Secular trend in skeletal maturation in southern Chinese girls in Hong Kong

Southern Chinese girls aged 11 years 9 months to 12 years 3 months in Hong Kong have a mean skeletal age of 12.57 years assessed from the left hand and wrist radiographs by the Greulich and Pyle Atlas Method. Significant secular trend of earlier skeletal maturation was demonstrated with p less than or equal to 0.001. Such difference was contributed by improved socio-economic, nutritional and socio-hygienic conditions during the past decades.     

Current age of the menarche in Belgium

In Belgium, as in most industrialized countries, studies about menarcheal age have shown an earlier physical and sexual maturation. In this paper we will consider the secular trend in menarcheal age over the last twenty years in Brussels. The results concerning menstruation have been obtained in 1980-1982 from 1048 Belgian girls aged between 9 and 17. These girls have very varied socio-economic backgrounds, representative of the diversity of social origin in the Belgian population of Brussels (city and suburbs). Our data were collected using the status quo-method and compared with Jeurissen's (menarcheal age in Belgium between 1915 and 1959). Percentiles and probits were used. The lower limit, where 10% of the girls have had their menarches remains more or less constant. Between 1915 and 1959, Jeurissen noted the tendency of the median menarcheal age toward earlier sexual maturation from 14 years 4 months to 13.0. But, for the first time in Belgium, it seems that the median age is stabilized at 13.0 years. However, the higher limit (age, where 90% have had their menarches) is attained at a lower age: 15.0 for girls born between 1950-1954 and 14.0 in our sample. In conclusion, it seems that better conditions of life cause an evolution in the cases of late menarches but have no more repercussions on the median menarcheal age in this Belgian group.     

Age of the menarche of girls in Thessaloniki, Greece

In 1982-1983 a total of 977 girls from Thessaloniki has been investigated for their menarcheal ages, using the retrospective and the status quo methods. 565 of these girls aged between 11 and 18.5 years (age classes 1964-1972) were found to menstruate. The mean menarcheal age amounts to 12.0 years. The results are compared with corresponding data from literature. They confirm a clear secular trend for the menarcheal age in Greek population.     

Comparison of the Somatic and Psychosexual Maturation in Menarcheal and Nonmenarcheal Girls

This study reports on the relation between somatic and psychosexual development in 911 urban girls age 8 to 17 years. Subjects were examined by anthropometric and questionnaire methods. We compared the variability of somatic proportions and indexes in two groups of girls at the same age, but with different levels of maturation (menarcheal vs nonmenarcheal). We also assessed their attitudes and knowledge in spheres of sexuality, partners, and matrimonial relationships. We observed that menarcheal girls differed significantly for several anthropometrical values (body weight, sitting height, gluteal circumference, arm circumference) for some age groups, and we recorded significant differences in values of some indexes (Quetelet-Bouchard, Pignet-Vervaek, BMI). The psychosexual development of the girls was assessed by the questionnaire method. The girls were asked to explain various terms. The main aim of our questionnaire was to detect the existence of a relationship between somatic and psychosexual development, whether knowledge of menarcheal girls is more advanced than knowledge of nonmenarcheal girls. Our results show that although there is a significant somatic distinction between menarcheal and nonmenarcheal girls, we are not able to unambiguously state that menarcheal girls are more psychosexually developed.     

Menarcheal age of Turkish girls in Bremen

Several studies have shown that there is a Northwest-Southeast gradient in menarcheal age of European girls, with menarche occurring on the average about one year earlier in girls living in the Southern parts of Europe as compared with those from the Northern and Northwestern European countries. Eveleth & Tanner (1976) as well as Danker-Hopfe (1986a) suggested that this gradient is due primarily to genetic differences rather than climatic or nutritional variation. To substantiate this hypothesis menarcheal age of Turkish girls who lived in Bremen for several years has been investigated. The mean age at menarche estimated by probit analysis based on status quo data from n = 494 girls aged from 9.0 to 16.5 years was 12.90 +/- 1.21 years. These results correspond very well to those reported by Neyzi et al. (1975) for girls from Istanbul. On the other hand mean menarcheal age of Turkish girls living in Bremen is distinctly lower than mean age at menarche of urban German girls, living in the same district. In summary the results of the present study support the hypothesis of a predominantly genetic cause for the observed Northwest-Southeast gradient in age at menarche in Europe.     

A Comparison of Functional Outcome in Patients Sustaining Major Trauma: A Multicentre,Prospective, International Study

Objectives

To compare 6 month and 12 month health status and functional outcomes between regional major trauma registries in Hong Kong and Victoria, Australia.

Summary Background Data

Multicentres from trauma registries in Hong Kong and the Victorian State Trauma Registry (VSTR).

Methods

Multicentre, prospective cohort study. Major trauma patients and aged ≥18 years were included. The main outcome measures were Extended Glasgow Outcome Scale (GOSE) functional outcome and risk-adjusted Short-Form 12 (SF-12) health status at 6 and 12 months after injury.

Results

261 cases from Hong Kong and 1955 cases from VSTR were included. Adjusting for age, sex, ISS, comorbid status, injury mechanism and GCS group, the odds of a better functional outcome for Hong Kong patients relative to Victorian patients at six months was 0.88 (95% CI: 0.66, 1.17), and at 12 months was 0.83 (95% CI: 0.60, 1.12). Adjusting for age, gender, ISS, GCS, injury mechanism and comorbid status, Hong Kong patients demonstrated comparable mean PCS-12 scores at 6-months (adjusted mean difference: 1.2, 95% CI: −1.2, 3.6) and 12-months (adjusted mean difference: −0.4, 95% CI: −3.2, 2.4) compared to Victorian patients. Keeping age, gender, ISS, GCS, injury mechanism and comorbid status, there was no difference in the MCS-12 scores of Hong Kong patients compared to Victorian patients at 6-months (adjusted mean difference: 0.4, 95% CI: −2.1, 2.8) or 12-months (adjusted mean difference: 1.8, 95% CI: −0.8, 4.5).

Conclusion

The unadjusted analyses showed better outcomes for Victorian cases compared to Hong Kong but after adjusting for key confounders, there was no difference in 6-month or 12-month functional outcomes between the jurisdictions.     

Menarcheals age and socio-economical factors in Marrakech (Morocco)

Data on the menarcheal age was collected from a sample of 749 girls, aged between 11 and 17 years of age, drawn from the population of Marrakech (Morocco). The mean age at menarche calculated for the entire sample was of 14.26 year of age (SD=1.20). Once having grouped the girls according to the different environmental factors, we calculated the mean menarcheal age for earch group. Comparisons of these means show that only the family size and the number of sibling have an effect on the age at menarche.     

Menarcheal onset is associated with body composition parameters but not with socioeconomic status

In the present study the menarcheal status (pre-or postmenarcheal), body composition, weight status, and socioeconomic parameters such as type of school and parental educational level as of 1752 female adolescents ageing between 12 and 18 years (x = 14.6) from rural areas of Eastern Austria were documented. Furthermore the association patterns between body composition, socioeconomic parameters and menarcheal status were analyzed. It turned out, that body composition parameters such as BMI, lean body mass and absolute and relative fat mass were significantly associated with menarcheal status. Postmenarcheal girls were taller and exhibited a higher weight status, a higher absolute and relative amount of fat mass and a higher amount of lean body mass than their premenarcheal counterparts of the same age. In contrast to the significant association between body composition and menarcheal status, no significant impact of educational level on menarcheal status, indicating socioeconomic status could be documented.     

新疆伊犁六个民族的初潮年龄

1983年7月至1984年7月,用回忆法调查了新疆伊犁地区3972名12—23岁的女性的初潮年龄,其中哈萨克族924人,维吾尔族864人,锡伯族486人,回族209人,蒙古族216人,汉族1273人。其平均初潮年龄是:哈萨克族14.37±1.09岁,维吾尔族14.34±1.41岁,蒙古族14.21±1.05岁,回族13.89±1.32岁,锡伯族13.78±1.02岁,汉族13.61±1.11岁。各族中均以七、八、九三个月来月经的最多。此外,还发现六个民族中1969—1972年出生的与1961—1964年出生的相比,平均初潮年龄都明显提前。在八年中,回族提前2.67岁,蒙古族提前1.90岁,锡伯族提前1.78岁,汉族提前1.64岁,哈萨克族提前1.17岁,维吾尔族提前1.13岁。     

Correlation of skeletal maturation with stature and body weight of southern Chinese girls in Hong Kong

Correlations of skeletal maturation with stature and body weight were studied in one hundred and seventeen Southern Chinese girls aged eleven years nine months and twelve years three months born and brought up in Hong Kong. The skeletal maturation was assessed from the left hand and wrist radiographs by the Greulich and Pyle Atlas Method. The early maturers in skeletal development were significant taller and heavier than the late maturers with p less than 0.001.     

Average menarcheal age of higher socioeconomic status urban Cape Coloured girls assessed by means of status quo and recall methods

The age of the onset of menstruation has been determined for the urban middle-class Cape Coloured population. From 1987 to 1992 data were collected from 857 girls aged 8 to 20 years attending primary and secondary schools in Cape Town. The schools were specifically selected for the highest socioeconomic status (SES) of pupils' parents. Three-quarters of parents fell into the higher three categories of the 5-category SES standard. Girls were interviewed with respect to their menarcheal status and those who were postmenarcheal were also asked to report when they had started to menstruate. The probit analysis of the status quo data yielded average of 12.61 years and a standard deviation (s) of 1.25 years. The retrospective method was applied only to recall data of 258 girls falling into fully postmenearcheal categories (16–20 years). It yielded an average of 12.75 (s = 1.32), insignificantly different from that obtained from the probit analysis. The menarcheal age of higher SES Cape Coloured girls is significantly lower than that of white girls in Cape Town (13.30 years) and much lower than that of any group of black South African girls. It falls close to the lower limit of the range reported worldwide. Body heights, weights, and Body Mass Index indicate good growth status of girls studied.     

The timing of sexual maturation among boys and girls in eastern Poland, 1980–2000: A rural–urban comparison

The aim of this study was to determine secular changes in the sexual maturation of children and adolescents from Eastern regions of Poland between 1980 and 2000, with special attention paid to rural–urban differences. Our sample comprised 34,055 girls and 28,100 boys from 9 to 18 years of age. The age at which each gender reached each stage of sexual maturation was examined, along with menarcheal age in girls. An increase in the rate of sexual maturation was observed over the 20-year period of this study. Menarcheal age in girls decreased by 0.59 years. The length of sexual maturation decreased: from 6.58 years to 3.85 years in girls and from 5.84 years to 3.65 years in boys. A significantly faster rate of sexual maturation was observed between 1990 and 2000. Over the entire 20-year period, adolescents living in rural settings experienced a slower rate of sexual maturation than did their urban peers.     

Changes in age at menarche in Spain (1909–1965)

The data used in this work have been collected from clinical histories of women who have been examined at the Ginecology and Obstetritian Service of the Santa cruz y San Pablo Hospital of Barcelona. The sample consisted of 12,803 Spanish women, born between 1909 and 1965, by regions of birth. The method used is retrospective. The maximum menarcheal age in Spain (13.91±0.049 years) is found among those women born between 1925 and 1929 and the minimum menarcheal age (12.92±0.036 years) among women born between 1955 and 1959; so in an interval of 30 years, a reduction of almost a year (11.88 months) has taken place in age at first menstruation. This means a reduction of almost four months per decade. These differences are significant (p=.0000). The higher menarcheal age appears in the Northern Zone, due to the influence of Galicia in the sample (Galicia being a depressed zone with a great emigration rate). The earliest menarcheal age appears in the Mediterranean Zone due to the great percentage of catalan women (Catalonia being a region with a higher socioeconomical level). It is also to be observed that although the menarcheal age has decreased in all the zones, it has done so more dramatically in those zones which had higher values at the beginning. Although the secular trend of reduction in the age at menarche varies greatly from region to region, it may be considered that, in general, the socieconomic conditions have been the decisive factor in the change in physical maturation of Spanish women.     

Results of long-term studies of the development of children in Goerlitz in the last 3 decades

The author reports on the results of investigations concerning the development of 15173 girls born in G?rlitz between 1944 and 1973. With regard to maturation a significant tendency toward deceleration has been observed. Late menarche is increasing, while early menarche is decreasing. Seasonal influences on the development are discussed. September born girls, for example, are characteristic for a high menarcheal age, those born in December for a low menarcheal age. Furthermore one can assume some relations between the month of birth and the birthweight.     

Trends in Menarcheal Age between 1955 and 2009 in the Netherlands

Aim

To assess and compare the secular trend in age at menarche in Dutch girls (1955–2009) and girls from Turkish and Moroccan descent living in the Netherlands (1997–2009).

Methods

Data on growth and maturation were collected in 20,867 children of Dutch, Turkish and Moroccan descent in 2009 by trained health care professionals. Girls, 9 years and older, of Dutch (n = 2138), Turkish (n = 282), and Moroccan (n = 295) descent were asked whether they had experienced their first period. We compared median menarcheal age in 2009 with data from the previous Dutch Nationwide Growth Studies in 1955, 1965, 1980 and 1997. Age specific body mass index (BMI) z-scores were calculated to assess differences in BMI between pre- and postmenarcheal girls in different age groups.

Results

Median age at menarche in Dutch girls, decreased significantly from 13.66 years in 1955 to 13.15 years in 1997 and 13.05 years in 2009. Compared to Dutch girls there is a larger decrease in median age of menarche in girls of Turkish and Moroccan descent between 1997 and 2009. In Turkish girls age at menarche decreased from 12.80 to 12.50 years and in Moroccan girls from 12.90 to 12.60 years. Thirty-three percent of Turkish girls younger than 12 years start menstruating in primary school. BMI-SDS is significantly higher in postmenarcheal girls than in premenarcheal girls irrespective of age.

Conclusion

There is a continuing secular trend in earlier age at menarche in Dutch girls. An even faster decrease in age at menarche is observed in girls of Turkish and Moroccan descent in the Netherlands.     

BMI and waist circumference in predicting cardiovascular risk factor clustering in Chinese adolescents

Objective: To derive the optimal BMI and waist circumference (WC) cut‐off values to predict clustering of cardiovascular risk factors in Hong Kong Chinese adolescents. Research Methods and Procedures: A total of 2102 Hong Kong Chinese 12 to 19 years of age were recruited. Participants were considered to have clustering of risk factors if at least three of the following risk factors were present: 1) high‐density lipoprotein cholesterol (HDL‐C) ≤1.03 mM, 2) low‐density lipoprotein cholesterol (LDL‐C) ≥2.6 mM, 3) triglyceride (TG) ≥1.24 mM, 4) fasting plasma glucose (FPG) ≥6.1 mM, and 5) age‐, sex‐, and height‐adjusted systolic or diastolic blood pressure (BP) ≥ 90th percentile. Receiver operating characteristics (ROC) curves were generated to identify the optimal age‐adjusted BMI and WC cut‐off values to predict clustering of risk factors in boys and girls separately. These age‐adjusted BMI and WC cut‐offs were transformed to percentile values. Cole's lambda‐mu‐sigma (LMS) method was used to obtain smoothed age‐specific BMI and WC at these percentile values. Results: The areas under ROC curves for BMI in girls and boys were 0.85 [95% confidence interval (CI), 0.77 to 0.92] and 0.76 (95% CI, 0.66 to 0.85), respectively. The respective areas under ROC curves for WC in girls and boys were 0.82 (95% CI, 0.74 to 0.91) and 0.78 (95% CI, 0.68 to 0.87). The optimal BMI thresholds were at the 78th percentile for girls and the 72nd percentile for boys. The respective values for WC were at the 77th percentile for girls and the 76th percentile for boys. The sensitivities and specificities of these cut‐off values ranged from 72% to 80%. Discussion: Age‐ and sex‐specific BMI and WC cut‐off values can be used to identify adolescents with clustering of cardiovascular risk factors.     

A forty-five year investigation for secular changes in physical maturation

In a stable, economically- and educationally-privileged population of 180 subjects observed from birth to beyond the period of maximum growth in height, no secular changes toward larger size or earlier adolescence were observed between the earlier-born and later-born boys or girls of the Child Research Council study series. The mid-birthdate for the 45 years of data collection was January 1, 1940 for the girls and May 1, 1936 for the boys. With none of the mean differences significant at the 0.05 level of confidence, the earlier-born subjects were both slightly taller and heavier from birth and, for the girls, adolescence was slightly earlier. Forty pairs of like-sexed siblings were included in the data. Coefficients of correlation were statistically significant for birthweight and menarcheal ages for the sisters and for height and weight at the age of maximum increment of growth in height for both sexes. In 12 of the 16 pairs of sisters, the older menstruated at an earlier age than the younger.     

Intake of Dairy Products,Calcium, Magnesium,and Phosphorus in Childhood and Age at Menarche in the Tehran Lipid and Glucose Study

Purpose

Studies indicate that milk intake is associated with insulin-like growth factor 1 (IGF-1) concentrations and height in childhood, whether milk and other dairy products promote puberty remains unclear. This study aimed to investigate influences of pre-pubertal intakes of milk, yogurt and cheese on menarcheal age in Tehranian girls. The associations of total dietary calcium (Ca), magnesium (Mg), and phosphorus (P) with menarcheal age were also examined.

Methods

This prospective study was conducted on 134 pre-pubertal girls, aged 4-12 years at baseline, who participated in the Tehran Lipid and Glucose Study (TLGS), and were followed for a median of 6.5 years. Dietary intakes were determined at initiation of the study using two non-consecutive 24-h dietary recalls and the age of menarche was documented during the follow-up. Logistic regression was used to calculate the risk of reaching menarche ≤ 12 years according to pre-pubertal levels of dairy or mineral intakes.

Results

The risk of earlier menarche was higher in girls with higher intakes of milk [OR: 2.28 (95% CI: 1.03–5.05)], Ca [OR: 3.20 (95%CI: 1.39–7.42)], Mg [OR: 2.43 (95% CI: 1.12–5.27)] and P [OR: 3.37 (95 % CI: 1.44–7.87) after controlling for energy and protein intake, interval between the age at study initiation and the age of menarche, and maternal age at menarche (Model 1). Girls in the middle tertile of cheese intakes had a lower risk of reaching menarche ≤ 12 years than those in the lowest tertile after controlling for covariates in model 1. These associations remained significant after further adjustment of BMI Z-score at baseline. The relationship of Ca, Mg, and P with menarche remained after further adjustment for height Z-score at baseline, whereas the association between milk and cheese intakes became non-significant.

Conclusions

Pre-pubertal intake of milk, but not cheese and yogurt, may hasten age at menarche.     

Age at menarche among the Bhotias of Mana Valley

The mean menarcheal age of the Bhotia girls of Mana Valley (Uttar Pradesh) has been found to be 16.38 +/- 1.53 years, which is the highest value so far reported from Indian populations. It is observed that altitude and nutritional status have a great bearing on the onset of menarche. The results obtained are compared with those from other Indian populations.     

Secular trends of stature and weight of Chinese girls.

Stature and weight were studied in 123 12-year-old Southern Chinese girls born and brought up in Hong Kong. The mean stature was 147.22 centimetres with a standard deviation of 6.65 centimetres. The mean body weight was 37.11 kilograms with the standard deviation being 7.39 kilograms. Secular trend of increased body size was demonstrated. The increase was more marked in the lower percentile groups.