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1.
青春期多囊卵巢综合征(PCOS)的诊断具有一定的临床挑战性。迄今未有报道青少年人群PCOS的患病率以及临床、超声和生化特征。为了评估PCOS的临床和生化特征在14~16岁月经初潮女孩中的普遍程度,确定内循环雄激素水平在卵泡期早期的正常范围。本研究进行了一项前瞻性群组研究,研究群组是244名未经选择的月经初潮后的女孩,平均年龄在15.2岁。从一个大的以人口为基础的出生群组(Raine队列)中招募受试者。临床高雄激素血症(HA)使用Ferriman-Gallwey评分进行量化。在卵泡期的初期(第2~第6天),本研究使用免疫法测定循环雄激素和性激素结合球蛋白,并通过经腹部超声检查来评估卵巢形态,得到了青少年女性群体卵泡期初期的雄激素的正常范围。循环游离睾酮水平的前5%和10%分别为45.6 pmol/L和34.5 pmol/L。51%的女孩报告月经不规律。临床HA是罕见的,仅观察到3.5%的女孩罹患此病。平均卵巢体积大于其他报道中成年妇女的卵巢体积,35%的女孩在经腹超声时显示有多囊卵巢形态。按照游离睾酮数值排序,取前5%作为HA。42名女孩(18.5%)符合PCOS的Rotterdam标准,11个女孩(5%)雄激素超出社会标准。本研究表明,月经不规律在青春期是常见的,不涉及临床或生化HA。卵巢体积和形态的PCOS诊断在青春期可能有局限性。  相似文献   

2.
The study is aimed at investigating the association of serum irisin, neuregulin 4 (NRG4), and anti-müllerian hormone (AMH) with adolescent obesity with polycystic ovary syndrome (PCOS) and the efficacy of weight management interventions. Serum levels of irisin, NRG4, AMH, sex steroid hormone, body mass index (BMI), serum insulin, and C-peptide were measured in 52 obese adolescent girls with PCOS (PCOS group) and 43 obese adolescent girls without PCOS (non-PCOS group). The levels of AMH, NRG4, serum irisin, sex steroid hormones, BMI, serum insulin, and C-peptide were evaluated in obese PCOS girls before and after one year weight management. The levels of AMH, serum insulin, NRG4, and total testosterone of PCOS group were significantly higher than those of non-PCOS group. On the contrary, serum irisin and serum C-peptide in PCOS group were significantly lower than that in non-PCOS group. The levels of fat mass, percent body fat, total testosterone, AMH, NRG4, and serum insulin in the obese girls with PCOS showed significant decreases compared with before weight management intervention. On the contrary, after one year of body weight management intervention, serum irisin and serum C-peptide was significantly increased. Adolescent obesity complicated with PCOS is significantly associated with glucose and lipid metabolism and sex steroid hormone disorders, but the exact pathophysiological and clinical features are highly variable. Weight management intervention can significantly improve the clinical symptoms and hematological indicators, serum irisin and NRG4 can be used as two essential biomarkers for evaluating weight management.  相似文献   

3.
Age at menarche is associated with anthropometry in adolescence. Recently, there has been growing support for the hypothesis that timing of menarche may be set early in life but modified by changes in body size and composition in childhood. To evaluate this, a cohort of 255 girls aged <5 years recruited in 1988 were followed up in 2001 in Matlab, Bangladesh. The analysis was based on nutritional status as assessed by anthropometry and recalled age at menarche. Data were examined using lifetable techniques and the Cox regression model. The association between nutritional status indicators and age at menarche was examined in a multivariate model adjusting for potential confounding variables. Censored cases were accounted for. The median age at menarche was 15.1 years. After controlling for early-life predictors (birth size, childhood underweight, childhood stunting) it appeared that adolescent stunting stood out as the most important determinant of age at menarche. Adolescent stunting still resonates from the effect of stunting in early childhood (OR respectively 2.63 (p<0.01 CI: 1.32-5.24) and 8.47 (p<0.001 CI: 3.79-18.93) for moderately and severely stunted under-fives as compared with the reference category). Birth size was not a significant predictor of age at menarche. It is concluded that age at menarche is strongly influenced by nutritional status in adolescence, notably the level of stunting, which is in turn highly dependent on the level of stunting in early childhood. A 'late' menarche due to stunting may be detrimental for reproductive health in case of early childbearing because of the association between height and pelvic size.  相似文献   

4.

Background

Age at menarche is considered a reliable prognostic factor for idiopathic scoliosis and varies in different geographic latitudes. Adolescent idiopathic scoliosis prevalence has also been reported to be different in various latitudes and demonstrates higher values in northern countries. A study on epidemiological reports from the literature was conducted to investigate a possible association between prevalence of adolescent idiopathic scoliosis and age at menarche among normal girls in various geographic latitudes. An attempt is also made to implicate a possible role of melatonin in the above association.

Material-methods

20 peer-reviewed published papers reporting adolescent idiopathic scoliosis prevalence and 33 peer-reviewed papers reporting age at menarche in normal girls from most geographic areas of the northern hemisphere were retrieved from the literature. The geographic latitude of each centre where a particular study was originated was documented. The statistical analysis included regression of the adolescent idiopathic scoliosis prevalence and age at menarche by latitude.

Results

The regression of prevalence of adolescent idiopathic scoliosis and age at menarche by latitude is statistically significant (p < 0.001) and are following a parallel declining course of their regression curves, especially in latitudes northern than 25 degrees.

Conclusion

Late age at menarche is parallel with higher prevalence of adolescent idiopathic scoliosis. Pubarche appears later in girls that live in northern latitudes and thus prolongs the period of spine vulnerability while other pre-existing or aetiological factors are contributing to the development of adolescent idiopathic scoliosis. A possible role of geography in the pathogenesis of idiopathic scoliosis is discussed, as it appears that latitude which differentiates the sunlight influences melatonin secretion and modifies age at menarche, which is associated to the prevalence of idiopathic scoliosis.  相似文献   

5.
In females, menarche is the defining moment of puberty, the period of life when the greatest body changes occur. In the present study, the metric and morphological variations associated with sexual maturation are defined in 155 Sardinian girls (10-17 years) and the role of some potentially influential variables is discussed: age, age at menarche and time since menarche. We studied thirty-eight anthropometric variables, the fat-free mass and the fat mass estimated by Bioelectrical Impedance Analysis. Statistical analyses were performed to evaluate the difference between pre- and post-menarcheal girls of the same age (Student's t-test) and to evaluate the different role played by the variables (principal components analysis, cluster analysis, multiple regression). The results demonstrate that the body dimensions of the adolescent girls mainly increase in concomitance with sexual maturation. The age at menarche influences the fat mass but not the distribution of visceral and subcutaneous fat. The time since menarche has also no effect on the distribution of subcutaneous fat.  相似文献   

6.
The present study focuses on the impact of age at menarche on body composition development during adulthood. With 459 healthy middle-class women between 18 and 67 years (x = 41.5) the association between age at menarche and body composition was tested. Body composition, described by absolute and relative amount of fat mass, lean body mass, and bone mass, was estimated by means of dual energy x-ray absorptiometry. In order to exclude the influence of the menopausal transition on body composition, pre- and postmenopausal females were examined separately. The absolute amount of body fat was significantly lower within the group of women whose menarche occurred later. However, postmenopausal females exhibit less significant relations between the two trait systems than premenopausal women. This may be due to the impact of menopausal transition which affected the hormone levels and body composition development independently from the adolescent hormonal transition. While in both proband groups the quantitative amount of body fat was significantly related to menarcheal age, a significant relation between menarcheal age and adult body fat distribution could not be verified. Am J Phys Anthropol 105:9–20, 1998. © 1998 Wiley-Liss, Inc.  相似文献   

7.
Menarche age was assessed in 93 adolescent females in a sample of public schools in East Hawaii. Native Hawaiian girls had significantly lower reported age at menarche than non-Hawaiian classmates. Age at menarche was significantly correlated with total fatness as measured by the sum of six skinfolds in girls who had reached menarche at least 2 years previous to measurement. When fatness was controlled in comparisons, the ethnic differences were not significant. Fat distribution, independent of fatness, was also significantly related to age at menarche. Socioeconomic, cultural, and admixture variables were not significantly related to age at menarche. Adiposity appears to be both a cause and a consequence of early age at menarche, with the relationship dependent on the elapsed time between menarche and measurement. This suggests that studies relating body composition to age at menarche must carefully control for the time interval between measurement and the date of menarche. © 1996 Wiley-Liss, Inc.  相似文献   

8.
Wiley AS 《PloS one》2011,6(2):e14685

Background

Several components of dairy products have been linked to earlier menarche.

Methods/Findings

This study assessed whether positive associations exist between childhood milk consumption and age at menarche or the likelihood of early menarche (<12 yrs) in a U.S sample. Data derive from the National Health and Nutrition Examination Survey (NHANES) 1999–2004. Two samples were utilized: 2657 women age 20–49 yrs and 1008 girls age 9–12 yrs. In regression analysis, a weak negative relationship was found between frequency of milk consumption at 5–12 yrs and age at menarche (daily milk intake β = −0.32, P<0.10; “sometimes/variable milk intake” β = −0.38, P<0.06, each compared to intake rarely/never). Cox regression yielded no greater risk of early menarche among those who drank milk “sometimes/varied” or daily vs. never/rarely (HR: 1.20, P<0.42, HR: 1.25, P<0.23, respectively). Among the 9–12 yr olds, Cox regression indicated that neither total dairy kcal, calcium and protein, nor daily milk intake in the past 30 days contributed to early menarche. Girls in the middle tertile of milk intake had a marginally lower risk of early menarche than those in the highest tertile (HR: 0.6, P<0.06). Those in the lowest tertiles of dairy fat intake had a greater risk of early menarche than those in the highest (HR: 1.5, P<0.05, HR: 1.6, P<0.07, lowest and middle tertile, respectively), while those with the lowest calcium intake had a lower risk of early menarche (HR: 0.6, P<0.05) than those in the highest tertile. These relationships remained after adjusting for overweight or overweight and height percentile; both increased the risk of earlier menarche. Blacks were more likely than Whites to reach menarche early (HR: 1.7, P<0.03), but not after controlling for overweight.

Conclusions

There is some evidence that greater milk intake is associated with an increased risk of early menarche, or a lower age at menarche.  相似文献   

9.
The energy demands of pregnancy and lactation together with the accumulation of stored fat in human females during development suggest that a critical level of fat may be required for menarche; but multivariate analyses have supported the alternative view that skeletal growth is the main factor. However, significant differences between upper- and lower-body (gluteofemoral) fat suggest that fat distribution may be more relevant than total fat. Using cross-sectional data from the third National Health and Nutrition Examination Survey (NHANES III) for females aged 10-14, we show that menarche is more closely related to fat distribution than to skeletal maturity. Unit increases in hip circumference are associated with 24% higher odds of menarche while increases in waist circumference and triceps skinfold lower the odds by 7 and 9%, respectively. Those with menarche despite low levels of total body fat have relatively more fat stored in gluteofemoral depots than those without menarche or those with menarche and greater total amounts of fat. In young women with completed growth, age at menarche is negatively related to hip and thigh circumference and positively related to waist circumference, stature, and biiliac breadth; and blood leptin levels are much more strongly related to gluteofemoral than upper-body fat, suggesting that leptin may convey information about fat distribution to the hypothalamus during puberty. Fat distribution may be relevant because gluteofemoral fat may provide neurodevelopmentally important fatty acid reserves.  相似文献   

10.
Resting metabolic rate (RMR) and body composition were measured in 44 initially nonoverweight girls at three time points relative to menarche: premenarche (Tanner stage 1 or 2), menarche (+/-6 mo), and 4 yr after menarche. Mean absolute RMR was 1,167, 1,418, and 1,347 kcal/day, respectively. Absolute RMR was statistically significantly higher at menarche than at 4 yr after menarche despite statistically significantly less fat-free mass (FFM) and fat mass (FM), suggesting an elevation in RMR around the time of menarche. The pattern of change in RMR, adjusted for FFM, log transformed FM, age, race, parental overweight, and two interactions (visit by parental overweight, parental overweight by FFM), was also considered. Adjusted RMR did not differ statistically between the visits for girls with two normal-weight parents. For girls with at least one overweight parent, adjusted RMR was statistically significantly lower 4 yr after menarche than at premenarche or menarche. Thus parental overweight may influence changes that occur in RMR during adolescence in girls.  相似文献   

11.
Puberty is a critical period in body composition development. The influence of puberty on the development of fat mass asks for further investigation. We investigated the development of fat mass during puberty in a longitudinal prospective study in 152 healthy nonobese white girls, initial ages between 9 to 12 years. The influence of menarcheal age and the existing of tracking of fat mass have been analyzed. In 10 years time, participants were measured on eight time points. Various anthropometric data were collected, breast development was staged according to Tanner and body composition was determined with the dual‐energy X‐ray absorptiometry (DXA) scan. Calculations were made with the use of a linear mixed model. Fat mass increases from 7.9 kg (23.6%) at B1 to 18.5 kg (29.3%) at B5. Fat mass is higher in girls with an early menarche than in girls with a late menarche from B2. Girls in the quartile with initially the lowest fat mass have a chance of being in the same quartile after 10 years of 77% (P < 0.001). Girls in the quartile with initially the highest fat mass, have a risk of staying in the highest quartile of 55% (P < 0.001). Menarcheal age is of great influence on the development of fat mass. Girls with an early menarche, will have a bigger fat mass, especially at the end of puberty. Tracking of fat mass exists: a high amount of fat mass in early puberty will continue to exist at young adulthood.  相似文献   

12.
The tempo, level of growth and maturation during adolescence may have important implications to future adult health. The purpose of the study was to examine factors associated with menarche. Three hundred and forty girls, 9 to 14 years old, were selected from all age eligible girls at Kaiser Permanente Oahu (Honolulu). Girls' age, ethnicity, menstrual status and feeding pattern during infancy were obtained by questionnaire. The mean age of girls was 11.5 +/- 1.4 yr and the mean age at menarche among 112 (33%) girls who had reached menarche was 11.6 +/- 1.1 yr. In logistic regression, achievement of menarche was positively explained by age, Asian ethnicity and formula feeding during infancy. In simple linear regression, higher body mass index (BMI) and subcutaneous fat were also positively associated with formula feeding during infancy. The study suggests that girls who were formula fed deposit more body fat than girls who were breast-fed, resulting in early attainment of menarche.  相似文献   

13.
Epigenetic age is an indicator of biological aging, capturing the impact of environmental and behavioral influences across time on cellular function. Deviance between epigenetic age and chronological age (AgeAccel) is a predictor of health. Pubertal timing has similarly been associated with cancer risk and mortality rate among females. We examined the association between AgeAccel and pubertal timing and adolescent breast composition in the longitudinal Growth and Obesity Cohort Study. AgeAccel was estimated in whole blood using the Horvath method at breast Tanner 2 (B2) and 4 (B4). Total breast volume, absolute fibro-glandular volume (FGV), and %FGV were evaluated at B4 using dual X-ray absorptiometry. The impact of AgeAccel (mean: 0; SD: 3.78) across puberty on the time to breast development (thelarche), menarche, and pubertal tempo (thelarche to menarche) was estimated using accelerated failure time models; generalized estimating equations were used to evaluate associations with breast density. A five-year increase in average adolescent AgeAccel was associated with a significant decrease in time to menarche [hazard ratio (HR): 1.37; 95% confidence interval (CI): 1.04, 1.80] adjusting for birth weight, maternal pre-pregnancy body mass index, maternal height, maternal education, B2 height, fat percentage, and cell composition. AgeAccel displayed a stronger inverse association with pubertal tempo (HR: 1.48; 95% CI: 1.10, 1.99). A five-year increase in AgeAccel was associated with 5% greater %FGV, adjusting for B4 percent body fat, and maternal traits (95% CI: 1.01, 1.10). Our study provides unique insight into the influence of AgeAccel on pubertal development in girls, which may have implications for adult health.  相似文献   

14.
There is increasing evidence for a link between prenatal growth and pubertal development. Here we highlight a selection of pubertal characteristics in children who were born small for gestational age (SGA). Boys born SGA are at risk of high levels of follicle-stimulating hormone (FSH) and low levels of inhibin B and a small testicular volume during adolescence. In girls born SGA, the age at pubertal onset and the age at menarche are advanced by about 5-10 months; prenatal growth restraint may also be associated with higher FSH levels and smaller internal genitalia in adolescence. The ovulation rate was found to be reduced in adolescent girls born SGA, and an insulin-sensitizing therapy was capable of raising this low ovulation rate. Menarche is definitely advanced in girls born SGA with precocious pubarche and in those with an early-normal onset of puberty. Current evidence suggests that insulin resistance is a key mechanism linking a post-SGA state to early menarche; hence, insulin sensitization may become a valid approach to prevent early menarche and early growth arrest in girls born SGA.  相似文献   

15.
Abstract

In this paper we applied a recently developed statistical technique, hazard modelling, to the study of menarche and adolescent subfecundity. Using data collected in Bangladesh in 1976 and 1977, which included anthropometric and socioeconomic status measures, we found that age and weight were significant predictors of menarche; no other measure of growth significantly added explanatory power. Weight was at least as good as other more complex measures, including the fat index proposed by Frisch. Low SES was associated with later age at menarche and appears to act through slower growth. Whenever weight was included in an analysis, the SES effects were not significant. Finally, although low SES tends to delay menarche, it seems to have little effect on the interval of adolescent subfecundity. Indeed, late maturers exhibit some degree of “catching up” in that the length of the subfecundity interval is negatively related to age at menarche.

The study also has a methodological focus. We demonstrate that use of hazard models permits more detailed and penetrating findings to be extracted from the kinds of retrospective data traditionally collected as well as from longitudinal data of the types only recently available. In particular, multivariate analysis of age at menarche and the subfecundity interval, and their relations to anthropometric time‐varying covariates as well as socioeconomic indicators, is shown to be feasible and informative.  相似文献   

16.
Objective: The ability of young women (n = 132, average age 17 years) to recall body size and age at menarche was examined. The use of body silhouettes to assist women in recalling their body size at menarche and to represent their current body size was also evaluated. Research Methods and Procedures: Subjects, who previously participated in a cohort study, were asked to recall height and weight at the time of menarche, to select body silhouettes that best reflected their body shape at the time of menarche and their current body shape, and to recall age at menarche. Two sets of body silhouettes were developed, one representative of an adult body shape and another representative of an adolescent body shape. Results: Pearson correlation coefficients between the adult and adolescent body figures and actual body mass index (BMI; kg/m2) at the time of menarche were not significantly different (r = 0.82 for adult figures vs. r = 0.72 for adolescent figures, p > 0.05). The correlation between actual BMI at the time of menarche and body silhouette (r = 0.77, all subjects) was similar to the correlation between actual and recalled BMI at the time of menarche (r = 0.83) as well as the correlation between current BMI and current body silhouette (r = 0.75). Recalled and actual ages at menarche were highly correlated (r = 0.83). Discussion: The recall of body shape was considered to be a less precise measure of body size than asking about height and weight, but use of body silhouettes may offer advantages in certain situations.  相似文献   

17.
Puberty represents the final stage of sexual differentiation when the individual acquires reproductive capacity. Puberty is not only characterized by maturation of sexual organs and the formation of oocytes and mature spermatozoa, but also by the development of secondary sexual dimorphism. In industrialized countries, the age of puberty has decreased steadily over the last 150 years in association with improved socio-economic conditions. However, the decreased onset of puberty, especially in females, is associated with problematic changes in behaviour such as early onset of sexual activity resulting in high-risk teenage pregnancies. In our study, we analysed the association between body composition (fat tissue and fat-free body mass, estimated by BIA analyses), height, body mass index and fat distribution and signs of puberty such as the timing of menarche in 228 girls and voice breaking and facial hair growth in 191 boys ageing between 10 and 15 years. In both sexes, signs of puberty were associated, highly significantly, with body composition parameters. Nevertheless, marked differences between the two sexes were observed: Female puberty was positively associated with weight status and the absolute and relative amount of body fat, while in males, puberty was positively related with a higher amount of fat-free body mass and a decreased fat mass. Male voice breaking was significantly associated with increased stature, body weight, waist and hip circumference, lean body mass and total body water. In contrast, voice breaking was significantly negatively associated with the fat percentage, the total fat mass and the waist-to-hip ratio. Female menarche was significantly positively associated with increased body weight, weight status, waist and hip circumference and also with increased absolute and relative fat mass, relative hip circumference, lean body mass and total body water. Only the waist-to-hip ratio was significantly negatively associated with the onset of menarche.  相似文献   

18.
The aim of this study is to examine sedentary and light activity in relation to overweight in adolescent girls. Adolescent girls were randomly recruited from 36 schools participating in the Trial of Activity for Adolescent Girls (TAAG). Assessments included age, ethnicity, socioeconomic status, and body composition estimated from weight, height, and triceps skinfold. Sedentary and light activity was measured for 6 days using accelerometry in 6th and in 8th grade among two randomly sampled cross‐sections of girls. Sedentary activity increased from the 6th to 8th grade by 51.5 min/day. In the 8th grade, a significantly higher number of hours in sedentary activity for each of the 6‐days of measurement were evident with higher tertiles of percent body fat (30–35%, >35% fat) (P < 0.05), but not across all increasing tertiles of BMI (5th to 85th, 85th to 95th, and >95th percentiles). The increase in sedentary activity was observed on weekdays, but not on weekends for percent body fat tertiles. In the cohort of girls measured in both 6th and 8th grades, the mean cross‐sectional coefficient estimates were significant for percent body fat, but not BMI for sedentary and light activities. Adolescent girls from the 6th to 8th grade are shifting their time from light to more sedentary activity as measured by accelerometers. In addition, the increase in sedentary activity is not associated with an adverse effect on BMI or percent body fat. The eventual impact of this shift to a more sedentary lifestyle on body composition and other outcomes needs to be evaluated further.  相似文献   

19.
In humans, the skin is a target tissue for androgen action; hair growth and sebum secretion are under active androgen control. An increased production or metabolism of testosterone, the main active androgen, shows up clinically in dermatological symptoms such as hirsutism, hyperseborrheic acne and alopecia. Polycystic ovary syndrome (PCOS) is the most frequent androgen disorder of ovarian function. PCOS patients have amenorrhea or severe oligomenorrhea, increased testosterone levels and most often enlarged polycystic ovaries on ultrasound examination. In addition, many PCOS patients have a tendency to accumulate abdominal fat and/or to develop obesity. Some also display a particular metabolic pattern including an atherogenic lipid profile, glucose intolerance and an increased fasting insulin level, which is known to be closely linked with an insulin resistant state. Several studies have now reported that PCOS patients show increased incidence of type 2 diabetes and cardiovascular disease. In addition to being a target for androgens the skin has abundant insulin receptors on the keratinocyte surface membrane and acanthosis nigricans is a common symptom of severe insulin resistance among patients with insulin receptor disorders. However, acanthosis nigricans could also be present in PCOS women given evidence of the intensity of their insulin resistance. This presentation will review the mutual relationship between hyperandrogenia and insulin resistance, with particular attention paid to: (1) insulin secretion and insulin sensitivity in PCOS; (2) the complexity of the molecular mechanisms involved in insulin resistance; (3) the paradoxical relationship between insulin resistance and hyperandrogenia; (4) the current genetic studies; and (5) new avenues for long-term treatment of PCOS women.  相似文献   

20.
《Animal behaviour》1988,36(5):1482-1495
In an individually marked population in southeastern Peru, males and females of the polygynous, colonial yellow-rumped cacique delayed successful breeding until they were 3 years old. Adolescent (2-year-old) females competed for nest sites, built nests, laid fertile eggs, incubated, and sometimes fed nestlings, but always abandoned nests before they fledged young. Females that completed nests during their adolescent years were also more successful in establishing nest sites the following year. Adolescent females that failed to establish nest sites and those that lost nests to predators tended to leave the study area altogether. By attempting to nest early, adolescent females may facilitate future nesting attempts by forming coalitions with other females and assessing nest site quality in an area. Adolescent males, on the other hand, avoided aggressive interactions with other males, but were very aggressive towards adult females and fledglings. Adolescent males attacked females in nests, chased females to and from the colony, pecked and mounted recent fledglings, and, rarely, pulled nestlings out of nests. This harassment resulted in the death of nestlings and fledglings and was energetically costly to females, which often fought adolescent males while defending their young. Adolescent males preferentially harassed nestling-feeding females, avoided egg-laying females and were never observed attempting to mate with females. Adult males rarely interfered during any of these interactions. Such anti-social behaviour may function as a way of practising adult behaviour, as a means of eliminating future competitors, or may be an epiphenomenon of rising hormone levels and therefore of no adaptive significance.  相似文献   

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