OBJECTIVE: To determine the association of early menarche increased body mass index among girls aged 8-12 years old in private and public schools in Cavite.
DESIGN: Case Control Study
SETTING: Public Schools (Indang Elementary Schools, Mendez Central Elementary School and Tanza Elementary School) and Private Schools (Saint Gregory Academy and Mater Dei Academy)
SUBJECT: Three hundred school girls aged 8-12 years old (150 menarcheal and 150 non menarcheal)
METHODS: School girls aged 8-12 years old, 150 menarcheal and 150 nonmenarcheal were included. Weight measured to the nearest OJ kilograms and height measured to the nearest 0.1 meter were determined based on study girls' school records. Maternal history of early menarche and body mass indices were determined. The body mass index was determined by weight in kilograms divided by the square of the height in meters (BMI=kg/m\ Included as obese are those with BMI :25 according to the recent American Heart Association definition. Cases were then classified into groups. The case group included girls aged 8 years old to 12 years old with menarche and the control group were girls aged 8 years old to 12 years old without menarche. Sample's characteristics were recorded with regards to age, weight, Body Mass Index when menarche commenced, maternal history of early menarche. Anthropometric measurements between the obese and non-obese group were compared by means of student's T-test and Chi¬Square. The relationship between Menarche and BMI was then evaluated by logistic regression model. To assess the association between pertinent variables and the presence of menstruation, odds ratios were calculated. Data on menses were collected by the status quo method menarche at age between 8-12 years old and precise weight and height when her mense commenced). The weight and height of these girls were obtained by reviewing old school health records. All data were entered and analyzed using Statistical Package of Social Science (SPSS) v 9.0. All statistical analyses were done using the EPI Info version 6 software.
RESULTS: Three hundred subjects included in the study whose age ranged from 8-12
years old. Majority of cases, those girls with early menarche belong to age 11 to 12 years old. The mean age of girls with early menarche is 11.19 years (SD 0.8224). Girls who are premenarcheal had a mean age of 10.27 (SD 0.9876). The mean age was significantly higher among the cases than among the controls. In univariate analysis there is a significant association between early menarche and maternal history of early menarche with a risk estimate of 3.46. The mean weight of girls with early menarche is higher than those of nonmenarcheal girls. The mean body mass index for girls with early menarche is also higher compared to those of the premenarcheal girls' mean body mass index. Majority of the 150 cases have high body mass index compared to the control group where majority have low body mass index. Using crude odds ratio, it was found that body mass index has a significant association with early menarche. To evaluate further if maternal history of early menarche and obesity affect or influence the onset of early menarche, logistic regression was utilized. After controlling for the effect of the other variable, only obesity emerged as the risk factor associated with onset of early menarche.
CONCLUSION: The findings reported in this study document an important effect of obesity, as reflected by Body Mass Index, on early onset of menarche. Increased body mass index was found to be a significant risk factor. The risk of having early menarche in girls with increased body mass index was twice more likely compared to those who are non-obese. Results showed that in univariate analysis, maternal history of early menarche and increased body mass index were significant variables. However, in the logistic regression analysis, only obesity was significantly associated with early menarche. The results are consistent to the hypothesis that the earlier onset of menarche is significantly associated to increased Body Mass Index (BMI). Implications for primary care clinicians and pediatricians include the following. Girls who are overweight are more likely to show early signs of pubertal development, specifically menarche. This should be taken into account when deciding either simply to follow early¬maturing 8 years old girls closely or to refer them to search for a pathologic cause for early puberty and for treatment. Although it may be useful to arrange dietary counseling for obese early pubertal girls, there are no data to indicate that slowing or stopping their weight gain would slow or arrest the progression of puberty.
To determine the association of early menarche increased body mass index among girls aged 8-12 years old in private and public schools in Cavite.
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