Fatness, menarche, and female fertility

It is hypothesized that a particular ratio of fat to lean mass is required for menarche and the maintenance of regular menstrual cycles. Females who lose 10-15% of normal weight for height, equivalent to a loss of 1/3 of body fat, become amenorrheic, presumably due to hypothalamic dysfunction. Adipose tissue may provide signals to the central nervous system and gonadotropin regulatory areas either directly, by estrogen production, or indirectly, by the effects of relative fatness on temperature control and metabolic rate, or by both means. Women with hypothalamic dysfunction experience changes in the secretion of gonadotropins, luteinizing hormone, follicle-stimulating hormone, and estrogen. Weight gain restores postmenarcheal secretion patterns. This approach suggests that the secular trend toward earlier age at menarche reflects earlier attainment of critical weight as a result of improved nutrition and child care. In many societies, subnutrition may explain the observed submaximum fertility. This suggests a need to integrate family planning programs with nutrition programs in many developing countries. It is important to note that the prediction of the minimum weight for height for onset and maintenance of ovulatory cycles is from total water as percentage of body weight. Although the percentage of fat in the body is inversely related to the percent of body water, only the latter is predictive. Successful prediction of the minimum weights for height is related to a lean mass/fat ratio represented by about 17% fat of body weight at menarche and 22% of body weight at the completion of growth at age 18 years.     

性发育对女性最大吸氧量的影响

根据是否发生月经，将１１－１３岁女童分为未来潮组及已来潮组，比较两组身高，体重，瘦体重及最大吸氧量的差。结果表明同龄月经来潮组女童身高，体重，瘦体重，ＶＯ２ｍａｘ绝对值，ＶＯ２ｍａｘ／身高及ＶＯ２ｍａｘ／ＨＲｍａｘ均低于已来潮女童，而ＶＯ２ｍａｘ／体重及ＶＯ２ｍａｘ／瘦体重略高于已来潮组女童，产生这种差异的可能原因。     

Changes in the biological status of Polish girls from a rural region associated with economic and political processes in the period 1967-2001

The age at menarche, body height and weight of the daughters of farmers, farmer-workers and landless villagers in a rural region of Poland were studied. In the period 1967-1977, a time of economic development, a decrease in age at menarche (by 0.74 years) and a secular trend in body height (by 2.4 cm/decade) was observed. In 1977-1987, a period of acute economic crisis, age at menarche increased by 0.16 years and the secular trend in body height was only 1.1 cm/decade. In 1987-2001, age at menarche decreased and body height increased by 0.28 years and 2.9 cm respectively. The percentage of families owning a car, freezer and video increased during this period. These last results are indicative of an improvement in living conditions, but the villagers regard themselves as losers as a result of the political transformation (1989) in Poland.     

Intergenerational context discontinuity affects the onset of puberty

The assumption that the onset of puberty is a context-sensitive marker of a reproductive strategy is tested by comparing parental and filial childhood context and somatic development in West and East Germany. Sixty-eight mother-daughter dyads and 35 father-son dyads were taken from two samples of families from Osnabrück in West Germany and Halle in East Germany. According to the observed context discontinuity between the generations in the male dyads, linear regression models show that no indicator of male sexual maturation was influenced significantly by the somatic development of the father. Instead of an inherited timing of maturation, antecedent distal factors like socioeconomic childhood context variables and critical life events lead to an acceleration of male sexual maturation. Finally we test the effect of two different conditions of childhood context continuity on daughter’s age at menarche with maternal age at menarche controlled. Linear regression models show that mother’s age at menarche predicts daughter’s age at menarche only under the condition of contextual continuity between generations, which was the case in the West German sample only. In East Germany, where mother’s age at menarche had no significant effect, the amount of variance explained by childhood context variables was almost the same. These results indicate the context sensitivity of somatic development which seems to follow an evolutionary rationale.     

昆明市儿童恒牙萌出时间及恒牙萌出与生长发育关系的调查研究

本文报道了昆明市8148例儿童恒牙（第三磨牙除外）萌出时间的横断面调查，对恒牙萌出与年龄、身高、体重和月经初潮的关系进行了探讨。经相关分析，恒牙萌出数与年龄高度相关，与身高和体重低度相关，并建立了由年龄、身高或体重推算萌牙数的回归方程。还发现恒牙萌出与青少年性成熟也有一定的联系。提示恒牙萌出也能反映儿童的生长发育状况，故可作为衡量儿童生长发育的一项指标。     

Malnutrition, menarche, and marriage in rural Bangladesh

In order to assess the impact of nutritional status on the onset of menarche and the association between age at menarche and age at marriage, a survey of 1155 girls, ages 10 through 20, was conducted in a rural area of Bangladesh in March 1976. In order to obtain an estimated mean of age of menarche, probit analysis was used. The mean age of menarche using this technique is estimated at 15.65 for Muslims and 15.91 for Hindus. It was learned that in recent years the age of menarche has increased in a rural area. This increase seems to be associated with malnutrition caused by the war, postwar inflation, floods and famines during the 1971-75 period. When age is controlled for, the prominent effect of weight on menstrual status is evident. 98% of the girls whose weights were 88 pounds or greater had reached menarche compared to only 1% of those weighing less than 66 pounds. Body weight appears to be 1 of the most important factors for the determination of onset of menarche. There exists a seasonality of onset of menarche with a peak in winter. Age of marriage among this rural population has increased and may be associated with the increasing age of menarche. Since both age of menarche and age of marriage have increased, fertility among females age 15-19 may be expected to decrease in the future if this pattern continues.     

Menarche in Newcastle upon Tyne girls

Using data for 699 white girls from Newcastle upon Tyne, England, who were born in 1962, the authors examine the relationship between age at menarche and selected social and anthropometric variables. Factors considered include family size, birth order, father's occupation, birth weight, and height and weight at five years of age and at menarche (SUMMARY IN FRE, GER)     

Predictors of age at menarche in the newcastle thousand families study

Several studies have found relationships between early life factors (birth weight, length of gestation, height, weight, duration of breast-feeding, maternal age, social class, periods of infection, presence of adverse life events, and quality of housing conditions in childhood) and age at menarche but none has considered all of these factors in the same study. The follow-up study of the Newcastle Thousand Families birth cohort, established in 1947, provided age at menarche data collected retrospectively at age 50 from 276 women who returned self-completion questionnaires in 1997. Three main independent associations were observed: girls who experienced a shorter gestation, girls whose mothers were younger when they were born, and girls who were heavier at age 9 had earlier menarche. Birth weight, standardized for gestational age, was found to have different relationships with age at menarche depending upon how heavy or light a girl was at age 9. The results of this study support the hypotheses that conditions in fetal and early life are associated with the timing of menarche and that greater childhood growth is associated with earlier menarche. It is suggested that future work should focus on illuminating the mechanisms underlying these statistical relationships.     

Tanner Staging of Secondary Sexual Characteristics and Body Composition,Blood Pressure,and Insulin in Black Girls

Objective: To assess Tanner staging (breast and pubic hair development) and its relationship to measures of body composition, blood pressure, and fasting insulin and glucose in young black girls. Research Methods and Procedures: Subjects were 138 black girls, 8 to 12 years of age, recruited from elementary schools in low socioeconomic status neighborhoods. Exclusion criteria included the presence of any acute/chronic medical conditions. Pubertal stages were assessed by one of two pediatricians and analyzed individually, as well as with a composite index (prepubertal, pubertal/premenarcheal, or pubertal/menarcheal). Glucose and insulin were measured after a 12‐hour fast. Measures of body composition included height, weight, BMI, waist and hip circumferences, fat mass, fat‐free soft tissue, bone mineral density (DXA), and visceral adipose tissue (magnetic resonance imaging). Resting systolic and diastolic blood pressure were measured by Dinamap. Results: With age in the model, breast development explained significant proportions of the variance in height, weight, fat‐free soft tissue, bone mineral density, and insulin. Adding pubic hair development or menarche to those models did not significantly increase the proportion of variance that was explained by breast development. Furthermore, using a composite index of pubertal staging explained a smaller proportion of the variance compared with breast development alone. Discussion: Combined with age, breast development was a better predictor of body composition and fasting insulin than was pubic hair development or a composite index of pubertal staging.     

Faster ticking rate of the epigenetic clock is associated with faster pubertal development in girls

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.     

A tradeoff between reproduction and growth in contemporary Finnish women

Women have been suggested to trade growth in height for reproduction, as an earlier age at menarche and first birth seem to be related to shorter adult stature. Although women likely accrue fitness benefits by maturing and starting reproduction at young age, short adult stature may be selected against by natural and sexual selection later in their life. We studied how age at menarche and first reproduction affected adult height and whether adult height in turn was related to lifetime reproductive success in Finnish women born 1946–1958. Our results show that a delay of 1 year in age at menarche and first reproduction was related to a 0.43- and 0.20-cm increase in adult height, respectively. The sex of the first-born offspring was not related to adult height. Moreover, women gained fitness benefits by starting reproduction early but not by growing tall. These findings among Finnish women are thus compatible with tradeoffs between reproduction and growth, by showing a compromised adult height at the cost of early age at menarche and first birth. However, in these women, natural selection favored those women who traded their stature for young motherhood.     

Assessment of developmental age: cross-sectional analysis of secondary sexual characteristics

The developmental age of a growing person does not necessarily correspond to his or her chronological age. The two sexes differ considerably in their developmental tempo, and there are tempo differences also within the same sex. Early developers appear older, late developers appear younger than their chronological age might suggest. Based on a sample of 8675 German boys and 8689 girls of the same ethnicity, aged between 8 and 17 years sex differences of height, weight and secondary sexual characteristics are analyzed. Girls on average, develop faster than boys. Their peak of highest increments of height occurs at 10.2 years and is positioned early within the events of sexual maturity. The peak of highest increments of height in boys occurs at age 11.2 on average and is positioned relatively early within the sequences of secondary sexual characteristics. Maturing development starts with breast-stage 2 in girls at age 10.9 and penis-stage as well as scrotum-stage 2 in boys at age 11.1 on average. The development of pubic hair follows and menarche in girls at age 12.7, respectively spermarche in boys at age 13.8, marks the border to theoretical fertility. There are remarkable differences in the tempo of sexual development between the different types of body shape. In girls the pyknomorphic types are the early developers. Breast stage 2 for instance occurs at age 10.1 in the stocky and corpulent pyknomorphic girls and at age 13.0 in the tall and slender leptomorphic girls. This is different in boys. Here are much less differences between the types of body shape, but generally it is the leptomorphic type, at whom the stages of his secondary sexual characteristics are developed a little earlier.     

Age at menarche in urban Argentinian girls: association with biological and socioeconomic factors

Age at menarche is regarded as a sensitive indicator of physical, biological, and psychosocial environment. The aim of this study was to determine the age at menarche and its association with biological and socioeconomic factors in girls from Santa Rosa (La Pampa, Argentina). An observational cross-sectional study was carried out on 1,221 schoolgirls aged 9-15 years. Menarche data were obtained by the status-quo method. Height, sitting height, weight, arm circumference, tricipital and subscapular skinfolds were measured. We also calculated body mass index, measures of body composition and proportions, and fat distribution. To assess socioeconomic factors, parents completed a self-administered questionnaire about their occupation and education, family size, household, and other family characteristics. The median age at menarche - estimated by the logit method--was 12.84 years (95% CI: 12.71, 12.97). Compared with their premenarcheal age peers, postmenarcheal girls had greater anthropometric dimensions through age 12. After this age, only height was higher in the latter group. Data were processed by fitting two logistic regressions, both including age. The first model included anthropometric variables and birth weight, while the second model included the socioeconomic variables. The significant variables derived from each model were incorporated into a new regression: height, sitting height ratio (first model), and maternal education (second model). These three variables remained significantly associated with menarche. The results suggest a relationship between linear growth and menarche and agree with those found in other populations where the advancement of menarche is associated with improved living conditions. In relatively uniform urban contexts, maternal education may be a good proxy for the standard of living.     

哈萨克族中小学生体质发育资料及身体发育指数分析

本文报告了新疆阿勒泰地区7—18岁哈萨克族中小学生体质发育的调查结果。重点分析3456名城镇哈萨克族学生的体质发育资料。体质发育调查指标包括身高、体重、胸围、坐高、肩宽、骨盆宽六项,其增长幅度及变异度皆以体重为大。哈萨克族学生的身高不论男女,在多数年龄组小于国内同龄汉族学生,而体重则多数年龄组大于国内同龄汉族。本文还分析了哈萨克族学生的六项身体发育指数。     

BODY FAT, PUBERTY AND FERTILITY

1. The high percentage of fat, about 26–28% in the mature human female, may influence reproductive ability directly through two mechanisms: ( a ) fat converts androgens to oestrogens; ( b ) relative fatness influences the direction of metabolism of oestrogen to the most potent or least potent forms. The relative degree of fatness thus is directly related to both the quantity of circulating oestrogen and the biological effectiveness of the oestrogen. This is a neat mechanism for relating rates of growth, nutrition and energy outputs to the energy requirements for reproduction. Fat is the most labile body tissue; it therefore reflects environmental changes more rapidly than other tissues of the body.
2. The slow maturation of the hypothalamus and pituitary up to menarche, or first oestrus, is accompanied by a slow maturation of the body, which changes not only in size but in the relative proportion of bone, muscle, and fat. Evidence is presented that a particular threshold ratio of fat to lean mass is normally necessary for puberty and the maintenance of female reproductive ability in the human and in the rat. The synchronizing mechanisms may be metabolic, relating food intake to core temperature and/or fat storage.
3. Undernutrition and weight loss in the range of 10–15 % of normal weight for height delays menarche and causes amenorrhoea. Ballet dancers and athletes also have delayed menarche and amenorrhoea. The cessation of reproduction in both groups can be considered adaptive. Refeeding and/or cessation of intense activity results in the initiation or resumption of menstrual cycles after varying periods of time. A necessary threshold weight for height can be predicted from a fatness index.
4. Differences in the natural fertility of historical and contemporary populations may be explained by a direct effect of food intake and energy outputs on fecundity.
5. The late maturing fat - 'sex fat' - may have a special role in reproduction.     

Correlates and predictors of the age of menarche

In a cross-sectional study of 452 girls between 10 and 16 years of age 36 indices of physical and 50 of mental development were tested for their correlation with age at menarche and chronological age, as well as for their predictive power for estimating menarche by multiple regression analysis. Indices of physical maturity and body weight when adjusted for chronological age showed the highest partial correlation coefficients with age at menarche. Among mental characters which show lower intercorrelations with menarche occurred the highest correlation coefficients for a handmotor factor "Spurennachzeichnen" and a factor "Gruppenabh?ngigkeit" (which indicates a type of social motivation). In general physical and mental factors correlate higher with chronological age than with age at menarche. By multiple regression analysis we determined 14 physical and 25 mental predictors explaining 21% and 17% respectively of the variance of age at menarche. The error of the estimate predicting menarche on body weight without knowledge of onset of menarche is +/- 1 year. Using chronological age in a sample of girls before menarche the error of the estimate only is +/- 6 months. To compare the predictive power of chronological age combined with body weight or with skeletal age the time interval is calculated within which 95% of girls attain menarche. The range of prediction extends from 4.3 to 1 year on chronological age (11-16 years); using mean body weight it can be improved by 1.8 to 6 months, while using mean skeletal age an improvement of 0.2 to 3.9 months is possible compared with body weight. The correlations between age at menarche and physical and mental variables are attributed to a common hormonal influence on rate of development.     

Critical period for menarche derived by the wavelet interpolation method from changes in BMI with age in South Korean girls

Recently, few studies regarding the changes in BMI with age have been reported. In the present study, the wavelet interpolation method (WIM) was applied to the changes in BMI with age from the first grade of elementary school until the second year of high school in Korean girls, and the relationship between age at the maximum peak velocity (MPV) of BMI and age at menarche was confirmed by determining the age at MPV of BMI. Age at menarche and activity status were obtained from questionnaires given to 263 second grade high school girls in the Pusan area of South Korea. Moreover, longitudinal growth data on height and weight from the first grade of elementary school until the second year of high school (from 1997 to 2008) were obtained from health examination records. BMI was calculated from height and weight values from the first grade of elementary school until the second year of high school, and wavelet interpolation was applied to the distances of BMI in each grade. The change curve of BMI with age was determined by wavelet interpolation, and the age at MPV of BMI was determined from the changes in the velocity curve with age as the differentiation curve. Age at MPV of BMI was found to be 12.76 +/- 1.6 years, and age at menarche to be 12.34 +/- 1.1 years. The interval in age at the two times was -0.42 +/- 1.6 years, and a significant difference was seen between age at menarche and age at MPV of BMI. The reason that the age at menarche was a little earlier than the age at MPV of BMI is hypothesized to be abnormal melatonin levels influenced by lack of sleep in Korean school girls. However, it is proposed that the age at MPV of BMI is valid as the critical period for the age at menarche.     

Ability of Young Women to Recall Past Body Size and Age at Menarche

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.     

Factors regulating the timing of puberty onset in female rhesus monkeys (Macaca mulatta): role of prenatal androgens, social rank, and adolescent body weight

This study investigated whether prenatal androgen exposure, social rank, and body weight are factors regulating pubertal development in outdoor-housed female rhesus monkeys. Subjects' mothers received injections of testosterone enanthate (20 mg/ wk), flutamide (an androgen receptor blocker, 30 mg/kg twice daily), or vehicle during Gestational Days 35/40-70 (early) or Days 105/110-140 (late). Monitoring of pubertal development began around 28 mo of age during the fall breeding season, with frequent assessment of menstruation, circulating steroids, and weight. Menarche occurred 1.5 mo later in females treated late in gestation than in females treated early in gestation. This short menarche delay occurred in females treated with androgen, flutamide, or vehicle. No effect of prenatal manipulations on first ovulation were found. Social rank was related to first ovulation but not menarche, with low-ranked females less likely than high- or middle-ranked females to ovulate at 2.5 yr than at 3.5 yr of age. Females ovulating early, around 2.5 yr, had higher pubertal body weights and body mass indexes (BMI) than did females ovulating later, suggesting that better nutritional reserves or positive energy balance affect pubertal development. Thus, social rank and likely nutritional status influenced pubertal development in this study. Hormonal manipulations had no detectable effect; instead, handling late in gestation, which may have increased maternal adrenal activity, delayed menarche. This finding contrasts with earlier studies that showed that prenatal androgens delay menarche by 4-6 mo on average. This study supports late gestation as a period of increased sensitivity to environmental insult and demonstrates that multiple factors, including prenatal programming, modulate the specific timing of pubertal events.