Abstract
BackgroundA unique standardized national dataset on adolescent girls (21 regions) participating in the Italian Health Behaviour in School-aged Children Study (HBSC) was used to investigate the correlation between body mass index (BMI) and age at menarche.MethodsTwo independent nationally representative survey datasets: one on 15-year-olds (n = 6907, in 21 regions, year 2013/2014) and one on 11-year-olds (n = 10,128, in 20 regions, year 2009/2010) were analysed. The survey instrument was a self-report questionnaire. Median age at menarche and 95% confidence intervals (CIs) were estimated by means of Kaplan–Meier analysis. Hierarchical models were used to assess the relationship between BMI and age at menarche (months). “Region-level obesity” was measured as the prevalence of overweight/obesity (%) in each region.ResultsRegion-level median age at menarche ranged between 12 years/3 months and 13 years/4 months. Region-level prevalence of overweight among 15-year-old girls ranged between 4 and 19%. Age at menarche was inversely associated with individual BMI (unstandardized regression coefficient beta = − 0.70; 95% CI, − 0.84 to − 0.56). Individual- and class-level measures of BMI accounted for 50% of the region-level variance in age at menarche.ConclusionsThe results show that overweight in childhood is in relation with the early puberty in girls. Future surveys may take into account this report to clarify if overweight is the cause or consequence of early menarche.
Highlights
A unique standardized national dataset on adolescent girls (21 regions) participating in the Italian Health Behaviour in School-aged Children Study (HBSC) was used to investigate the correlation between body mass index (BMI) and age at menarche
The teachers of the classes included in the sample were informed and asked to deliver an information sheet, containing basic information about the survey, to each student, who in turn had to give it to parents or guardians and an opt-out form to be signed and sent back only in case of refusal to participate
Since the 1980s, several epidemiological studies have indicated an association between early puberty and increased BMI, which is an index that remains at the epidemiological level and is mostly used for measuring, even if indirectly, overweight and obesity [23,24,25]
Summary
A unique standardized national dataset on adolescent girls (21 regions) participating in the Italian Health Behaviour in School-aged Children Study (HBSC) was used to investigate the correlation between body mass index (BMI) and age at menarche. Given the serious health consequences associated with overweight and obesity, new public health challenges have been developed globally. The consequences of overweight include insulin resistance and diabetes mellitus, resistance to leptin and insulin, two hormones that play an important role. Lazzeri et al BMC Women's Health (2018) 18:168 of the World Health Organisation concluded that no single intervention could halt the rise of the obesity epidemic and recommended that attention should be devoted to preventive measures in three sensitive periods of life: preconception and pregnancy, infancy and early childhood, and older childhood and adolescence [9]. Obesity has an important impact on health leading to earlier pubertal onset, manifested by earlier thelarche [10] and menarche [11]. It is yet to be elucidated whether weight gain precedes early puberty, early puberty predisposes to abnormal weight gain or both
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