中国北方人骨密度及影响因素的多元回归分析

目的：确定我国北方人群的峰值骨量并分析影响骨峰形成与丢失的相关因素。方法：随机抽取４２５例北方健康志愿者，测量骨密度并做详细的相关因素问卷调查。对影响因素作多元回归分析。结果：腰椎、股骨近端和全身的峰值骨量形成年龄，男性在２０岁～２４岁；女性除腰椎部位在３０岁～３４岁外，其余部位均在２５岁～２９岁，在随后的１５ａ内，骨量基本稳定或稍有下降。体重除与男性股骨颈骨密度无关外，与其它部位骨密度均显著相关（Ｐ＜００５）。男女性峰值骨量形成之前，青少年时期活动量与骨密度成正相关。峰值骨量形成之后，活动量与骨密度无统计学意义。青少年男性组Ｗａｒｄ氏和全身骨密度与每天吸烟支数呈负相关。女性腰椎部位骨密度与初潮年龄呈负相关。平均母乳喂养时间、茶叶消费、近５ａ活动量等因素与骨密度无关。结论：体重与骨密度显著相关；男性吸烟、女性初潮年龄对骨密度有一定的影响。男性２５岁、女性３０岁以前增加运动量有利于形成较高的峰值骨量，有助于预防骨质疏松的发生。     

青春期女性骨密度变化及相关影响因素分析

目的:分析9～16岁女性骨密度(BMD)值的差异及相关影响因素。方法:随机选取广西省桂林市和广东省广州市714名青春发育期女性(9～16岁) ,采用跟骨超声骨密度仪测量BMD ,采用问卷调查了解对骨密度有影响的生活因素。结果:青春期女性BMD 12岁较9岁高4 4 % ,14岁较12岁高6 . 0 % ,16岁较14岁高2 5 % ;户外活动时间超过6小时/周的女性BMD值高于不足6小时/周者(P <0 . 0 5 ) ;摄入牛奶量≥1杯/天(2 0 0ml/杯)的女性BMD值高于摄入不足1杯/天者(P <0 .0 5 ) ;月经初潮早的女性BMD值比月经初潮晚的女性高(P <0 . 0 5 )。逐步回归分析表明,对青春期女性BMD有影响的因素为月经来潮年限、体重和牛奶摄入量。结论:12～14岁是青春期女性BMD的快速增长期,青春期女性身高增长与BMD增长不同步;月经初潮晚于平均年龄的女性BMD值低;积极参加户外活动对青春期女性BMD积累有一定作用;维持适宜的体重和一定量牛奶的摄入有利于提高青春期女性BMD和达到理想的峰值骨量。     

蒙古族学生月经初潮年龄变化趋势与影响因素

目的分析蒙古族学生月经初潮年龄的变化趋势及影响因素,为学生性教育提供干预建议。方法对2000年7~18岁蒙古族学生的体质调研资料与1985年调查资料进行对比分析。采用概率单位回归法及多元回归分析法,进行月经初潮平均年龄及性发育与体质关系的研究。结果15年间,初潮平均年龄城乡分别提前0.81岁与0.72岁,平均每10年分别提前0.54岁和0.48岁。蒙汉族学生之间月经初潮年龄差异无统计学意义。城市月经初潮年龄与体重、维尔维克指数、肺活量及肺活量/胸围指数等4个因素有关;乡村月经初潮年龄与体重、肺活量、肺活量/胸围指数、身高及脉搏等5个因素有关。结论月经初潮年龄与体质因素关系密切。蒙古族城乡学生月经初潮均表现提前趋势,性教育应提前,加强青春期性教育尤为重要。     

Impact of being born small for gestational age on onset and progression of puberty

Children born small for gestational age (SGA) are at higher risk for perinatal morbidity, mortality and chronic diseases in later life. There is increasing evidence for a link between prenatal growth and pubertal development, but studies concerning the timing, duration and progression of puberty in these children are scarce and the results are difficult to compare due to the various methodologies employed. Most boys born SGA have normal pubertal timing, but often attain an adult height below the target height. In girls, most studies document a relationship between intra-uterine growth retardation and earlier pubertal development or normal timing but with rapid progression. This chapter will discuss the factors that could influence pubertal development in children born SGA and the information reported to date.     

Age at Menarche Among In-School Adolescents in Sawla Town,South Ethiopia

Background

Although a declining trend in age at menarche has been observed in developed countries over decades commonly attributed to childhood excessive weight gain and sedentary life, little is known about this case in the developing countries.

Methods

A cross-sectional study design and multistage sampling was used to include 660 school adolescents for analysis. Data collection included weight and height measurements. Multinomial logistic regression analyses were done for early and late age of menarche, in reference to average age at menarche, to measure the association of age at menarche with some socio-demographic variables and body habits.

Results

The mean age at menarche was 13.9±1.2 years (95%CI, 13.8–14.0). The menarche ages ranged between 10 and 12 years for 10.5%, 13 and 14 years for 54.5%, and 15+ years for 35%. Low menarche age was independently associated with high calorie consumption, high protein diet, more coffee intake, low physical activity and parents'' low educational background. Low body mass index, low parents'' income, exercise, and Amhara ethnic background were associated with late menarche age.

Coclusion

The mean menarche age found in this study was higher than the report from developed countries. But, the proportion of adolescents with low menarche age was comparable with reports from developed countries. Inactive adolescents were more likely to see menarche earlier than average age. Healthy eating habits, regular exercise and nutrition education need to be promoted among school children.     

Clinicopathological characteristics of ovarian tumours according to menarchal status in Korean girls

Aim: To evaluate our experience with ovarian tumours in young girls and to identify specific characteristics in relation to their menarchal status that might assist in the early diagnosis and prompt management. Methods: Girls younger than 18 years of age who had an adnexal tumour confirmed at surgery from 1985 to 2008 were identified from the pathology database of Hanyang University Medical Centre. Clinicopathological characteristics such as patient's age, age at menarche, presenting symptoms, operative findings and final histological diagnosis were analysed. Results: Twenty‐four of the 90 patients operated on for an ovarian tumour were pre‐menarchal and 66 were post‐menarchal. Most tumours were of germ cell origin: 83% of tumours in pre‐menarchal and 53% in post‐menarchal girls. Most of the patients complained of abdominal pain (～70%), although a palpable mass was identified in only 17% of pre‐menarchal and 30% of post‐menarchal patients. Vomiting was a major complaint in pre‐menarchal patients (30%) but was uncommon in post‐menarchal patients (<5%). The frequency of torsion was significantly higher in pre‐menarchal (50%) than in post‐menarchal (17%) patients, and more than 90% of the torsion in pre‐menarchal patients occurred in tumours of germ cell origin. Conclusions: The incidence of ovarian tumour and torsion is rare, especially in pre‐menarchal girls. However, we found a higher prevalence of torsion in pre‐menarchal girls with an ovarian tumour. A high level of suspicion for torsion should be considered when treating pre‐menarchal girls with an ovarian tumour, irrespective of the tumour size to preserve adnexal tissue.     

青春期及儿童卵巢肿瘤46例临床分析

目的：探讨儿童及青春期女性卵巢肿瘤的临床特点。方法：对我院46例青春期及儿童卵巢肿瘤患者的临床资料进行回顾性分析,所有病例均经手术及病理支持。结果：46例中良性肿瘤42例,恶性肿瘤4例;从组织学类型上看,包括生殖细胞肿瘤29例,上皮性肿瘤16例,性索间质肿瘤1例;月经初潮前生殖细胞肿瘤发生率较高,为51．72％,月经初潮后上皮性肿瘤的发生率较高,为93．75％;实性及混合性B超回声的卵巢肿瘤共19例,其中恶性肿瘤4例,囊性回声的卵巢肿瘤27例,其中恶性肿瘤0例。结论：肿瘤组织学类型与月经初潮与否有关,超声检查对卵巢肿瘤性质初步诊断有重要意义。     

Premenarcheal Mexican girls’ expectations concerning peri menstrual changes and menstrual attitudes

Background.?Eating, body weight and shape feelings and behaviours of female adolescents in relation to the time since their first menstrual period were studied.

Method.?Three hundred sixty three female school students, aged 12–17 years participated in a cross-sectional computer survey.

Results.?There was a significant increase in body weight following menarche including a rapid rise from 7–12 months after menarche (47.4 kg, 95% CI 45.2–49.7, 56.9 kg 95% CI 54.0–59.8). Students did not immediately adjust their perception of body weight to incorporate this rapid rise. The discrepancy between actual and desired weight was greatest 7–12 and 13–24 months after menarche. Weight losing behaviours and associated feelings around body image increased significantly following menarche in adolescents of all body weights. Increases were related to body weight and time since menarche, but not to age. Binge eating commenced more than 6 months after menarche and purging behaviour after 12 months.

Conclusion.?Both time since menarche and increase in body weight following menarche are associated with increasing concerns about eating, body image and weight losing behaviour. Some young women develop eating disorders. Menarche and subsequent weight gain appear as a risk factor for the onset of eating disorders.     

Sex features at menarche in relation to gonadotropin,estradiol and sex hormone-binding globulin concentrations in girls with constitutional delay of puberty. Preliminary report

Objective.?Constitutional delay of puberty (CDP) is the absence of secondary sexual features in otherwise healthy girls past the 13th year of life. The aim of the present work was to follow the development of estrogen-dependent sexual features, determine the concentrations of gonadotropins, estradiol and sex hormone-binding globulin (SHBG) in girls with CDP at menarche and compare the findings with normal controls.

Methods.?We enrolled 11 girls with CDP and 40 controls. Primary, secondary and tertiary sexual features were studied at menarche?±?3 months. The size of the ovaries and uterus was measured using transabdominal ultrasound. Maturation of breasts and pubic hair was staged according to Tanner. Concentrations of gonadotropins (follicle-stimulating hormone (FSH), luteinizing hormone) and estradiol were measured with immunoenzymatic methods. For measurement of SHBG, a radioimmunoassay was applied.

Results.?Menarche in CDP girls usually appeared with Stage IV or V of breast development and Stage IV of pubic hair development according to Tanner. CDP girls demonstrated a significantly smaller volume of the uterine body at menarche compared with controls (p?=?0.0004). Significantly lower levels of FSH (p?=?0.0363) and estradiol (p?=?0.0332), as well as a tendency towards lower levels of SHBG, were revealed in CDP girls at menarche.

Conclusion.?In CDP girls, menarche is accompanied by more mature tertiary sexual features, apparently resulting from longer exposure of estrogen-dependent tissues to the action of bioactive endogenous estrogens. The smaller volume of the uterine body in CDP girls at menarche may be attributed to decreased concentrations of FSH and estradiol, as well as to the possibility of decreased insulin-like growth factor-1 and increased neuropeptide Y levels.     

Secular trend of menarche in Zagreb (Croatia) adolescents

Objective

To study the secular trend of menarche in high-school urban adolescent girls (Zagreb, Croatia) over the last two decades, and to evaluate the possible impact of worsening of socio-economic conditions on age at menarche during the Croatian War of Independence (1991-1995).

Study design

Three surveys of female adolescents aged 15-19 years: (a) 523 girls interviewed in 1990, (b) 888 girls interviewed in 1997, and (c) 399 girls interviewed in 2010. Self-reported age at menarche (in decimal years) was presented by age groups and year of interview. Differences in mean age at menarche between adolescent age groups as well as between surveys were tested using One-way ANOVA.

Results

The mean age at menarche was 12.82 years in 1990, 12.92 years in 1997 and 12.31 years in 2010. It increased by 0.10 years from 1990 to 1997 (p = 0.290) and then declined by 0.61 years from 1997 to 2010 (p < 0.001). Over the 20-year period, the overall mean age at menarche declined by 0.51 years (p < 0.001).

Conclusion

The age at menarche in Zagreb adolescents continued to decline significantly from 1990 to 2010 (p < 0.001), in spite of a statistically insignificant initial increase between 1990 and 1997. When put in broader context, age at menarche mirrored socio-economic changes in the war period.