girls in Shaanxi,China: a cross sectional study

Background

Menarche is a milestone for adolescent girls. The timing of menarche is influenced by genetics, social status and nutritional status (e.g., height, weight and body mass index [BMI]) and impacts future health (e.g., obesity and breast cancer). There have been many studies on trends in age at menarche among adolescent girls in China, but few have investigated associations between growth status and the timing of menarche. This study examined the association between age at menarche and growth status among adolescent girls in Western China.

Methods

The participants in this cross sectional study came from three geographical regions of Shaanxi Province. A total of 533 adolescent girls from urban and rural areas were randomly selected. Trained investigators administered a standard questionnaire to each participant during a face-to-face interview and carried out anthropometric measurements.

Results

The average age at menarche was 13.3 years. There were statistically significant differences in BMI z-scores between pre-menarcheal and post-menarcheal girls of the same age and these differences were related to socioeconomic factors. Girls who had reached menarche, in particular those aged 13–14 years, were significantly taller (P?<?0.01) and had higher BMI (P?<?0.01) than girls in the same age group who had not reached menarche.

Conclusions

BMI is associated with the timing of menarche but socioeconomic factors are also important.

     

A prospective cohort study of nutrient intake and age at menarche

A cohort of 213 girls (aged 10 y, range +/- 9 mo) whose parents reported their dietary intakes (including nutritional supplements) using a semiquantitative food frequency questionnaire, was followed for 4 y until 82% of the 194 parents who responded to follow-up letters had reported that their daughters had had their first menstrual periods. The relative risk (RR) of menarche before age 12.5 y was 2.0 [95% confidence interval (CI) = 1.1-3.8] for the tallest girls (greater than 150 cm) compared with the shortest girls (less than 130 cm). The RR was 2.1 (95% CI = 1.1-3.8) for the fattest girls [Quetelet's index of relative weight (in kg/m2) greater than 19] vs the leanest girls (less than 15). After adjusting for height and Quetelet's index, menarcheal age was not associated with intake of energy nor energy-adjusted intake of protein, fat, or carbohydrate. The overall results are consistent with the hypothesis that nutritional factors influence age at menarche mainly through their effects on accumulation of adipose tissue.     

Socioeconomic status and age at menarche in indigenous and non-indigenous Chilean adolescents

The objective was to analyze the relationship between socioeconomic status and age at menarche among indigenous and non-indigenous girls in the Araucanía Region of Chile, controlling for nutritional status and mother's age at menarche. A total of 8,624 randomly selected girls from 168 schools were screened, resulting in the selection of 207 indigenous and 200 non-indigenous girls who had recently experienced menarche. Age at menarche was 149.6 ± 10.7 months in the indigenous group and 146.6 ± 10.8 months in the non-indigenous group. Among the non-indigenous, the analysis showed no significant association between age at menarche and socioeconomic status. In the indigenous group, age at menarche among girls with low socioeconomic status was 5.4 months later than among those with higher socioeconomic status. There were no differences in nutritional status according to socioeconomic level. Obesity was associated with earlier menarche. Menarche occurred earlier than in previous generations. An inverse relationship between socioeconomic status and age at menarche was seen in the indigenous group only; low socioeconomic status was associated with delayed menarche, regardless of nutritional status or mother's age at menarche.     

The relationship of childhood adiposity to parent body mass index and eating behavior

OBJECTIVE: To better understand risk factors for the development of obesity in early childhood, we examined the association between children's adiposity and their parents' eating behavior and body mass index (BMI). RESEARCH METHODS AND PROCEDURES: Parents of 85 white children 36 months of age (49 boys and 36 girls) completed the Three-Factor Eating Questionnaire measuring three dimensions of parent eating behavior: disinhibited eating, cognitive restraint of eating, and susceptibility to hunger. Parent BMI (kg/m2) was calculated using self-reported height and weight. The children's percentage body fat was assessed by dual energy X-ray absorptiometry analysis. RESULTS: Twenty-six percent of parents were obese (BMI > or = 30 kg/m2). Both maternal and paternal BMI were associated with higher scores for disinhibition (r = 0.69 and r = 0.68, p < 0.001), and maternal BMI was also associated with higher scores for hunger (r = 0.51, p < 0.001). There were no significant relationships between children's percentage body fat and parent eating scores, and the correlation between children's percentage body fat and parent BMI was significant only between mothers and daughters (r = 0.35, p = 0.04). Obese parents were no more likely to have a child who was fatter (upper quintile of percentage body fat for gender). DISCUSSION: Among 36 month-old white children, parent eating behavior was related to parent BMI, but not to children's adiposity. There was only a weak relationship between parent BMI and child adiposity. Despite the aggregation of adiposity within families due to shared genes and environments, children may not express differences in susceptibility to obesity by 3 years of age.     

Association of age at menarche with cardiovascular risk factors, vascular structure, and function in adulthood: the Cardiovascular Risk in Young Finns study

BACKGROUND: It is unclear whether age at menarche is an independent determinant of future cardiovascular risk. OBJECTIVE: We aimed to determine whether menarcheal age is an independent predictor of body mass index (BMI) and a wide range of cardiovascular risk factors in adolescence and adulthood. DESIGN: We examined the associations of menarcheal age with BMI (in kg/m(2)) and other cardiovascular risk factors in adolescence and adulthood in a population-based sample of 794 female adolescents aged 9-18 y at baseline. Their age at first menstruation was requested at baseline and again 3 and 6 y later. Cardiovascular risk factors were assessed at baseline and at age 30-39 y. RESULTS: A 1-y decrease in menarcheal age was associated with 0.81 (95% CI: 0.53, 1.08) higher adult BMI as well as greater waist circumference and waist-to-hip ratio, elevated systolic blood pressure, higher insulin resistance, and greater risk of metabolic syndrome (P < 0.05 for all). In multivariable analysis in which these adult risk factors were mutually adjusted for, only the inverse association between age at menarche and adult BMI remained. However, this inverse association was lost after adjustment for premenarcheal BMI (beta: -0.16; 95% CI -0.55, 0.23; P = 0.42). Higher premenarcheal BMI predicted earlier menarche, and the strong association between premenarcheal BMI and adult BMI was robust to adjustment for age at menarche. CONCLUSIONS: These findings suggest that early menarche is only a risk marker. Greater childhood BMI seems to contribute to earlier age at menarche and, because of tracking, greater adult BMI and associated cardiovascular risk. An independent effect of early menarche on adult adiposity cannot be excluded, but it is likely to be small at best.     

安徽省汉族女生月经初潮与体脂关系

目的了解安徽省女生月经初潮及初潮前后体脂变化情况,为采取干预措施和健康教育提供理论依据。方法按照2005年全国学生体质调研要求,采用分层整群抽样方法,对安徽省南、中、北3个地区城乡9-18岁中小学女生3000人进行调查,并测量体质指数（BMI）、腹部皮脂厚度、上臂皮脂厚度和肩胛下皮脂厚度4项指标。结果城市女生半数月经初潮平均年龄为12.76岁,农村女生13.11岁,城乡最小月经初潮年龄均为10岁。体质指数、腹部皮脂厚度、上臂皮脂厚度和肩胛下皮脂厚度4项指标均值来潮组均大于未来潮组,差异有统计学意义,P〈0.01。结论月经初潮年龄与体脂因素关系密切;安徽省汉族学生月经初潮年龄呈现提前趋势,性教育应提前,加强青春期性教育尤为重要。     

Age at menarche in relation to maternal use of tobacco, alcohol, coffee, and tea during pregnancy

To investigate the potential effects of common early life exposures on age at menarche, the authors examined data collected in a follow-up study of pregnancies that occurred during the 1960s in California. Among 994 female offspring interviewed as adolescents, 98% had started their menstrual periods at a mean age of 12.96 years. After adjustment, the mean age at menarche was a few months earlier among girls whose mothers smoked a pack or more of cigarettes daily during pregnancy compared with unexposed girls (difference = -0.22 years, 95% confidence interval (CI): -0.49, 0.05) and more so among girls who were not White (difference = -0.52 years, 95% CI: -1.1, 0.08). Girls with both high prenatal and childhood passive smoke exposure had an adjusted mean age at menarche about 4 months earlier than those unexposed. The daughter's mean age at menarche varied little by maternal prenatal alcohol consumption. Daughters of tea consumers had a later mean age (difference = 0.41 years at >/= 3 cups (0.7 liter)/day, 95% CI: 0.03, 0.80) and were more likely to start menarche later (>13 years) (odds ratio = 1.7, 95% CI: 0.91, 3.2), but daughters of coffee consumers did not. These suggestive findings, which merit further investigation, may be related to hormonal effects.     

Secular trends in age at menarche in women in the UK born 1908-93: results from the Breakthrough Generations Study

Menarcheal age decreased over time in Western countries until cohorts born in the mid-20th century. It then stabilised, but limited data are available for recent cohorts. Menarche data were collected retrospectively by questionnaire in 2003-10 from 94,170 women who were participating in the Breakthrough Generations Study, aged 16-98 years, born 1908-93 and resident in the UK. Average menarcheal age declined from women born in 1908-19 (mean=13.5 years) to those born in 1945-49 (mean=12.6 years). It was then stable for several birth cohorts, but resumed its downward trend in recent cohorts (mean=12.3 years in 1990-93 cohort). Trends differed between socio-economic groups, but the recent decline was present in each group. In conclusion, menarcheal age appears to have decreased again in recent cohorts after a period of stabilisation.     

Age at menarche in Canada: results from the National Longitudinal Survey of Children &; Youth

Background  

Given the downward trend in age at menarche and its implications for the reproductive health and wellbeing of women, little is known about menarcheal age in Canada. Most Canadian studies are only representative of specific populations. The present study, therefore, aims to assess the distribution of age at menarche for Canadian girls and explore its variation across socio-economic and demographic factors.     

Mothers and daughters: intergenerational patterns of reproduction

BACKGROUND: The objective of this study was to assess intergenerational mother-daughter patterns of reproduction. METHODS: In 1966, 12 055 pregnant women in Northern Finland, representing 96% of all births in the region, responded to a questionnaire in mid-gestation. In 1997-98, the 31-year-old daughters born from those pregnancies were sent a questionnaire and 4523 (80%) responded. Reproduction was compared between all mother-daughter pairs (n=4523) and separately for the pairs (n=489) of similar age (mothers 30-32 years). RESULTS: The menarcheal ages of the mothers and their daughters correlated slightly (Spearman correlation coefficient 0.206). The probability of the daughter to be multiparous was higher if her mother was multiparous at the time of the daughter's birth than if she was not. No association in the rate of spontaneous abortions was found. The first pregnancy of the daughters born from unwanted pregnancies was more often unwanted than the first pregnancy of the wanted daughters, after adjusting for parity (P=0.004). The analysis of the age-matched mother-daughter pairs gave similar results. CONCLUSION: A positive association between mothers and daughters in menarcheal age, parity and desirability of pregnancy was found.     

Psychosocial risk and correlates of early menarche in Mexican-American girls

Mexican-American girls have one of the fastest rates of decline in age at menarche. To date, no study has addressed the role of psychosocial factors on age at menarche in this population. Using data from a longitudinal cohort of Mexican-American girls from the Houston, Texas, metropolitan area recruited in 2005, the authors investigated associations between family life and socioeconomic environment and age at menarche in 523 girls. After adjusting for maternal age at menarche, daughter's age, and body mass index at baseline, perception of family life environment as conflict-prone was significantly associated with an earlier age at menarche (< 11 years). Additionally, there was a 2-fold higher risk (odds ratio = 2.22, 95% confidence interval: 1.12, 4.40) of early menarche among daughters of mothers who were single parents compared with those who were not. Furthermore, girls who matured early had a 2.5-fold increased risk (odds ratio = 2.69, 95% confidence interval: 1.04, 6.96) of experimenting with cigarettes compared with those who had an average-to-late age at menarche (≥ 11 years). This study provides important information regarding the role of family life environment and single parenting on age at menarche in Mexican Americans. Awareness of the impact of the family life environment and fathers' absence during the early years should be emphasized when addressing early age at menarche across cultures.